How Long for Shin Splints to Heal? (+ Physio’Tips)

Do you have shin splints ? Are you looking for the most precise information possible on the progression of pain , and how long we are bothered when we have it?

Physiotherapist (and former hepathlete… I knew shin splints well!), I rely on my experience and my in-depth research in medical studies published all over the world to give you answers.

Still questions, comments? See you in the comments 🙂!

Last update: September 2023
Declaration of financial interests: none directly related to the subject. My complete declaration of links of interest is in legal notices. Written by Nelly Darbois, physical therapist and scientific writer

What exactly is shin splints?

When you have shin splints, you have pain along the inner edge of the shin, usually just above the ankle or halfway between the knee and ankle.

What are the common causes of shin splints?

It generally occurs in people who practice high-impact physical activities, such as running or jumping: long-distance runners, military personnel, ballet dancers, etc.

Sometimes simply in people who walk or stand a lot at work.

This often happens when you quickly increase the intensity, frequency, or duration of the physical activity you do. Probably especially if it’s on hard surfaces, or suddenly barefoot (or with relatively “hard” shoes compared to what you’re used to).

When we exert stress on a bone (for example by playing sports, weight training, or simply by walking) it strengthens it.

But if we suddenly exert too much constraint on our habits, this can on the contrary damage it a little and trigger inflammation, to repair the tissues damaged by this excess constraint.

Why is it called shin splints?

Because in this place of the body, you have periosteum : it is a fairly thin membrane which covers the tibia. And it can become inflamed and painful.

We therefore call it periostitis, the suffix ite meaning “inflammation”.

Is this common?

Even if we have sometimes never heard of it before it happens to us, it is very common: 1 in 5 people who practice running will have at least one in their lifetime.

You can have shin splints on both shins at the same time (right and left leg) or on just one.

How can we be sure that this is it?

Here are the different signs suggestive of shin splints:

• Pain especially with exercise along the lower two-thirds of the medial (=inner) border of the tibia. It is also awakened when we press on this place, and it is present over 5cm long.
• Pain that subsides with relative rest
• No cramping, burning pain in the posterior compartment and/or numbness/tingling in the foot
• Possibly swelling and redness (erythema), but not significant
• No loss of pulse when taken at foot/ankle level

These signs make it possible to make what is called a “differential diagnosis”: to eliminate other problems that would require another type of treatment.

There is no need to do an X-ray, MRI, scintigraphy or CT scan to diagnose shin splints: this is done simply by asking questions and examining yourself.

When we do an additional x-ray examination, it is only if the symptoms suggest something else such as a stress fracture of the tibia, which however occurs much more rarely.

Source: McClure 2023; Deshmukh 2022

Why care about the healing time for shin splints?

Even though it’s a benign thing, not a sign of a serious problem, shin splints can be very bothersome .

You can really have trouble continuing to do sports (or work), you sometimes have to stop in the middle of a session, wait for several things, and then start again… in pain.

You are therefore most likely wondering how much longer you will have this pain . And if there is anything to be done to hasten their disappearance…

Questions that most runners (and other athletes) ask themselves one day or another! Hence this article.

How do you know how long shin splints last?

Here are 3 ways to know the  healing time for shin splints  :

1. ask people you know around you  how long it took for the pain to go away and when they were able to resume all their activities, including sports. As it is a fairly common pathology (1 in 5 people who run will have one in their lifetime), we are likely to know one or more people who have already had it;
2. ask health professionals  (physiotherapists, doctors) for their opinion on the duration of development. As they see many people with health problems, they may have a more precise idea because they have access to a larger sample;
3. look at the statistics on the duration of evolution in studies  which follow for a long time people who have had shin splints.

Personally, I prefer to rely on this third option. I find this to be the most reliable:

• it is the one that allows access to the greatest number of people;
• it is the one that is the most methodical in its way of collecting information and trying to be  as reliable as  possible.

This is why in the rest of the article, I will rely on this data from clinical studies, in addition to my own professional experience  🙂.

How long does shin splints last?

I will therefore rely as much as possible on studies which follow the evolution of people who have been diagnosed with shin splints.

Knowing that there is little data available: probably because periostitis is relatively benign and many people do not consult for it, or because the pain and discomfort stopped before we had time to treat them. include in a clinical trial !

How long does shin splints last on average?

A Dutch research team (Moen 2012) tried to see:

• how shin splints progress over the weeks;
• what are the factors that make things go more or less quickly for the better?

Already, it was based only on men (35) who had pain for more than 2 weeks.

Good news by the way: some people no longer have any discomfort after only less than 2 weeks of strict cessation , provided that they very gradually resume the training load (or demanding activity).

How do these people who have had periostitis for 2 weeks or more progress?

The average healing time for shin splints is 58 days . And the majority of people in this sample fully recover in 31 days (1 month) to 85 days (2 and a half months).

Among all the factors studied to see if they were indicators of longer healing, only one really stood out: BMI, body mass index (the ratio between your height and your weight). A higher BMI (although within the normal range) indicated a greater likelihood of lasting longer .

My experience :

I have really seen all the scenarios with shin splints . More in my life as an athlete (athletics, running) than as a physiotherapist, because few people consult a physiotherapist for periostitis (and even fewer see a physiotherapist at home!!). The typical table:

• pain from time to time depending on physical activities, without this requiring really reducing the activity that triggers them;
• then little by little the pain comes faster or lasts longer;
• this leads to having to reduce the activity and reintroduce it gradually after 10 days for those in a hurry, 2/3 weeks for others;
• we then grope to find the right dosage;
• sometimes, we remain embarrassed for several months, but without really stopping our activity completely;
• We sometimes try quite a few things along the way, sometimes we have the impression that it had an effect, and sometimes not.

How long does shin splints last?

After reducing or stopping activities that trigger or aggravate shin pain, we see that people recover completely after about 2 months in those in whom the pain has lasted for at least 2 weeks.

But as is often the case in medicine, there are people at both extremes. And some people can drag their shin splints for a long time without it indicating a serious underlying problem.

How long maximum? Some people may have pain for years , but the pain often fluctuates: it lessens or disappears, then returns.

Without necessarily a direct link with the amount of training, which can be frustrating.

In a British study following people with recalcitrant periostitis (Padhiar 2021), most of the people followed had pain 1 year after follow-up.

But they still resumed sporting activities, and some at the level before the appearance of the first symptoms.

Can we speed up the healing time for shin splints?

Wondering how to speed up healing time from shin splints is akin to wondering if there are effective treatments other than rest/reducing training load.

You are of course not alone in asking yourself this question, and dozens of studies (generally not of very good quality) have been carried out to try to answer this question.

However, here is what the authors of an academic publication say about the recommended treatment for shin splints:

Management of shin splints is conservative and focuses primarily on rest and activity modification with less repetitive and weight-bearing exercise . There are no specific recommendations on the duration of rest necessary for resolution of symptoms, and this duration likely varies between individuals.McClure 2023

McClure 2023

And even :

The treatment is educational and focuses on a graduated exercise regime , as well as the prevention of overtraining .McClure 2023

McClure 2023

And the authors of 2 other summaries:

Although many physical therapeutic modalities , including instrument-assisted soft tissue mobilization, fascia release, ultrasound therapy, and electrical stimulation can be used during the acute period (shin splints), there is no no evidence of their effectiveness .Deshmukh 2022

Deshmukh 2022

None of the studies is sufficiently free from methodological bias to recommend any of the treatments studied.

As shin splints are most likely a bone overload injury, rehabilitation programs appear to be most appropriate . We can consider several days without weight bearing, then progressive weight bearing until full function is obtained.Winter 2013

Winter 2013

Of course you will always find doctors or physiotherapists who will offer you different treatments “to try”, just to do something “more” than simple progressive recovery:

• crush the periosteum with the back of a small spoon;
• stretching of the leg muscles;
• a prescription for insoles;
• footwear recommendations;
• shockwave therapy or ultrasound therapy ;
• massages (especially with ice cubes ) or manual therapy techniques;
• taking anti-inflammatory drugs (orally, or applied to the skin) or acetaminophen;
• wearing compression stockings ;
• muscle strengthening;
• wearing an orthosis;
• dryneedling, k-taping, acupuncture;
• cryotherapy .

And the list is far from over, and you’ll probably always find something you haven’t tried yet .

None of these therapies have undergone rigorous evaluation that would support their significant effectiveness compared to doing nothing more, or as a replacement for rest.

Some are more biomechanically consistent than others.

Personally, for myself as for the patients who seek my opinion on the treatments to be tested, I always favor treatment with:

•  maximum efficiency (theoretical / empirical)
• minimal side effects
• minimum cost (in time, energy, money)
• minimum dependence on a third person or equipment

However, for shin splints, we find many examples in the literature as well as in the practice of health professionals of people who recovered without treatment other than reducing and adapting the training load .

Something that you can implement alone or under the supervision of a physiotherapist or other professional.

I therefore favor this type of care, without additional treatment.

If you really want to do something extra, you can draw from the list above according to what seems the least restrictive for you , and which wins your support the most. But it is not certain that this speeds up your healing time, nor that it allows you to reduce your training or activity load less!

These articles might also interest you:

• What is the difference between tibial stress fracture and shin splints?
• Can physical therapists prescribe xray?

Do you want to share your experience or ask a question? Head to the comments!

SOURCES

McClure CJ, Oh R. Medial Tibial Stress Syndrome. [Updated 2023 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538479/

Deshmukh NS, Phansopkar P. Medial Tibial Stress Syndrome: A Review Article. Cureus. 2022 Jul 7;14(7):e26641. doi: 10.7759/cureus.26641 . PMID: 35949792; PMCID: PMC9356648.

Winters M, Eskes M, Weir A, Moen MH, Backx FJ, Bakker EW. Treatment of medial tibial stress syndrome: a systematic review. Sports Med. 2013 Dec;43(12):1315-33. doi: 10.1007/s40279-013-0087-0 . PMID: 23979968.

Winters M, Eskes M, Weir A, Moen MH, Backx FJ, Bakker EW. Treatment of medial tibial stress syndrome: a systematic review. Sports Med. 2013 Dec;43(12):1315-33. doi: 10.1007/s40279-013-0087-0 . PMID: 23979968.

Moen MH, Bongers T, Bakker EW, Zimmermann WO, Weir A, Tol JL, Backx FJ. Risk factors and prognostic indicators for medial tibial stress syndrome. Scand J Med Sci Sports. 2012 Feb;22(1):34-9. doi: 10.1111/j.1600-0838.2010.01144.x. Epub 2010 Jun 18. PMID: 20561280.

Padhiar N, Curtin M, Aweid O, Aweid B, Morrissey D, Chan O, Malliaras P, Crisp T. The effectiveness of PROLOTHERAPY for recalcitrant Medial TIBIAL Stress Syndrome: a prospective consecutive CASE series. J Foot Ankle Res. 2021 Apr 16;14(1):32. doi: 10.1186/s13047-021-00453-z . PMID: 33863355; PMCID: PMC8052809.

Images: Franklyn M, Oakes B. Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments. World J Orthop. 2015 Sep 18;6(8):577-89. doi: 10.5312/wjo.v6.i8.577 . PMID: 26396934; PMCID: PMC4573502.