How to Fix Shin Splints for Good: Build It Up and Return to Running the Right Way with Daniel Island Physical Therapy
- Made 2 Move Team
- 3 days ago
- 5 min read
About the Author: Hannah Breal, PT, DPT is the co-owner of Made 2 Move Physical Therapy in Charleston and Charlotte. She helps athletes and active adults rebuild strength, mobility, and confidence so they can move pain-free for life.
Made 2 Move Physical Therapy – Charleston | Daniel Island | Mount Pleasant | Charlotte
Shin splints are one of the most common & most misunderstood running injuries.
Most people either push through (don't do that) OR they rest, stretch, use ice, and pray it magically goes away (don't do that either)
In Part 1, we talked about what causes shin splints, the reason stretching/icing/rest doesn't do much, and the first thing you should do to fix it.
READ PART 1 HERE: catch up here.
If you've had shin splints before, you've probably been in this frustrating cycle:
run - pain - rest - try again - pain again…
so in Part 2, I'll show you how to break that cycle.
Quick Recap:
Why This Keeps Happening
Shin splints are a loading issue.
The load you placed on your body (from running, jumping, etc) exceeded your capacity (what your body was currently prepared to handle)
So the fix isn't just rest. It's building a BIGGER cup so it stops overflowing (that is, if you want to be able to hit all those miles without pain)
Step 2: Build It UP
This is the step most people skip entirely - and it's exactly why their shin splints keep coming back.
Just because your pain went away while you were resting doesn't mean the problem was solved.
Nothing changed. You just temporarily removed the stress. As soon as you go back to running, it will come back.
That's why we actually have to build tissue capacity through strength work, plyometrics, and a smart return-to-loading plan.
But before you go balls to the wall and add in a bunch of exercises, please know that the WAY you do these (how much, how often, which ones) depends on YOU and your pain, function, your history, and your goals.
The goal is progressive loading:
start with exercises your shins can tolerate without increasing pain above a 3
add in lower body exercises (will explain) to strengthen the whole chain
gradually increase the stress over time, based on how your body responds
it's almost like we're trying to figure out the best recipe.
Here's What We Need to Work On to Improve Your Shin Splints:
1. Ankle mobility
When your ankle can't move through a full range of motion, it prevents us from being able to use other muscles (ahem, quads) to help with the load of running. We want your whole leg to share the load, like a group project!
2. Anterior Tibialis
This is the muscle that's being overloaded - meaning it needs more capacity. It controls the lowering of our foot with every step, otherwise we'd trip and slap our feet everywhere.
3. Posterior Tibialis
This muscle runs on the inside of our lower leg and controls how our foot and arch land when we hit the ground.
4. Calf raises
Our calves do an INSANE amount of work when we run to push us off the ground. Thousands of reps every mile. We gotta make sure they are prepared for all that work.
5. Soleus raises
A huge shock absorber - the soleus - is a deeper calf muscle that's more involved when our knee is bent (like in running, rather than in a straight leg calf raise)
6. General single leg strength & stability
Say it with me: running is a single leg sport. It's also a group project. and if one member of the team isn't doing their part... the other members get upset.
7. PLYOMETRICS - HUGE for runners
Running is also thousands of jumps, one after the other. Plyometrics help train our bones, tendons, and muscles to be more prepared for that impact, in more specific doses, rather than going from 0 to a mile run. Plyo's bridge the gap and are SO important to build a foundation for any impact sports.
A Quick but Very Important Note
Shin splints and stress reactions/fractures are on the same spectrum.
On one end, we have shin splints: irritated & overloaded tissue.
On the other, we have stress fractures: the bone itself has started to respond to the overload by breaking down faster than it can be built up.
It's easy to confuse shin splints & stress reactions because they can happen in the same area, but if you're experiencing:
Pain that doesn't calm down with reduced activity and hurts with a single jump
Pain that wakes you up at night
A very specific spot that hurts to touch (versus a general ache along the shin)
Pain that gets progressively worse despite doing all the right things
If any of those sound familiar - please go get this looked at. Do NOT push through and ice and stretch and hope for the best. I'd so much rather this be a couple weeks of modified activity rather than a couple of months on the sidelines.
Step 3: Having a Smart Return-to-Run Plan
Honestly, this is the most underrated part. A lot of injuries could be prevented altogether with a smarter running and mileage plan. You heard me.
Most recurring running injuries aren't simply a strength or mobility problem. They're a dosage problem.
What That Actually Looks Like
Shorter distances, easier effort, more rest between runs than feels necessary. Not because you're weak or broken or "unfit" - but because we're rebuilding trust with your body after it already sent you a warning signal.
What I Do With My Patients
Start with a walk-run approach: 1 minute running, 2 minutes walking
Increase your weekly mileage by no more than 10% per week
Hold off on intensity - no sprints, no hills, no back-to-back hard days - until you have 2-3 weeks of pain-free easy running under your belt
The goal isn't to get back as fast as possible - it's to prevent this from happening again.
and remember:
Shin splints aren't a life sentence and they are NOT a sign that running is bad for you.
You CAN get back to doing what you love, without shin pain!
If You’re in Charleston, Daniel Island, Charlotte, or Mount Pleasant…
At Made 2 Move Physical Therapy, we help active adults and athletes and recreational athletes get out of pain and keep doing what they love.
We have three convenient locations:
Our team of DPTs can help you move, play, and live without limitations.
👉 Learn more about physical therapy for runners
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Written by Hannah Breal, PT, DPT, Co-Owner of Made 2 Move Physical Therapy, helping Charleston and Charlotte move pain-free for life.