Shin Splints Physiotherapy Malvern East

By Jacinta Pedis, Physiotherapist, Malvern Physiotherapy Clinic

Shin splints (medial tibial stress syndrome) cause a spread-out ache along the inner shin, usually after a jump in running or sport, and often settle with load changes and strengthening. Pain in one small spot, pain at rest or at night, or pain when hopping may signal a bone stress injury and needs prompt assessment.

This guide explains how to tell the two apart, and what shin splints physiotherapy in Malvern East involves. As a physiotherapist and a runner, I see a lot of shin pain in spring and early summer: new runners, summer sport pre-seasons, and Melbourne Marathon runners planning their next goal.

What are shin splints?

Shin splints are the everyday name for medial tibial stress syndrome (MTSS): exercise-related pain along the inner border of the shin bone (tibia). Healthdirect describes it as pain caused by repeated stress on the shin bone.

The pain is usually a dull ache spread over several centimetres of the lower half of the shin, and the area is often tender to the touch. It happens when the bone and the tissues attached to it are loaded faster than they can adapt. Healthdirect notes that untreated shin splints may lead to a stress fracture, which is one reason early management matters.

Why am I getting shin splints now?

The most common reason is a change in load: doing more, faster or on harder ground than you are used to. Sports Medicine Australia’s shin pain guide notes that shin pain usually follows a sudden increase in how often, how long or how hard someone trains.

Common situations we see include:

New runners on a beginner program, or returning after a break
Summer sport and preseason, such as basketball, netball, tennis and touch football, especially on hard courts
Post-marathon runners who jump straight back into speed sessions or a new race block

Hard or uneven surfaces, worn-out shoes, foot posture, and weak or tight calf and hip muscles can also contribute. A previous bone stress injury is one of the strongest risk factors for another. Our broader guide to running injury prevention explains why training load matters across all running injuries.

Is it shin splints or a stress fracture?

The pattern of pain is the main clue. Shin splints tend to cause a spread-out ache that often eases once you warm up, while a bone stress injury tends to cause sharp pain in one small spot that gets worse the more you do.

Feature	Shin splints (MTSS)	Possible bone stress injury
Where it hurts	Spread along the inner shin	One small, very tender spot
During exercise	Often eases as you warm up	Gets worse the longer you go
After exercise	Sore afterwards and next morning	Can ache at rest or at night
Walking and hopping	Usually fine to walk	Walking or hopping may hurt

These features overlap, and you can have both. Research in the British Journal of Sports Medicine found shin splints can be diagnosed reliably using history and examination, and that other lower leg injuries alongside it were common. A thorough assessment is important to determine the most appropriate treatment approach.

A bone stress injury at the front of the shin bone is considered higher risk because it can be slower to heal. Our post on stress fractures explains how bone adapts to load.

Can I keep running with shin splints?

Sometimes, with changes. Once shin splints are confirmed, some running may continue at a reduced load. If a bone stress injury is suspected, stop running until you have been assessed.

As a general guide, pain that stays mild during a run and has settled by the next morning suggests the load is manageable. Pain that builds, makes you limp, or is worse the next day means back off. Cycling or swimming can help maintain fitness meanwhile.

How can shin splints physiotherapy in Malvern East help?

Physiotherapy aims to find out why your shins are overloaded, settle the pain and rebuild your capacity.

What happens at the assessment?

Your physiotherapist will assess your recent training and footwear, where the pain is and how it behaves, your calf, foot and hip strength, and how you run. They will also ask about sleep and fuelling.

If a bone stress injury is suspected, your physiotherapist may refer you for imaging or work with your GP. An international consensus on bone stress injuries in the British Journal of Sports Medicine reports that most of its panel consider MRI the imaging of choice. Our post on whether you need a scan explains the options.

What does treatment usually involve?

Following an assessment, treatment often includes:

Load changes: adjusting how much and how often you run, rather than stopping everything
Strength work: especially the calf and soleus, plus hip and foot strength (see our post on strength requirements for running)
A graded return to running with clear checkpoints
Technique and footwear review: small changes, such as step rate, may help some runners

For ongoing strength and control, Clinical Pilates can be a useful addition for some runners. Treatment recommendations will depend on your individual presentation, and responses vary from person to person.

Could under-fuelling be playing a part?

It can, particularly with repeated bone stress injuries. Low energy availability means not eating enough to cover the energy used in training, and over time it can affect hormones and bone health.

The bone stress injury consensus states that low energy availability is the cause of Relative Energy Deficiency in Sport (RED-S). The Australian Institute of Sport lists signs such as fatigue, frequent illness, declining performance, bone issues and irregular or absent periods. It affects men as well as women, and is often unintentional, simply from training more without eating more.

We ask about this routinely and without judgement, and may suggest involving your GP or a sports dietitian. I have also written about bone health in women.

How can I lower my risk of shin splints this summer?

Build up gradually. Bone adapts more slowly than muscle, so the first weeks of a new program are when shins are most vulnerable.

Increase one thing at a time: distance, speed or hills
Mix in softer surfaces such as grass where you can
Do calf and hip strength work twice a week
Replace worn-out running shoes
Eat enough to match your training

Just finished a marathon? Our post-race recovery guide covers a gradual return to running.

When should I see a physiotherapist?

Book an assessment if shin pain has not started to settle after a week or two of reduced load, keeps returning when you increase your running, or you are unsure whether it is shin splints or something more.

You do not need a referral. Healthdirect confirms you can see a physiotherapist without a doctor’s referral. Our sports physiotherapy team sees runners and athletes of all levels.

When should I see a doctor instead?

See a doctor or seek urgent care if you have:

Severe pain, swelling or tightness in the lower leg after a fall, knock or collision
Pins and needles, numbness or weakness in the foot or lower leg
Severe or constant pain with fever or feeling unwell
Pain in one spot on the shin that makes walking difficult

Sports Medicine Australia notes that pins and needles with shin pain requires urgent medical attention. Your physiotherapist also screens for these features.

Frequently asked questions

What causes shin splints?

Shin splints are usually caused by loading the shin bone faster than it can adapt, often after a sudden increase in running or sport. Hard surfaces, worn shoes, foot posture and weak calf or hip muscles can also contribute.

How do I know if it is shin splints or a stress fracture?

Shin splints usually cause a spread-out ache along the inner shin that often eases as you warm up. A stress fracture tends to cause sharp pain in one small spot that worsens with activity and may ache at rest or at night. If you are unsure, stop running and get assessed.

Can I keep running with shin splints?

Sometimes, at a reduced load, once a physiotherapist has confirmed shin splints rather than a bone stress injury. Pain should stay mild during the run and settle by the next morning. If pain builds or you limp, stop and seek advice.

How long do shin splints take to heal?

It varies with how long the pain has been present, how much you are training and what is contributing. Your physiotherapist will give you a realistic plan after assessing you, and adjust it as you respond.

Can a physio help with shin splints?

Physiotherapy can assist. Your physiotherapist will assess what is overloading your shins, then use load changes, strength work and a graded return to running. Treatment recommendations will depend on your individual presentation.

Should I get a scan for shin pain?

Many people with shin splints do not need a scan, because it can be diagnosed through history and examination. If a bone stress injury is suspected, your physiotherapist may refer you for imaging or work with your GP.

Do I need a referral to see a physio for shin splints?

No. You can see a physiotherapist in Australia without a referral from your doctor, and you can book directly with our Malvern East clinic.

Book a shin pain assessment in Malvern East

If sore shins are getting in the way of your running or summer sport, an assessment can help you plan your next steps.

Book online at malvernphysio.janeapp.com or call our team on 03 9078 8434. We are at 299 Wattletree Road, Malvern East VIC, convenient to Malvern, Armadale, Toorak, Glen Iris and the wider Stonnington area. No referral is needed.

About the author

Jacinta Pedis is a Physiotherapist at Malvern Physiotherapy Clinic. She completed her Bachelor of Physiotherapy at La Trobe University in 2020 and began her career at The Alfred Hospital, working across orthopaedic, trauma, acute and rehabilitation settings. In 2025, she started a Master of Musculoskeletal Physiotherapy. Jacinta’s clinical interests include running-related injuries such as bone stress injuries and tendon and muscle conditions, pre- and post-operative rehabilitation, and supporting female runners and athletes, including low energy availability and RED-S. An avid runner, she is also a Pilates instructor who teaches at Return Pilates Studio, MPC’s sister studio, and often uses Clinical Pilates in rehabilitation.

This article is general information only and is not a substitute for individual assessment or advice. Please book an appointment so we can tailor recommendations to you. All practitioners at Malvern Physiotherapy Clinic are registered with the Australian Health Practitioner Regulation Agency (AHPRA).