Jon Grayson of Six Physio explains how to get running again if you’re struggling with shin splints / lower leg pain.

Shin splints or to give it its fancy medical term, medial tibial stress syndrome (MTSS), is one of the most common running injuries. It is an overuse injury that is rarely a short-term issue and is usually persistent and recurrent.

Shin splints makes itself known through a dull, nagging soreness on the inside of the shin bone spreading down towards the ankle (medial tibial stress syndrome) or on the front of the shin bone (anterior tibial stress syndrome).

This is usually evident at the start of the run, tends to ease once into the run as you warm up, but then intensifies. The intensity can vary but it often reaches such a level it causes runners to have to stop early into the run and then sticks around for the next few days, causing irritation when walking.

There are many common biomechanical, neuromuscular and technique faults that result in your shins getting overloaded.

Every time you land on one foot during running, a force up to two and a half times your body weight will be going through your leg. For example, a four-hour marathon runner, running at an average pace of 155 steps per minute, will be taking around 37,200 steps.

That’s a lot of force going through each foot every step, and it needs careful controlling.

Therefore, the key message is to get assessed by a running specialist. When treating a runner with pain we will use video analysis to assess the technique, then break this down to screen for mobility, strength and control. A tailored strength and conditioning program along with simple running technique tips can go a long way.

The usual “PRICE” treatment (protection, rest, ice, compression and elevation) along with taping, correcting footwear or orthotics are all short-term symptom relievers.

They will not get rid of the problem. Common technique faults include slow step rates and over striding. Adjusting your step rate towards the more desired level (170-190 steps per min) can always help reduce the overload on landing.

A quicker, shorter step rate is what you should aim for. I’d strongly recommend using a running specialist to help with this.

Calf, quads and glut strengthening is essential to any runner’s strength and conditioning. For example, you should be able to perform 25-30 single calf raises on a step.

Ask the Expert: Stephen Garvey, physiotherapist and cycling specialist at Six Physio

Q: After quite a bad bike crash (I broke my collarbone) I’m back in the saddle but I’m unsure how to start building up my distances again. What can I do to get my strength and stamina back?

Simon Bradshaw via email

A: Great to hear you’re getting back in the saddle after some time off. Mentally it’s tough to get your confidence up again. Not knowing much about your training habits and the extent of your downtime from injury will make it difficult to determine the correct training regime for you.

Initially I would get on a static bike and start with a cadence of around 80-90RPM with light resistance for 20-30mins about 2-3 times per week, resting sufficiently between each session. On your days off do some light conditioning work such as varied squats and lunges.

Next, try a session of repeated interval climbs, followed by sprint intervals on the flat a few days later and finishing your week with a long endurance ride. Start with a low mileage and build up gradually over a six to eight week period.

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