Shin splints are overuse injuries, meaning they occur over time though repeated use. Shin splints occur most often in people who:

Intensify training
A rapid change in training, such as increasing volume or intensity, can bring on shin splint pain. Shin splints are common early in a sports season when people start or intensify training.

Excessive pronation refers to when most or all of the body’s weight rest on the inside sole of the foot. Hyperpronation can cause increased eccentric loading of the soleus and tibialis posterior muscles in the calf, which can lead to shin splint pain.


Have flat feet (pes planus)
Like people who hyperpronate, people who have flat feet, called pes planus, tend to put more stress on the inside sole of the foot.

Have slightly different leg lengths
A person can have slightly different leg lengths and not be aware of it. A relatively small leg length difference can cause problems in running biomechanics, leading to shin splints or other repetitive use injuries.


Wear improper footwear
Running shoes that do not provide enough cushion and support proper foot mechanics may encourage the development of shin splints.

Run on hard surfaces
Running on hard surfaces, such as concrete sidewalks, increases the impact on the musculoskeletal system and can lead to shin splints.

Run on uneven surfaces
Running on uneven trails or pavement can force the body to make constant adjustments, causing strains that can lead to shin splints.

Have bad running form
A runner who has poor form puts additional stress and strain on the musculoskeletal system, which can lead to shin splints.

A person with shin splints may have only one of these risk factors or all of them.

Dr. Robert Wilder is a sports medicine physician serving as Chair of the Department of Physical Medicine and Rehabilitation at the University of Virginia School of Medicine and as Medical Director of The Runner’s Clinic and the UVA SPEED Clinic Motion Analysis Lab. He also directs the Primary Care Sports Medicine Fellowship Program.