Skip to content

Conditioning: Phase 1

The following is the first of four phases that will guide you from shin splints toward healthy running. Progress from each phase as instructed, applying rehabilitation modalities such as taping where needed.

Duration: 2-4 Weeks
Goal: Reduce pain through unloading
Frequency of Exercises: 4-5 Days per Week (once per day), without pain. No running.

a. HIGH PAIN

START HERE if pain is > 7/10 with prolonged walking, actively bringing toes up – anterior tibialis – and/or standing on your toes – soleus
Goal: Reduce inflammation. Do not run or exercise into pain.

  • Taping: Putting tape along the shin may assist in offloading the anterior tibialis. Purpose: decrease load on anterior tibialis.
  • Biking: Walking may be too painful at this point (but if it feels okay then walk).  Light stationary biking may be a good alternative as it places less stress on the recovering shin. Do not bike with straps.
  • Soft Tissue Massage: 3-5 minutes. Lying down or sitting, gently massage the shin (anterior tibialis) or inside the calf (soleus). Pretend that it is a sponge, and you are gently squeezing some of the fluid out to reduce inflammation build up. The motion should be up the line of tissue; some discomfort is okay. Purpose: reduce scar tissue adhesions and promote healing.
  • Calf Stretching: 1 minute per side.
    • Gastrocnemius: Standing with one foot back, place your toes on a half roll or rolled up towel to increase stretch. Lean forward while keeping your knee straight.
    • Soleus: Next, holding a split stance, bend your knee and get a lower stretch. Purpose: improve calf mobility to decrease strain on the anterior tibialis.
  • Foot Stretching (3 Parts): Keeping your feet and knees together, sit on your knees with an emphasis on the balls and toes of your feet, and place your weight back onto your heels. You should feel your arches stretching. Next, settle your weight on the knuckles of your toes, which should stretch the top of your feet. If painful, shift some of your upper body weight off the heel. Finally, plantar flex your foot so as to rest your weight on the front of the ankle, thereby stretching your shin muscles. Purpose: improve foot and ankle flexibility while also removing tension.
  • Ice: 10 minutes on shin to reduce pain and inflammation.

b. MODERATE PAIN

START HERE if pain is 4-6/10 with prolonged walking, actively bringing toes up – anterior tibialis – and/or standing on your toes – soleus
Goal: Continue to reduce pain. Do not run. 

  • Taping: Putting tape along the shin may assist in offloading the anterior tibialis. Purpose: decrease load on shin.
  • Double Leg Bridges: 3 x 10 reps. Place your legs shoulder width apart with knees bent. Bring your hips up and down. You should feel your hip and thigh muscles working. Purpose: increase glute strength to reduce foot pronation and shin strain.
  • Ankle Pumps (With Band): 2 x 20 reps. On your back or sitting, bring your ankle slowly back using a towel to assist, and then down without going into significant pain. Purpose: reduce swelling and improve circulation.
  • Clamshells: 3 x 16 reps. Lying on your side with your knees bent (hips to 45 degree angle), bring your top knee up and hold for 3 seconds, then back down.  Repeat until completed reps or fatigue. You should feel hip muscles working, and can add a Resistance Band for increased resistance. Purpose: increase strength in glutes to reduce ankle pronation.
  • Posterior Tibialis Exercise (With Band): 3 x 16 reps. On a smooth surface, place a towel under your toes, keeping your heel on the ground). Wrap a band around your toes, and anchor the other side of the band on a door or other structure.  Place your hands in between your knees to prevent the knees from moving. Keep your first toe down on the ground and rotate your ankle inward slowly, then back out. You should feel this on the inner part of your calf. If you feel it in the hip, you are rotating your leg too much. Purpose: strengthen posterior tibialis, which helps support the ankle and counter excessive pronation.
  • Arch Exercise (3 Parts): Think of your sole as having three key points of contact with the ground: two points on the ball of the foot and one at the heel. Stand with your feet shoulder-width apart and lift up all your toes. Hold that position for 10 seconds, maintaining the three-point anchor and a stable curved arch. Next, still maintaining the sole’s 3-point connection to the ground, lift up your big toes while keeping the little toes down for 10 seconds. Finally, bring your big toes down with little toes up, watching that your foot does not rotate inward, collapsing your ankle. Hold that for 10 seconds. If difficult, you may have to train your toes by positioning them with your hands. Purpose: improve arch posture and tissue strength to absorb the impact forces of foot strike while stabilizing the foot and shin muscles.
  • Arch & Shin Exercise (3 Parts): Standing with your feet and knees together, assume a crouched position balanced on your forefeet while you sit on your heels. You should primarily feel your arch and toe muscles working to stabilize your weight. Your legs should be mostly relaxed while doing so. Hold that position for 10 seconds and then slowly lower your knees to the ground. Briefly hold that position and then return to the first position. Finally, shift back to your heels while maintaining a tight crouched position. Here, you should feel your front shin muscles working the hardest. Purpose: strengthen feet and shin muscle groups.
  • Biking: Walking may be too painful at this point (but if it feels okay then walk).  Light stationary biking may be a good alternative as it places less stress on the recovering shin. Do not bike with straps.
  • Soft Tissue Massage: 3-5 minutes. Lying down or sitting, gently massage the shin (tibialis anterior) or inside the calf (soleus).  Pretend that it is a sponge, and you are gently squeezing some of the fluid out to reduce inflammation build up. Slight discomfort is okay. and the motion should be up the line of discomfort. Purpose: reduce swelling and improve circulation in order to reduce pain and improve healing.
  • Stretching: 1 minute per side.
    • Gastrocnemius: Standing with one foot back, place your toes on a half roll or rolled up towel to increase stretch. Lean forward while keeping your knee straight.
    • Soleus: Next, holding a split stance, bend your knee and get a lower stretch. Purpose: improve calf mobility to decrease strain on the tibialis anterior.
  • Foot Stretching (3 Parts): Keeping your feet and knees together, sit on your knees with an emphasis on the balls and toes of your feet, and place your weight back onto your heels. You should feel your arches stretching. Next, settle your weight on the knuckles of your toes, which should stretch the top of your feet. If painful, shift some of your upper body weight off the heel. Finally, plantar flex your foot so as to rest your weight on the front of the ankle, thereby stretching your shin muscles. Purpose: improve foot and ankle flexibility while also removing tension.
  • Ice: 10 minutes on shin to reduce pain and inflammation.

c. MILD PAIN

START HERE if pain is < 3/10 with prolonged walking and actively bringing your toes up.
Goal: Continue to reduce pain. No running.

  • Taping: Putting tape along the shin may assist in offloading the anterior tibialis. Purpose: decrease load on anterior tibialis.
  • Single Leg Bridges: 3 x 10 reps. On your back with one knee up, bring your hips up and down slowly. You should feel your thigh and hip muscles working. Purpose: increase demand on the hip to reduce knee from caving in and stressing the shins.
  • Calf Raises (Ball Between Heels): 3 x 16 reps. Place a ball between your heels/ankles while on a step. As you come up, keep the ball stable in between your ankles. Go up on your toes and back down. Purpose: Put more demand on ankle and calf muscles for stability.
  • Clamshells (With Band): 3 x 16 reps. Lying on your side with your knees bent (hips to 45-degree angle), bring your top knee up and hold for 3 seconds, then back down.  Repeat until completed reps or fatigue. You should feel hip muscles working, and can add a Resistance Band for increased resistance. Purpose: increase strength in glutes to reduce ankle pronation.
  • Posterior Tibialis Exercise (With Band): 3 x 16 reps. On a smooth surface, place a towel under your toes, keeping your heel on the ground). Wrap a band around your toes, and anchor the other side of the band on a door or other structure.  Place your hands in between your knees to prevent the knees from moving. Keep your first toe down on the ground and rotate your ankle inward slowly, then back out. You should feel this on the inner part of your calf. If you feel it in the hip, you are rotating your leg too much. Purpose: strengthen posterior tibialis, which helps support the ankle and counter excessive pronation.
  • Walking and/or Biking: Light walking is okay if your pain doesn’t get >3/10 and does not linger or increase the next day. Light stationary biking may be a good alternative as it places less stress on a recovering shin (no bike straps).
  • Soft Tissue Massage: 3-5 minutes. Lying down or sitting, gently massage the shin. Pretend that it is a sponge, and you are gently squeezing some of the fluid out to reduce inflammation build up. It should not be painful, and the motion should be up the leg. Purpose: reduce swelling and improve circulation in order to reduce pain and improve healing.
  • Arch Exercise (3 Parts): Think of your sole as having three key points of contact with the ground: two points on the ball of the foot and one at the heel. Stand with your feet shoulder-width apart and lift up all your toes. Hold that position for 10 seconds, maintaining the three-point anchor and a stable curved arch. Next, still maintaining the sole’s 3-point connection to the ground, lift up your big toes while keeping the little toes down for 10 seconds. Finally, bring your big toes down with little toes up, watching that your foot does not rotate inward, collapsing your ankle. Hold that for 10 seconds. If difficult, you may have to train your toes by positioning them with your hands. Purpose: improve arch posture and tissue strength to absorb the impact forces of foot strike while stabilizing the foot and shin muscles.
  • Arch & Shin Exercise (3 Parts): Standing with your feet and knees together, assume a crouched position balanced on your forefeet while you sit on your heels. You should primarily feel your arch and toe muscles working to stabilize your weight. Your legs should be mostly relaxed while doing so. Hold that position for 10 seconds and then slowly lower your knees to the ground. Briefly hold that position and then return to the first position. Finally, shift back to your heels while maintaining a tight crouched position. Here, you should feel your front shin muscles working the hardest. Purpose: strengthen feet and shin muscle groups.
  • Stretching: 1 minute per side.
    • Gastrocnemius: Standing with one foot back, place your toes on a half roll or rolled up towel to increase stretch. Lean forward while keeping your knee straight.
    • Soleus: Next, holding a split stance, bend your knee and get a lower stretch. Purpose: improve calf mobility to decrease strain on the anterior tibialis.
  • Foot Stretching (3 Parts): Keeping your feet and knees together, sit on your knees with an emphasis on the balls and toes of your feet, and place your weight back onto your heels. You should feel your arches stretching. Next, settle your weight on the knuckles of your toes, which should stretch the top of your feet. If painful, shift some of your upper body weight off the heel. Finally, plantar flex your foot so as to rest your weight on the front of the ankle, thereby stretching your shin muscles. Purpose: improve foot and ankle flexibility while also removing tension.
  • Ice: 10 minutes on shin to reduce pain and inflammation.

TO GRADUATE TO PHASE 2

  • Note: If you begin at Phase 1.a., before graduating to Phase 2, be sure to progress in turn through Phases 1.b. and 1.c.
  • Required: Pain is < 3/10 (for at least 2 weeks); and when aggravated, pain does not linger for more than 1 minute
  • Required: Can actively complete 10 x calf raises and 10 x toe raises with minimal pain (<3/10)
  • Required: No noticeable redness and minimal swelling, if at all 
Principles of Shin Splints: A Review
  • CAUSE – overloading the muscle attachment to the bone of the shin (tibia), generally rooted in muscle weakness from either the soleus, tibialis anterior, and/or foot arch
  • NEED – manage pain, such as by self-massage and/or icing, and strengthen mechanics
  • PLAN – once pain is reduced, progressively load and strengthen the tissue

Still Need Help?

You are welcome to meet virtually with our PT for additional feedback and assessment. Otherwise, continue to the next step to learn how best to manage the pain from your injury.

Schedule Assessment
Return to REHABILITATION
Continue to Phase 2: CONDITIONING