Shin splints are one of the most frustrating and misunderstood injuries in running and tactical populations. Whether you’re training for a marathon or marching under a ruck, this nagging pain along the inner shin can derail weeks, or even months of progress. But here’s the problem: most people still don’t actually know what causes shin splints.

If you’ve been stretching, foam rolling, or blaming your foot posture, this article will change the way you think about shin splints and, more importantly, how you fix them.

Traditional Views on What Causes Shin Splints

For decades, the prevailing theory was simple (and flawed): shin splints are caused by muscle overuse, especially the tibialis anterior, which was believed to tug on the periosteum (the outer lining of the shinbone), causing inflammation and pain.

This theory assumes that a relatively minor muscle, one that contributes very little to the force production in running, is somehow to blame for a bone stress injury. That’s not just misleading, it’s misdirecting rehab and prevention efforts.

Even worse, traditional research linked shin splints to things like:

• Ankle and hip flexibility
• Static foot posture
• Arch height or overpronation
  

This line of thinking led to treatment strategies that focused on:

• Static stretching
• Foam rolling
• Tibialis anterior strengthening
• Foot orthotics
  

The result? Countless athletes stuck in a cycle of ineffective interventions, chronic pain, and giving up a career or activity that they love.

Modern Views: What Really Causes Shin Splints

Thankfully, modern research gives us a clearer picture.

A leading study states:

“Histological studies fail to provide evidence that shin splints are caused by periostitis as a result of traction. It is caused by bony resorption that outpaces bone formation of the tibial cortex.”

In plain English: Shin splints are not a soft tissue issue. They are a bone stress injury caused by more bone being broken down than rebuilt, especially in the cortex of the tibia (shinbone).

So what’s actually happening?

• Every time you run, jump, or march, your muscles, especially your calves generate force that compresses and slightly bends the tibia creating a shear force. This shear force is coupled with further compressive force via ground reaction forces aka the force of your foot impacting the ground.
  
• The posteromedial (lower backside) part of the tibia, the area where shin splints typically occur, takes on the highest stress.
  
• If that repetitive load outpaces the bone’s ability to adapt and remodel, micro-damage accumulates, eventually leading to pain and injury.
  

Ironically, while stronger calf muscles (soleus and gastrocnemius) increase compressive force, they may also reduce harmful bending shear forces, which makes them potentially protective, not harmful.

So no, shin splints aren’t caused by poor flexibility or your foot shape. They’re caused by bone overload that exceeds your body’s ability to adapt.

Ideas on Treatment and Prevention

The updated science flips the script on how we approach shin splints:

What doesn’t work:

• Static stretching
• Soft tissue work, taping, scrapping the Tib anterior
• Chasing foot alignment
  

What does work:

Over the years, we’ve worked with some of the most elite performers on the planet, from world-class runners to Special Warfare Operators, and through that experience, we developed a powerful framework that consistently resolves shin splints at the root level. We call it B.O.U.N.C.E.

This isn’t a generic “rest and ice” approach. It’s a performance-based progression that addresses the underlying causes that most treatment plans miss, including three key hidden factors that are rarely talked about.

Here’s a glimpse into the formula:

B – Break
Take a temporary break from high-impact activities to allow tissue stress to subside. (This is NOT the same as “do nothing.”)

O – Optimize Calf Strength
Most people overlook this. Weak or imbalanced calf muscles are often the first hidden factor quietly fueling chronic shin pain.

U – Uplift Nutrition
The second hidden factor: Caloric deficits. A deficit greater than 20% is a major risk factor for musculoskeletal injury. Calories are energy; if you want to recover, you need calories. See where we’re going with this 🙂

N – Nourish Your Spirit
Another critical piece: the third hidden factor in the recovery process. Without this, symptoms often return — even after rest and rehab.

C – Carefully Return
We apply progressive overload and load management principles to rebuild resilience — without triggering a setback.

E – Elevate Performance
If you’ve properly addressed the B, O, U, N, C, then the E will take care of itself.

Final Thoughts and Real Solutions to Shin Splints

Understanding what causes shin splints in military athletes and runners allows you to address the real causes of shin splints using a framework of hope vs false hope.

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Author: 

Dr. Dillon Caswell, PT, DPT, SCS

Doctor of Physical Therapy | Board Certified Sports Specialist

Hope Evangelist | Top-Selling Author & Speaker | Human Performance Expert