Shin Splints Before a Marathon? What to Do When Your Race Is 10 Weeks Away
- Marie Whitt
- Aug 10
- 9 min read
Maybe this sounds familiar?
You’ve been a casual, consistent runner. You regularly squeeze in 2-3x runs a week with roughly 10-15 miles per week.
You have 2-3 marathons under your belt, in addition to a bunch of 5ks, 10ks, and you take a few weeks off during the year because recovery is important.
Fall training season rolls around and you get the itch.
You sign up for a marathon in 16 weeks and jump into running 4x a week and build to 30 mpw.
However, a pesky niggle covering the span of a few inches, has developed along the inner border and lower two thirds of your shin.
You notice it’s tender to the touch when you go to massage it out and it’s stiff-feeling in the mornings.
You head out for your morning run, noting it’s sore for the first 10 minutes, but it fades.
The problem?
It returns worse than before, like a boomerang. You easily clock it at a 4/10 on easy runs and 6/10 pain on the day after long runs.
You go down the google-rabbit hole: trying ice massages, ordering compression sleeves, buying new shoes, trying foam rolling, anterior tib raises,...but nothing is sticking.
And now it’s 10 weeks until race day.
Can you save your shins in time?
As a running physical therapist who has treated their fair share of shin splints, let me give you my unfiltered professional opinion, especially if you’re in this runner’s shoes.
Because we have hard evidence now about the efficacy of foam rolling, compression sleeves, shockwave therapy, and all the other gadgets.
But we have less clear information guiding exactly which exercises are “best” for treating and managing shin splints.
So let me guide you through where I would start if you were working with me.
BIG BUT…realize, this is NOT a step-by-step guide on how to fix shin splints with your race looming on the horizon. We will only be dipping our toes in the incredibly nuanced subject of shin splints.
But yes, I will have exercises for you to try and take the first step. Let’s hop in.
Do Foam Rollers, Massage Guns, and Compression Sleeves Actually Help Shin Splints?
Here’s the truth:
recent literature has debunked the efficacy of ice massages, compression sleeves, foam rolling, shockwave therapy, and kinesiotape.
Meaning: they don’t technically “work”. They do not have scientific data that says “yes, these will help heal the pathological, injured tissue”.
However, I have treated multiple runners who have told me “but these take away my pain. They help me run with only 3/10 pain on my easy runs.”
Here’s the kicker: I don’t tell these runners to stop.
But I do make sure they understand, these are pain management tools rather than “these are actively helping my shin splints heal” tools.
There’s a difference, and it’s an important one.
The reason I’m harping on this: you WILL find internet sources saying these will heal your MTSS pain. These are lies.
Because what I see happening is a runner will experience the very common initial shin soreness for the first 10 mins of their run, feel it fade, only for it to pop back up at around mile 4 or 5.
This is completely normal, and I will occasionally have my runner continue running but ONLY after stopping and walking, to bring pain levels back down to a 3/10 or lower.
I tell them do NOT keep running past a 4/10 pain because we are looking to maintain adaptive stress and load on the injured tissues to help it heal, but not so much as to make it so cranky you experience 6/10 pain the following day.
This tells me you’ve done too much, too soon.
The trouble runners get into here: they use those variety of pain management tools to decrease the 6/10 pain back down to a 3/10.
And then repeat this vicious cycle, never allowing their shins to actually heal.
So pain management tools: good. Ignoring pain signals from your body: bad.
Shin Splint Exercises for Runners: What Actually Helps?
"Ok, so I’ll just do 30 anterior tib raises a day and be fine, right?"
Maybe? Maybe not.
Because here’s another inconvenient truth:
We don’t have consistent data in the literature telling us anterior tib raises are the savior of shin splints.
I wish we did; it would make all our lives easier.
What we do know from looking at countless papers and studies:
Runners struggling with shin splints experience decreased levels of pain and are able to return to running when we look at the big picture.
The clearest “list” I’ve found is this:
Runners show improvement when we address:
“plantarflexor muscle endurance capacity
invertor and evertor strength imbalance
smaller flexor hallucis longus cross-sectional area,
and deficits in maximal plantarflexor isometric strength”
Because these “are other muscular risk factors associated with MTSS development”
Breaking this super-sciency list down, it’s saying:
You need strong gastrocs and solei, but in an endurance or “long run” way. (think: they can go the distance)
You need strong inner (medial) and outer (lateral) ankle stabilizers
You need strong toe muscles, specifically big toe flexor muscles
And you need strong ankle muscles (more gastroc and soleus strength) but in the sense that they can move heavy weight.
This is big picture “build stronger ankles / lower legs” rather than “focus only on this one specific muscle”.
I’ll throw in an extra tid bit:
When I’m in the clinic treating runners with MTSS, I also make sure we strengthen their glutes and hamstrings so we don’t miss any potential weak links
But in the meantime, here are a few ankle and foot exercises I would start my runners on.
The Best Shin Splint Exercises for Runners, According to a Physical Therapist
Circuit 1: "Plantarflexor muscle endurance capacity"
Body weight
35 single leg calf raises ea side
This is a lot. Use this initially more as a test to gauge where you’re at and progress towards completing 35 single leg calf raises
Circuit 2: Ankle and Foot Strength
light to medium resistance bands, medium to heavy weights
Tip toe sideways walk with band around ankle
A medium tension resistance band
3 rounds (or to fatigue): 5 yards down/ 5 yards back
Resisted great toe flexion with Band
A light to medium tension resistance band (depending on what your foot can handle)
3x12 or to fatigue (which ever comes first)
Weighted single calf raise
medium to heavy weights
3-4 sets of 8 reps each side // 3 secs up/3 secs down
Runner's Lunge SL calf raise
typically body weight
3-4 sets of 8 reps each side // 2 secs up/2 secs down
Shin Splint Exercises for Runners: What Actually Helps?
35 single leg calf raises
What this is for: "plantarflexor muscle endurance capacity"
THE POINT: if you do 35 single leg calf raises. Each side. And then try to do the rest of the exercises, your legs might fall. So don’t feel you have to do both circuits.
Realize, 35 single leg calf raises with good form comes from running related physical therapy research that helps me, as a clinician, determine whether you have the muscle or work capacity to optimally return to run after an injury. It can also be a really good objective “pass or fail” test to help me figure out where you weak link is. So, now, you can do that too.
Don’t be surprised if one side is weaker than the other. Gradually progress these, honey boo boo. Otherwise you can risk making yourself even more sore.
Tip toe sideways walk with band around ankle
What this is for: fixing "invertor and evertor strength imbalance"
THE REASON: standing on tip toes obviously continues to engage your calf raises, but it also recruits some toe and foot muscles in addition to the lateral (or outside) ankle stabilizers.
But do realize, if we were working together, we would still progress this exercises and find another one to address the inverters, or inside/ medial ankle stabilizers. But this at least gets your started.
Try to keep your heels high throughout the entire rep. If you need to come down and rest after 5 yards down before walking back, please do. I would be looking for quality, not just quantity.
Resisted great toe flexion with resistance band
What this is for: fixing "smaller flexor hallucis longus cross-sectional area"
THE KEY: it can technically be for debate whether strengthening this particular big toe muscle is imperative to shin splint recovery. I personally choose to interpret it as “foot strength is important”. And if we know from several cases that strengthening a particular toe muscle can help, why not?
Also realize, a recent study has also shown that really well done, weighted, single leg calf raises (below) also automatically strengthen tiny foot muscles. This just further builds the case: build strong feet and ankles.
Weighted single calf raise // 3 secs up/3 secs down
What this is for: fixing "deficits in maximal plantarflexor isometric strength"
PRO TIP: You need strong calf muscles. And your gastroc plays a huge part in your running stride. And while body weight calf raises like the 35 SL ones we discussed above are important, by adding weight and time under tension (3 secs up and 3 secs down) we improve not only muscle strength, but also tendon strength.
When it comes to managing shin splints, I personally believe it’s optimal to treat the entire “team” of muscles. We support the injured tissue, allowing it to heal (hopefully faster), while simultaneously preparing you to return to run without the risk of a repeat injury cycle.
If you’re going to do it, do it right.
Runner's Lunge Single Leg Calf Raise
What this is for: fixing "deficits in maximal plantarflexor isometric strength"
YUP SAME THING: that’s on purpose. The gastroc easily gets all the glory, but your soleus potentially plays a huge a part in shin splint management.
It technical can act as a foot inverter, scooping your foot in…which is also what your anterior tib does. So if shin splints are a result of anterior tibalis irritation, it makes sense to also strengthen the other muscle teammates that share the “inversion”-job. In addition to, your soleus is a plantarflexor, meaning it helps point your toes down and push off into your next stride
Again, my personal treatment philosophy: let’s treat the whole team so you can get better, faste
WRAPPING UP
If you take nothing else away from this blog, I want it to be this:
shin splints are rarely a “just strengthen your anterior tib” problem.
Your shins are part of a much bigger team.
And your calf muscles need to have the endurance to go the distance.
You need strong ankle and feet lateral and medial stabilizers so you can run mile after mile.
You need big toe and smaller foot muscles with the endurance capacity to handle the impact of every stride.
And your glutes and hamstrings shouldn’t be forgotten either.
And while foam rolling, massage guns, compression sleeves, and ice might help you feel better in the moment, don’t confuse pain relief with tissue healing.
These can be useful pain management tools, but they shouldn’t be your entire treatment plan, or a way to mask pain so you can keep pushing through the same training load that caused the problem in the first place.
The goal isn’t to find the one magical exercise that will fix your shin splints.
The goal is to build a stronger, more resilient lower leg that can actually handle the mileage demands you’re placing on it.
So yes, start with those 35 single-leg calf raises.
Build your calf and foot strength.
Gradually add load.
Pay attention to your pain levels.
And most importantly, respect the signals your body is giving you.
Because if you keep running the same mileage, at the same intensity, with the same weaknesses, and simply use a massage gun to make the pain go away…you’re probably going to find yourself right back where you started.
If you’re going to do it, do it right.
Treat the whole team. Build the capacity. And give your shins a chance to actually heal.
Dare to Train Differently,
Marie Whitt, PT, DPT //@dr.whitt.fit
REFERENCES:
Listed from highest and strongest level of evidence (meta-analysis), moving to standard/ average (randomized control), and ending with the lowest and weakest level of evidence (case studies)
Comments