Why Your Shin Splints Keep Coming Back (And It's Not What You Think)
You've been there. Mile 6 of your long run, and that familiar sharp pain starts creeping up the front of your shins. You slow down, maybe walk a bit, but it doesn't go away. Sound familiar?
If you're a marathon runner in San Diego, you've probably dealt with shin splints at least once. And if you're reading this, they've probably come back despite everything you've tried.
Here's what I've learned after nine years of treating runners: where you feel the pain isn't what's causing the pain.
The Rowing Team That Explains Your Shin Pain
Picture this: you're watching a crew team practice on Mission Bay. When every rower does their job equally, the boat glides smoothly through the water. But what happens when half the rowers stop pulling their weight?
The remaining rowers have to work twice as hard. Over time, those overworked rowers get fatigued, strained, and eventually injured.
Your body works the same way. When certain muscles stop doing their job—weak glutes, tight calves, poor core stability—other muscles have to pick up the slack. Your shins become those overworked rowers, taking on stress they were never meant to handle alone.
This is why stretching your shins and taking anti-inflammatories only provides temporary relief. You're treating the overworked rowers instead of getting the whole team back in sync.
The Real Culprits Behind Your Shin Splints
After working with hundreds of San Diego runners, I've discovered that anterior shin splints typically stem from five main root causes:
1. Overly Tight Posterior Chain
Your calves (gastrocnemius and soleus) are locked up tighter than a jar of pickle juice. When these muscles stay shortened, they limit your ankle's range of motion, forcing your shins to work overtime with every step.
2. Weak Anterior Tibialis
The muscle running along your shinbone—your anterior tibialis—is supposed to control your foot as it hits the ground. When it's weak, it can't handle the impact forces, leading to that familiar burning pain.
3. Poor Running Mechanics
Heel striking with excessive impact or overstriding (landing with your feet way ahead of your hips) sends shock waves straight up your shins. It's like repeatedly hitting your shins with a hammer.
4. Weak Glutes
This might surprise you, but weak glutes are one of the biggest culprits. When your glutes don't stabilize your hips properly, your entire lower leg has to compensate with every stride.
5. Weak Core
A weak core can't maintain proper posture and alignment, creating a domino effect down to your lower legs.
Why These Problems Cluster Together
Here's what's fascinating: these root causes don't usually show up alone. They tend to cluster in predictable patterns:
Pattern 1: Tight calves + weak anterior tibialis often go hand-in-hand. When your calves are chronically tight, your shin muscles work overtime trying to balance things out.
Pattern 2: Weak glutes + weak core + overstriding form a perfect storm. Without hip stability, you naturally reach forward with your legs, landing heel-first ahead of your center of mass.
This is why cookie-cutter treatment approaches often fail. Your shin splints might have a completely different root cause than your training partner's, even though you both have the same symptoms.
The 80-20 Rule of Shin Splints
So what creates these imbalances in the first place?
About 80% of the time, it comes down to one thing: our modern lifestyle.
If you're like most San Diego professionals, you sit at a desk all day, then lace up your running shoes and hit the trails. But sitting for hours does predictable things to your body:
Your glutes and core naturally weaken from lack of use
Your hip flexors and calves tighten up
Your anterior tibialis gets weak from not having to work
Then you ask your body to run 26.2 miles. No wonder your shins revolt.
The other 20% usually comes from training errors—ramping up mileage too quickly, running on hard surfaces, or only running without cross-training to strengthen your supporting muscles.
Why Weak Muscles Still Feel Tight
Here's something that confuses a lot of runners: "My shins feel tight, so shouldn't I just stretch them?"
Actually, weak muscles can still develop tightness and knots. When a muscle is weak, it often stays in a shortened or tense state trying to stabilize the area. Those trigger points and knots form from the muscle working inefficiently, not from being too strong.
This is why you need both strengthening AND release work. It's like that rowing team again—you need to get the weak rowers stronger while helping the overworked ones recover.
Your Body's Suspension Bridge
Think of your body like the Coronado Bay Bridge. Your core and glutes are the main support towers that keep everything stable. When those towers weaken, the cables—your legs—have to take on extra stress to keep the bridge from swaying.
Over time, that extra load leads to wear and tear in predictable places. Your shins are often the first to send up a distress signal.
The Path Forward: Prevention, Self-Care, and Recovery
The good news? Once you understand what's really causing your shin splints, you can address it systematically.
Prevention starts with building that foundation—strengthening your glutes and core while improving ankle mobility. Think of it as regular bridge maintenance.
Self-Care means consistent foam rolling, Yoga Tune-Up ball work on your calves, and Foundation Training exercises that teach your entire posterior chain to work together.
Recovery combines reducing the load (smart training adjustments) with manual therapies that help restore proper muscle function and communication between your brain and body.
What This Means for Your Training
Here's what I want you to understand: you don't have to choose between healing and performing. Your body wants to do both—it just needs the right support.
The runners who get back to pain-free training fastest are the ones who address their specific root cause pattern, not just their symptoms.
Want to discover which of these five patterns is affecting YOUR shins? At our Recovery ReCharge sessions, we guide you through hands-on assessments to identify your unique pattern. You'll experience exactly how each root cause shows up in your body and learn targeted techniques you can use at home.
Curious about your individual pattern? Our free 20-minute consultation isn't about needles or pressure—it's about understanding what's really going on with your specific case. Because while these five patterns cover most shin splint cases, everyone's body tells a slightly different story.
The solution isn't one-size-fits-all. But once you understand your pattern, the path back to pain-free running becomes much clearer.
Your body already knows how to heal and perform. Sometimes it just needs a reminder of what that feels like when everything's working together.
Ready to get your whole rowing team back in sync?
Mike Cohen is a licensed acupuncturist specializing in sports medicine at Acupuncture Athlete in San Diego. As a marathon runner and former rugby player, he understands the athlete's mindset and has helped hundreds of San Diego runners identify their unique injury patterns and get back to pain-free training.