Why your shins hurt during formation runs and what you can do to keep going: A first aid guide

“Pain is weakness leaving the body” – said no one with shin splints, ever!

Ever suffered from shin pain with running? It might be shin splints. While not usually caused by weakness, the pain of shin splints can bring even the best runners to their knees. 

Shin splints are the common name for medial tibial stress syndrome. In this condition, the shin muscles and bone are overloaded by running and other impact sports. Most shin splints are caused by “too much, too soon.” A rapid increase in running distance or volume without a proper conditioning base is usually to blame. 

However, when you have to run in a group, shin splints can strike even if your fitness preparation is solid. A group pace that’s different than you are used to running can stress your legs more quickly than you can adapt to the new routine. 

And when your group runs in formation, cadence calling can be problematic if the call is too slow. Military cadence calls during unit formation runs often clock in at a tempo of around 150 total steps per minute. However, most research on good running form finds that 170-180 steps per minute are best for reducing excessive shin, knee, and hip impact forces. 

While you might not be able to change the tempo of group runs if you’re not the leader, there are steps you can take to minimize shin pain and avoid other injuries. 

In this article we’ll go over three topics: 

  1. First aid for shin splints caused by group or formation runs (PACE program)
  2. Key signs to help you judge the urgency of seeking professional care
  3. Lessons we’ve learned over the years about running-related shin pain 

Remember: good judgment is your responsibility. No article can replace the advice of a healthcare professional who has examined you and knows your situation. While some injuries will heal on their own, many others will require additional attention. Consider this info as a starting point, not a treatment plan.

Part 1: First aid for shin splints: PACE yourself

PACE is a self-care first aid method to mitigate further damage and prepare for rapid recovery following an injury: 

  • Protection – prevent further injury so healing can begin.
  • Activity Modification – encourage the repair process while staying active.
  • Comfort – manage pain and circulation to promote normal healing.
  • Exercise – maintain nutrition and circulation while preventing a loss of motion.

Protection: fix your stiff ankles 

While you can’t avoid impact forces when running, you can improve your ankles’ spring-action to better absorb the shock. The stiffer your ankles, the more force you’ll feel in the shin and knee bones.  

Stretching your calf muscles using a “runners Achilles stretch” is a great start, but may not be enough to get the ankle joint flexible. This video shows how to measure your ankle mobility, and, if needed, a corrective exercise that tends to work well for runners: 

Activity modification: step it out, don’t stride it out 

The fastest way to reduce shin splints during a run is to increase your cadence, or total steps per minute. Think about cycling your legs faster underneath your body frame, like when jumping rope or running in place. This doesn’t require running faster, just that your legs cycle faster underneath you. 

Ideal cadence is highly personal, and the 180 rate is not right for everybody. However, deliberately increasing your step rate can help with shin pain in the short term. This video shows a quick way to estimate a 180 cadence:

If you are stuck with a slow tempo cadence call and can’t increase your steps, the next best thing you can do is try to land on the ball of your foot with each strike, and avoid shuffling your feet just because the pace is slow. Each shuffle-step ‘skids’ the foot across the ground, increasing your risk of blisters, Achilles tendon and knee pain, and shin splints. 

Comfort: wear compression socks

Compression socks assist blood flow to hard-working muscles and may reduce muscular vibration, resulting in decreased pain and fatigue. Any pair of compression socks that are comfortable immediately after putting them on (not too tight!) and that won’t bunch up will work. This video shows when to choose compression socks, or when shin sleeves might be better: 

Exercise: ball “peanut” shin muscle release

Before runs, and in the evening before bed, a self-massage technique using two tennis balls taped together can stretch the hard-to-reach areas affected by shin splints. The key is to use rubber balls that have some “give” to splay the muscle and tissue fibers effectively – try to avoid hard baseballs or lacrosse balls. 

Part 2: When should you get help? 

Shin pain from running can sometimes be caused by other injuries, including bone fractures, blood vessel, or nerve injuries. Seek guidance from a physical therapist, physician, medic, or athletic trainer:

Urgently (today) if you notice: 

  • Muscle weakness such that you can’t pull your toes or foot up to clear the ground when running 
  • Shin swelling that indents when you press on it 
  • Severe pain when you touch the bony crest along the front of the shin bone
  • Inability to bear weight or walk without a limp after running

Promptly (within a few days) if you notice:

  • Numbness or burning pain in the foot or toes during or after running
  • Calf or shin muscle cramping that isn’t relieved with rest, or returns at night
  • Worsening shin or calf pain when wearing compression socks or sleeves
  • Worsening pain at just one point on just one shin during consecutive runs
  • Pain or pressure that always returns at the exact same time, distance, or intensity of running

Schedule an appointment soon if you notice: 

  • Persistent shin pain despite 1-2 weeks of rest from running 
  • Low tolerance for hiking uneven terrain, especially declines
  • Unexplained shin pain even when you’re not running or doing anything strenuous.
  • Inability to balance on either leg for 10 seconds each with eyes closed 
  • Inability to perform 20 full single leg calf raises on each side (minimal upper body support)

Part 3: Lessons we’ve learned about shin splints 

The good news is that shin splints usually do heal with rest. But we know that being told to rest is one of the most frustrating things about it! Unfortunately, the recovery process is rarely a straight path. 

Full recovery can require several weeks off from land-based running (pool and cross-training workouts will become your friends here). Next, a slow and steady retraining phase will usually require vigilance about shutting down workouts before they become painful. 

If you have a history of repeated shin splints, a thorough sports medicine evaluation that includes a conversation about your running history is necessary. Several factors must be investigated, such as muscle imbalances, scar tissue, running technique, and footwear, to eliminate shin splints. 

It absolutely can be done!


Shin splints from running are often a case of too much, too soon. Adjusting to a different pace or cadence when running in formation compounds the problem. 

To manage shin splints for group runs, PACE yourself. If you have signs of a worsening problem or you experience repeated bouts of shin pain, seek the guidance of an athletic trainer or physical therapist to find the right treatment, technique, or program for you. 

Questions about shin pain or repeated injuries? Send us your question. We answer every question. 

If you have a friend or teammate who could use this information, please share it with them.


EE Johnson. Use proper running pace to prevent serious injury. 2016.

Reinking MF, Austin TM, Richter RR, Krieger MM. Medial tibial stress syndrome in active individuals: a systematic review and meta-analysis of risk factors. Sports Health. 2017; 9(3):252-261.

DeFroda SF, Cameron KL, Posner M, Kriz PK, Owens BD. Bone stress injuries in the military: diagnosis, management, and prevention. Am J Orthop. 2017;46(4):176-183.

Buerba RA, Fretes NF, Devana SK, Beck JJ. Chronic exertional compartment syndrome: current management strategies. J Sports Med. 2019;10:71-79. 

Related Articles:

Selection Injuries: The Good, Bad and Ugly, Part 3 (Shin and Ankle)

How to manage a twisted ankle even when you have to keep rucking

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