Though running can be enriching and rewarding to both professional athletes and long-time couch potatoes looking to get back in shape, it comes with a few injury risks. Arguably the best known of these injuries is Medial Tibial Stress Syndrome, also known as “shin splints.” If you ever suffer from shin splints, you should take the time to understand where it comes from, how to treat it, and, above all, how to prevent it before planning your next marathon.

Medical experts generally define shin splints as pain along the tibia, or the shinbone. It is most common among joggers, but dancers, soldiers, and various other athletes have also reported it. In mild cases, it only affects a small region of the tibia, and the pain goes away within hours. However, if ignored, the pain can spread, intensify, and last for several months, sometimes even progressing into a far more serious injury.

Shin splints are caused by excessive tibial stress. Like the supporting beams of a skyscraper, the tibia absorbs shock and bends a little every time the foot hits the ground. Any sports that involve running or jumping add even greater stress to this supporting bone. Once believed to be a soft tissue injury, researchers have demonstrated in tibial CT scans that bone density is considerably lower in places where athletes with shin splints claim to feel the pain, suggesting that a bone injury causes the pain. If ignored, this weakened bone can fracture.

Shin splints are far more common among inexperienced athletes, arguably because their bones and supporting muscles have not yet grown accustomed to intensive use, and among flat-footed people as the arch in a normal foot helps absorb shock. Likewise, women are two to three times more likely to suffer from shin splints.

Over time, the tibia adapts to the repeated stress by getting thicker and stronger, which is why shin splints are extremely uncommon among experienced athletes.

Treating and Preventing Shin Splints

If your shin starts to hurt during a run, the best thing to do is slow down or stop. Do no try to “run it off.” The less impact on your shinbone, the quicker it can heal. If concerned about your cardio routine, perhaps try swimming, bicycling, or walking until your shin pain is gone and you can run again without it returning. Medical experts recommend waiting at least two weeks before you go back to running to test if your shin is completely healed. For continuous pain, try applying ice packs for 15 to 20 minutes at a time, four to eight times a day to the affected area, over-the-counter pain relievers, or a combination of both.

As for prevention, it is best to start a new routine little by little until your body adapts. Consider strength training exercises for the lower leg muscles to provide better tibial support during runs. It is also important to choose the right shoes for the job. Invest in some shock absorbing insoles with arch support, especially if you are flat-footed. Shin splints happen much more often on hard surfaces and uneven terrain, so avoid such places until you are more experienced.

Whether you plan to enter a competition or run just for exercise or enjoyment, think of it as an art. Like all forms of art, it takes time to hone your craft. A case of the shin splints can be a minor setback or the gateway to a far greater injury. Therefore, always be aware of your own limitations and never be afraid to quit when necessary.