Posterior Shin Splints: Causes, Treatment, and Recovery – A Case Study

Date: August 13, 2025

Posterior shin splints are a common yet often misunderstood lower leg injury. They cause pain along the inside of the shin, typically due to inflammation of the posterior tibialis muscle and tendon. If untreated, shin splints can progress into stress reactions or stress fractures, leading to long recovery times.

At Pain Free Health, we regularly treat athletes, runners, and active individuals with shin pain. This case study shows how a full assessment and targeted treatment can prevent a mild injury from turning into a more serious problem.

The Patient’s Main Complaint

Our patient came in with:

Sharp shooting pain along the inside border of the shin (posterior shin splints)
Increased discomfort with walking, running, or standing for long periods
Mild swelling and tenderness along the tibia
Flat feet (fallen arches) contributing to overloading of the posterior tibialis tendon

What Causes Posterior Shin Splints?

The posterior tibialis muscle plays a key role in supporting the arch of the foot. Overuse, poor biomechanics, or inadequate footwear can cause it to work harder than it should, leading to:

Inflammation of the tendon
Stress along the inner shin bone (tibia)
Potential progression to a tibial stress fracture if left untreated

Common risk factors include:

Flat feet or collapsed arches
Sudden increases in running or activity levels
Hard training surfaces
Improper footwear
Weak calf or hip muscles

Our Treatment Plan

1. Reduce Pain & Inflammation

Shockwave therapy to stimulate blood flow, reduce inflammation, and speed recovery
Kinesiology taping from foot to shin for arch support and reduced tendon strain

2. Correct Biomechanics

Custom orthotics to lift the arches and offload the posterior tibialis
Gait retraining to promote even weight distribution and prevent excessive inward rolling (overpronation)

3. Strengthen Key Muscles

Posterior tibialis strengthening: heel raises and resistance band inversion
Calf strengthening to absorb impact forces
Hip and glute exercises to improve lower limb alignment

4. Mobility & Self-Care

Foam rolling the calves and inner shin to release tension
Foot arch rolling with a lacrosse ball to improve fascia mobility
Calf Stretching
Gradual return-to-activity plan to avoid re-injury

Recovery Timeline

With consistent treatment and home exercises, most mild-to-moderate posterior shin splints improve in 4–6 weeks. More severe cases or stress fractures may require 8–12 weeks and modified activity.