This article originally appeared in “Women’s Running”

Shin splints are sometimes thought of as a rite of passage for runners. They are especially common in beginners—and women are two to three times more likely to develop them than men. But what exactly are shin splints and what the heck can you do about them?

What are they?

Formally known as medial tibial stress syndrome (MTSS), shin splints are caused by an overloading of the tibia bone and associated muscles. When bone tissue breaks down faster than new tissue can be formed, the result is inflammation and pain. This occurs most commonly along the inside of the tibia, but it can also occur on the outside of the bone.

Characterized by general soreness, shin splints should not be confused with compartment syndrome, which causes a feeling of gradual weakness as you run, or a stress fracture, which produces a more intense, localized pain.

Why do they happen?

Shin splints occur when you suddenly change some aspect of your training, says Garrett Petry, DPT, a Chicago-based manual physical therapist. That’s why newbies often fall prey, but it can happen to longtime runners as well. “For instance, if you’ve recently switched from trail running to running on sidewalks, the cement is not going to absorb the impact as effectively as the trail, and there will be increased stress into the leg,” Petry says.

If you’ve ramped up your running, this “too much, too fast” phenomenon is likely to blame. However, Petry says, “If shin splints are a chronic problem for you, it’s important to look at the biomechanics of your gait.” It’s possible you have navicular drop. The navicular is the bone at the top of your arch; in its normal motion, it helps absorb stress. But if you over-pronate (land on the outside of your foot), the arch may collapse and the navicular drops. This causes your tibia and associated muscles greater stress.

How can I fix it?

Rest, ice the area and focus on the treatments listed here to strengthen your body and improve form. Stronger intrinsic muscles of the feet and the calf muscles help prevent navicular drop, Petry says. He also recommends strengthening the hip external rotators and abductors (your glutes), which help control pronation and help keep your knees in efficient alignment while running.

“Also, look at where your pelvis is relative to your feet while running,” Petry says. “If you’re landing with your foot too far out in front of you, this will change the angle of the tibia and stress it more on impact.”

Petry recommends seeing a manual PT if your shin pain has persisted for three or more runs. If you let shin splints go untreated, they can develop into a stress fracture. “If you keep going, you’re setting yourself up for compensations, which can lead to other injuries down the road.”

Treatments to Try

Self Soft-Tissue Mobilization

  • Feel along the inside of your shinbone where the muscle meets the bone and note areas that feel thick, stiff or tender.
  • Apply a gentle but firm pressure to the areas of stiffness and slowly move up or down along the margin of the shinbone to soften the tissue.
  • Perform for no more than 3 minutes at a time.

Eccentric Heel Drops

  • Stand barefoot on a step on one foot, with your heel off the edge of the step.
  • Gently press through the ball of your foot and slowly lower your heel toward the floor on a count of 3 seconds. You should feel a calf stretch. Hold for a count of 10 seconds.
  • Focus on pressing your toes into the step and activating your foot and calf muscles as you lift your heel back up on a count of 3 seconds.
  • Repeat 5 to 7 times on each side.