I run four or five times a week (usu­ally for about 40 minutes). A month ago I developed pains in my right shin dur­ing a long run, which las­ted for a few days. Since then, the pain returns whenever I try to run. Could I have shin splints? If so, how long will it take to heal and how will I main­tain my fit­ness levels in the mean­time?

All reg­u­lar run­ners dread the pro­spect of “shin splints”, an over-​use injury where the front of the lower leg becomes inflamed and pain­ful. Technically known as “medial tibial stress syn­drome” or MTSS, it is the most com­mon of a group of lower-​leg prob­lems that can affect run­ners, race-​walkers, foot­ballers and other sporty types who run and jump.

Several injur­ies have sim­ilar symp­toms, though, and what you have described is a good example of when it is time to stop run­ning and visit a sports ther­ap­ist for expert dia­gnosis and treat­ment. Anyone who does a lot of exer­cise or sport gets aches, sprains, strains and inex­plic­able twinges from time to time. Usually these are minor and dis­ap­pear by them­selves with a few days’ rest. Sometimes they may bene­fit from a cold com­press (bag of frozen peas) or some anti-​inflammatories such as ibupro­fen.

But when a pain is more intense, comes on dur­ing your exer­cise and keeps on return­ing, your body is send­ing you a clear warn­ing. Don’t ignore it and don’t be temp­ted to self-​diagnose from the inter­net – you can­not hope to know all the pos­sib­il­it­ies that a trained sports physio­ther­ap­ist or osteo­path will need to elim­in­ate in work­ing out the cause of your pain.

It’s also very import­ant that the sports ther­ap­ist helps you work out why you got injured in the first place, if you are to avoid a relapse in six months’ time. Injuries not caused by a spe­cific event or acci­dent (we call them “chronic” or “over-​use” injur­ies) can develop for many reas­ons, includ­ing: poor tech­nique, over-​training, the wrong foot­wear, a need for foot sup­port, a change of run­ning sur­face, a con­sequence of another uncon­nec­ted injury (eg, in your back) and so on. Part of your rehab will involve pin­point­ing how you got your injury in the first place and cor­rect­ing that prob­lem.

If you have developed shin splints, you will prob­ably be advised to stop run­ning for a couple of months, dur­ing which time your ther­ap­ist will give you spe­cific shin-​strengthening exer­cises and guide you through your gradual return to full activ­ity.

To stay fit in the mean­time, you could switch to swim­ming or run­ning in deep water (a very chal­len­ging workout for your heart and lungs). Or use an arm-​cycle machine if your gym has one (leg cyc­ling may be unhelp­ful). Avoid any­thing that loads your injured lower leg and ankle or repeatedly flexes the ankle. Above all, make sure you do the rehab exer­cises your sports ther­ap­ist will pre­scribe, and be patient: too much too soon could land you in worse trouble in the longer term.