The primary symptom of shin splints is tenderness or pain along the shin, especially the lower part of the shin. This pain typically begins as a dull ache and gradually worsens as the tibia (shinbone) and surrounding tissues are stressed. The pain usually flows out from the lower half of the posteromedial (in back and toward the midline) border of the tibia.  However, it may also occur in the tibialis anterior and extensor hallucis longus muscles along the tibia and in the membrane between the tibia and fibula (interosseous membrane).

Initially, symptoms are relieved by rest. However, over time they may become continuous. In addition to the pain and tenderness, there may be mild swelling and induration (hardening) of the soft tissues around the tibia. Occasionally, there may be numbness or loss of sensation over the fourth toe, but this is usually suggestive of a similar condition known as compartment syndrome.