Shin splints is a painful and common injury amongst runners. The exact cause of the condition is unknown. I recently wrote an article for Trail Magazine on Runner’s Shin Splints and wanted to share with you my thoughts on this frustrating condition.
Usually there is a gradual onset of a broad area of pain along the inside part of the lower leg. This pain generally eases with warming up. The area is sensitive to the touch. Often the running session can be completed pain-free but the pain gradually returns after exercise and is worse the next morning.
Some common findings in research regarding the possible causes of shin splints:
- Hips internally rotate excessively – this can be seen in “cross – over” while running and increased pronation excursion at the foot
- Less knee flexion (bending)
- Cadence, or step rate, equal to or below 164
- Training Loads
- Training intensity
- History of tight calves
- Change of footwear
- “Loud” runner – slapping feet on the ground while running
The running terrain is equally important. Any big changes to training gear or training itself may increase the load on your shins and result in an overload which develops into shin splints, or medial tibial stress syndrome (MTSS).
If you overload the tissue – ignore the symptoms – it struggles to cope which can result in shin splints. Most importantly, there may be a need for a thorough Physiotherapy assessment to ascertain the main cause (s) of your shin splints so that a very specific, goal – orientated program may be given individually.
If you continue to run and aggravate shin splints, it will progressively worsen. Unfortunately, relative rest is needed to stop irritating the shins and allow sufficient time to rest and recover. This can be followed by slowly building up the load that you place on your legs as you return to running. It is important that you are under the guidance of a Physiotherapist who understands running and can progress your training in this manner.
Treatment is guided to relieve the pain and strengthen the surrounding muscles:
- Pain and anti – inflammatory medication
- Pain – free cross training – both cardiovascular (Cycling, Stepping and Orbitrek) and strength (no ballistics, jumping) is important
- Relieve calf tightness – myofascial release (deep massage), dry needling, specific lower leg stretching
- Ankle joint mobilisation and release
- Strapping to aid while returning to running
Running technique should be assessed. Strengthening, stretching, proprioception and balance work needs to be rehabilitated in order to maintain the correct running technique.
Managed well, there is a good chance of a full recovery with shin splint pain and a full return to pain – free running. Monitor training carefully based on symptoms. This can easily be done using a visual analogue scale (VAS) indicating pain levels where “0” is no pain and”10″ is the worst pain. If the pain level is 3 or below, you can continue. However, if the pain is above a 3, stop running and cross train or rest to relieve pain.
Ensure that your training program increases gradually and steadily – in all aspects (load, mileage, speed etc). Any sudden increase may place your body on undue stress which may lead to an overload condition such as shin splints.
Calf strength is important. Test out your calves to make sure that you have specific calf strength that will support your run training.
General strengthening and conditioning is vital. Check out my blog on Strength Training for Trail Runners.
Take note of any symptoms early on to prevent them progressing and adapt your training.
I have experienced the start of of this frustrating condition. The best action I did was to back off my training, stretch and loosen up my calves and my front shin (anterior tibialis) and listen to my pain levels. Thankfully it only lasted a week or so and I was back to normal.
Shin splints is a common running condition which gradually worsens with time and if left untreated, can be quite severe in nature. If you experience tight calves with some pain on the inside of the lower leg, consult with a Physiotherapist in order to get early assessment, treatment and rehabilitation. You will then quickly return to running pain – free and be a stronger, happier runner. Happy running.
Check out my blog on Plantar Fasciitis for more practical physio tips on this condition.
See below for a really great way to strap and support the painful shin splints area.