Anyone who’s ever had shin splints can tell you how disabling it can feel, especially when they were training for a big marathon or event. They are pretty common too, with some research saying up to 20% of runners experience this. This number shoots all the way up to 35% in military recruits! I can personally attest to how common shin splints and other running-related injuries are when I did my national service in Singapore years ago.
What are shin splints?
Officially called Medial Tibial Stress Syndrome, shin splints occur for a variety of reasons. Repetitive unaccustomed stress from lower leg muscles and tendons can cause irritation and pain on tissues that sit next to the shin bone. It could also be a stress reaction on the bone itself. The pain is most commonly in the lower third of the shin bone and tends to be a “sharp” pain on or immediately next to the bone, but can feel like an ache after a run.
As with all repetitive injuries, shin splints can happen for a variety of reasons, often all contributing to the issue. The most common factor tends to be training load. Running too much too soon, or ramping up your marathon training too quickly can easily lead to failure in tissue adaptation (the body can’t keep up with your running) which in turn causes pain.
Other factors that may contribute to shin splints include (but are not limited to):
- poor calf strength
- running speed
- tight or overactive calf/lower leg muscles
- certain running styles (people who heel strike are thought to be more “at risk”)
- flatter feet
- old or improper footwear
- running surface
- past history of shin splints
You do have to be somewhat cautious as continuing to run without a care to pain or to training loads MAY cause further bone stress injury which in the end could lead to a stress fracture.
What do I do now?
It may be easy to think “I’ll just give it a week’s break and should be right,” and it may be all you need to bounce back into running, but if you go back into training just as you were before, there is a good chance this will happen again.
Physio for shin splints is a very logical process – find the why, which will lead to “how can I stop this and prevent it in the future?” Hopefully after reading the above you have a sense that these sorts of problems tend to be multifactorial and each contributing factor has a different weighting. Everyone is different and will need different management plans.
As mentioned before, training load – in particular big jumps/spikes in training load without adequate rest periods can cause unaccustomed stress and should be managed first. Initial rest and unloading is important to give the body time to recover. A gradual progression in speed and/or distance (while taking into account running surfaces) is important. Sadly there is no perfect recipe and every runner will progress at a different pace, and so some trial and error is needed.
Next comes strength work to improve calf strength. Relatively new runners especially tend to have weaker calves. Improving strength tends to improve calf tightness as well, particularly when the weakness is causing the overactivity in the first place. Single leg calf raises (both with a straight and bent knee) are easy and effective ways of overcoming this. Reps and sets differ for each person so you might try 3 x 12-15 per leg to start with.
Lastly, good quality running shoes are important as they are the last barrier of shock absorption between your foot and the ground.
For a thorough assessment of your shins and to optimise your treatment plan to allow you to perform your activity pain free, come and see one of our physiotherapists today.
Written by physiotherapist Jedidiah Lee.