Running Injury Series – Shin Splints
What is it?
Also known as medial tibial stress syndrome (MTSS), shin splints most often can be captured in four words: too much, too soon. Shin splints present as lower leg pain that occurs below the knee either on the front outside part of the leg (anterior shin splints) or the inside of the leg (medial shin splints). Runners may be able to train through the early stages, but if the injury progresses, running becomes intolerable and may even result in a stress fracture. On the other hand, shin splints sometimes clear up on their own in about three months’ time, which possibly related to the amount of time it takes the bones to adapt to the physical stress of running.
Overpronation, inadequate stretching, worn shoes, or excessive stress placed on one leg or one hip are the common causes of shin splints. Typically, one leg is involved and it is almost always the dominant one. Anterior shin splints (toward the outside of the leg) usually result from an imbalance between the calf muscles and the muscles in the front of your leg, and often afflict beginners who either have not yet adjusted to the stresses of running or are not stretching enough.
Treatment and Recovery
- If you suspect you have shin splints, experts recommend to stop running completely or decrease your training depending on the extent and duration of pain, along with frequent icing to ease inflammation of the area.
- Gently (GENTLY) stretch your Achilles (for medial shin splints) and your calves (for anterior shin splints).
- Cross training is a great way to keep your fitness while healing your shins. Swim, run in the pool, or bike. When you return to running, increase your mileage slowly, no more than 10 percent weekly.
- Avoid hills and excessively hard surfaces until shin pain goes away completely, then re-introduce them gradually to prevent a recurrence. If you frequently run on roads with an obvious camber, run out and back on the same side of the road. Likewise, when running on a track, switch directions.
- Some signs that your shin splints are fully healed: your injured leg is as flexible as your other leg, your injured leg feels as strong as your other leg, and you can jog, sprint, and jump without pain.
- Warming up before your run is always a good precaution to take. When your muscles are warm, there is a smaller chance of putting too much stress on them too soon during your run. You can warm up by walking, biking, doing butt kicks/high knees, etc.
- Make sure you wear the correct running shoes for your foot type. If you are unsure, head on over to your local running store to be fitted. Having two pairs of shoes and alternate wearing them varies the stress on your legs.
- To prevent shin splints due to muscle strength imbalances between the anterior (front) and posterior (back) muscles of the lower leg, try these strengthening moves: To work the anterior leg muscle, known as tibialis anterior, do some toe taps. Raise the ball of your foot off the ground, keeping your heel on the ground; this is the “up” phase of tapping your foot, you will feel and see this anterior muscle contract. Release. Do several repetitions, holding it at the top of the movement for 10-15 seconds. This muscle will fatigue rather quickly, so repeat this exercise several times a day.
- Find a training plan that allows you to run three days a week on alternate days and one that builds mileage very gradually, like 10 percent per week, known as the “10 percent rule.” Cross training two or three days a week for by doing non-impact activities that are easy on your shins like swimming, cycling, or spinning is a great preventative measure. And remember to always take at least one day a week completely off—even two days wouldn’t hurt you! Rest is good!
- When you complete your runs, ice your shins immediately to prevent or reduce any irritation or inflammation. You can do a full-on ice bath or fill a small paper cup with water, freeze it, and rub the cup on the affected area in a circular motion for 10 to 20 minutes.
A word of caution: The pain that may feel like shin splints may be something worse such as compartment syndrome (symptoms include leg pain, unusual nerve sensations, and eventually muscle weakness) or a stress fracture (definite spot of sharp pain, not as generalized as shin splints). If you think you have either of these, STOP RUNNING, and see a doctor as soon as possible.
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I hope you all find this helpful. Shin splints was an injury that ailed me for the first couple years I began running, and they are not fun at all! If you have any questions, do not hesitate to ask :) Be on the look out for more running injury posts, and if you would like to see a specific injury, let me know!
- JoEllen [kickin-asphalt] May your feet be light, and your heart full xx
A recent systematic review (Winters et al 2013) of the treatment of MTSS revealed that to date, research does not support stretching for the treatment of MTSS. The same goes for compression stockings and strengthening exercises. There is however more promising evidence for ice massage, ultrasound and extracorporeal shockwave therapy (ESWT)… but it’s better to prevent than treat! Start slowly and don’t increase your mileage by more than 10% per week. If you start to feel the pain of MTSS, stop and rest for a 2-3 days and reassess your contributing factors.