How to prevent shin splints as a runner

How to prevent shin splints as a runner

Shin splints. Even just hearing those two words sends shivers down my spine as I know first hand how painful, and how frustrating this injury can be for runners. If you are someone who has been trying to beat shin splints and have found yourself constantly having to rest, shoving your legs into tubs of ice after each session, or spending way too much time and money on massages or new running shoes, only to find that the pain eventually returns - then this post is for you!

Although stupidly common among the running population, shin splints is something that in my mind as a physio, can actually be easily managed and prevented if we just get a few simple things right from the get go.

Before I get into how exactly we do that, it is helpful to have an understanding as to what is actually happening when you experience that horrific pain in your lower leg.

What are shin splints?

The proper term for shin splints is medial tibial stress syndrome which basically means ‘stress’ on the medial part of your tibia (the inside shin bone). The stress presents in the form of inflammation at the connective tissue that sits between your calf muscles and your tibia.

Shin splints will cause pain down the front or inside of the shin bone, often when running. When really pissed off, they can cause pain when walking or even at rest. The shin is often painful to touch, and may feel lumpy or swollen. Ouch!

Why do we get shin splints?

Why does the connective tissue become stressed and inflamed in the first place? And why does it happen at the shin bone and not in other areas of the body?

When we run, we spend the whole time either landing or pushing off from one of our legs. We know from the research that 50% of the force required to propel you forwards when jogging (not sprinting as that is different), comes from below the knee. Which means that there is a lot of stress going through the calf muscles, shin bones, and feet all the time.

I thought I would note that although the word stress is often looked at in a negative light, a certain level of stress on our tissues (bones, muscles, tendons, connective tissue) is actually a good thing. If we didn’t have it, then our tissues would never adapt and become stronger.

The issue with shin splints (and many other injuries) is that the stress is often too much, too quickly.

So what pushes them over the edge? And how can we prevent this from happening?

1. Training load errors

• Be careful with your training load management and make sure that you are not increasing your total kms or duration by more than 10% per week
• Be mindful of how quickly you are adding in speed/intensity work into your training. We know that increasing intensity of training exponentially increases the stress on bones and muscles compared to just increasing distance alone

1. Biomechanical concerns

• Make sure that your shoes are comfortable and fit well, and are made for the type of training that you are doing. Eg a race shoe shouldn’t be worn for your Sunday long run as there is not enough support or cushioning
• Have someone assess your running technique and give you some pointers. Common issues that I see in those experiencing shin splints are slow cadence (leg speed), and landing with the foot out in front of the body.
• Aim for a cadence of 160-180 steps per minute to limit ground contact time, and see if you can have your foot land underneath your body as opposed to out in front of you.

1. Calf strengthening

• ALWAYS do your calf strengthening in the gym! Having strong calf muscles allows your tissues to cope with training loads easier, helps to absorb some of the shock and take it away from your bones, and helps you to run faster. Win win!
• Aim to do your calf exercises in single leg (to mimic running), and always try to work both of the key calf muscles by doing one set with your knee straight (gastrocnemius) and one with your knee bent (soleus)
• Start with body weight and slowly add extra weight as tolerated. Note that as a runner, you should be able to do at least x25 single leg bodyweight calf raises on each leg before fatiguing

What about massage and ice?

You might have noticed that I haven’t really talked about massage, icing, foam rolling or stretching here. The reason why is that all of these things are only proven to help with short term pain relief only, and are not going to help you to prevent shin splints in the long term. Sorry!

When to seek professional help?

If you have been struggling with shin splints for a long time, or are feeling pain when walking or at rest then my best suggestion for you would be to book yourself in with a running physio who can assess you and give you individual advice on next steps.

Good luck and happy running!!