With so many people taking up running since lockdown, the number of physio-related questions I receive over on my Instagram has increased exponentially. One of the most common questions I’m asked (at least once a day at the moment) is how to cope with shin splints, an issue common with runners, especially those increasing the amount of running they are doing too quickly.

As someone who isn’t a physio, I never feel comfortable answering these questions (aside from giving personal advice and opinions on injuries I’ve personally experienced), so instead have asked my physio Zoe from Physio Motion to write something to help you all out. I understand that not everyone can afford/has access to a physio, so I hope this helps! That being said, if you continue to struggle with injury even after rest and rehab, I would really recommend getting in touch with a physio to ensure you’re treating the right issue, and that the problem isn’t something bigger.

Without further ado, onto Zoe! If you enjoyed this post, please do share and tag @physiomotionlimited and @foodfitnessflora so we can see 🙂

What are shin splints?

Shin splints is a generic term that describes any disorder that causes shin pain.  This historically would be called medial tibial stress syndrome.

It is typically found as pain along the shin bone (anterior tibia), which will settle with rest but will reappear when you start running again and at worse when walking.

With all of these conditions that cause shin pain, it is typically due to repetitive strain injury that is common in runners when they are starting to run or suddenly increase their amount of running.

The characteristics of shin splints can also be an identification of different conditions.

 

What other conditions can have shin splint characteristics?

It is important to know that it could also be due to tibial stress fracture (break within the bone that doesn’t move) or compartment syndrome (high pressure within the muscle caused by swelling).

 

How can I distinguish between these conditions?

If it is true shin splints, the pain will subside with rest and slowly build up again if not managed adequately. Also, people that have just started running will notice that the pain improves over time as your legs get used to the new loads being put upon them.

With stress fractures and compartment syndrome, however, the pain is persistent or can get progressively worse.  If your pain does get progressively worse, it is a good idea to seek medical advice and investigations in order to rule out a stress fracture or compartment syndrome.

 

Why have I got shin splints?

The main cause for shin pain is the load that you are putting through the lower half of your leg when running, and that you do not have the capacity to manage these loads.  This could be due to increasing your training too quickly; increasing the running speed; or inadequate rest periods between your runs and other training.

There is no evidence that a certain type of running footwear will stop you getting shin splints, but if you have been using the same trainers for many years and they are hanging off your feet it might be an idea to treat yourself to a new pair.

 

Do I need to stop running?

For most people you can continue running, but you need to return to running a distance, speed and frequency that previously did not cause you problems. 

If you are new to running then it might be better to start with slow interval running (run walk, or run stop run) and build up the duration that you are running in each interval before continuously running. 

If you are still getting pain then it maybe necessary to stop running for a short period and swim or cycle instead for this period in order to maintain cardiovascular capacity. 

 

What can I do to help with my shin splints?

As shin pain is due to overloading the legs, you need to make sure that the legs are strong enough to absorb running forces.  Therefore, you need to have a strengthening regime to ensure adequate strength in your calf complex, but it is also important to increase the strength in your gluteals and thigh muscles.

We would recommend exercises such as calf raises, slow step ups and bridges, athough we always assess our patients for areas of weakness in the lower limb and tailor a programme to their needs.

Due to the shin pain you can get a secondary response of tightness in the calf.  You can stretch this out, but it will only provide you with temporary short term relief until you start walking and/or running again.  It is more important that you make sure you find out what is causing your shin pain in the first place. Failure to do so could result in a stress fracture or compartment syndrome.

 

What can I do to prevent reoccurrence of shin splints?

When the pain has completely disappeared at the running mileage that is comfortable or after a period of rest, you need to think about how you progress your running programme. Typically coaches recommend 10% increases, but something to remember is that this doesn’t have to be every week and also every run doesn’t have to be to your maximal capacity.

It is also important to have strength and conditioning days, and recovery days in your training regime.

As shin splints are now categorised as a bone stress response, it maybe worthwhile looking at whether your vitamin D and calcium intake is adequate for bone recovery, especially when you start running during the winter or at the start of the spring, when it is shown that vitamin D especially is low for us Brits!

 

How long will it take me to recover from shin splints?

It can take between 6 weeks and 6 months to make a full recovery from shin splints depending on the severity of the condition.  So it is important to be patient and consistent with your treatment and advice given.

 

If you’re currently experiencing injuries, you may find this Q&A vlog with Zoe interesting, as well as this chat with my coach, where we cover running injuries and the importance of recovery, especially in such a stressful time. 

 

References:

 1. Heiderscheit, B. C.; Chumanov, E. S.; Michalski, M. P.; Wille, C. M.; Ryan, M. B., Effects of Step Rate Manipulation on Joint Mechanics during Running. Medicine & Science in Sports & Exercise 2011, 43 (2), 296-302.

2. Bennell, K. L.; Malcolm, S. S.; Thomas, S. A.; Reid, S. J.; Brukner, P.; Ebeling, P. R.; Wark, J. D., Risk factors for stress fracture in track and field athletes: a twelve-month prospective study. American Journal of Sports Medicine24 1996, 6 (810-818).

3. Madeley, L. T.; Munteanu, S. E.; Bonanno, D. R., Endurance of the ankle joint plantar flexor muscles in athletes with medial tibial stress syndrome: A case-control study. Journal of Science and Medicine in Sport 2007, 10 (6), 356-362.

4.. Lappe, J.; Cullen, D.; Haynatzki, G.; Recker, R.; Ahlf, R.; Thompson, K., Calcium and vitamin d supplementation decreases incidence of stress fractures in female navy recruits. Journal of Bone and Mineral Research 2008, 23 (5), 741-749.