Troubleshooting Your Running Injury - Shin Splints
Shin splints can be an extremely frustrating injury for runners to deal with! Not only can they derail your upcoming race but they can cause you to quit running all together! A common mistake that runners make is that they treat their symptoms instead of identifying and addressing the true cause of their injury. There are many factors that can contribute to shin splints but most often they can be traced back to excessive overload and poor running mechanics. If you are a runner and you are experiencing lower leg pain, please read on for some tips that will help resolve your pain and get back to running!
What are shin splints?
“Shin splints is a general term that can always be narrowed down to something more specific. In my 18+ years of sports medicine experience I have heard every injury of the lower leg described as shin splints at one point or another. Everything from medial tibial stress syndrome, tibialis tendinosis, stress reaction/fracture, achilles tendinosis, compartment syndrome, to name some of the more common ones.” - Dr. Hal Rosenberg, Mt Tam Sport and Spine
For the sake of this blog, I am going to focus on tips for avoiding medial tibial stress syndrome. MTSS is an overuse and/or repetitive stress injury of the Tibia which (weight bearing, shin bone). If untreated MTSS can lead to more serious injuries such as compartment syndrome (increased pressure within a muscle compartment of the arm or leg that, untreated, can cause nerve damage), and tibial stress fracture
How to know if you have Medial tibial stress syndrome (MTSS)?
The most common symptom is a feeling of pain and tenderness of the lower leg, especially on the inner shin bone
You feel less pain after taking a few days to rest
What to do now?
This guide is intended to assist you avoiding or reducing the possibilities that you get shin splints. The causes and interventions for shin splints are complex and there is still a lot of research that needs to be done in this field. This guide is not intended to be an end all solution to fixing your shin splints, but if you practice my suggestions you can improve your situation!
The most immediate intervention is to REST! Resting might be a foreign concept to an avid runner and triathletes but the only true way for the bone to heal is to reduce the impactful stress on the tibia. How long you need to rest is dependent on the severity of your pain. A 2-6 week break from running is recommended. To maintain your endurance you should consider cross training such as biking, swimming, rowing, or an elliptical.
Schedule a Gait and Movement Analysis. Chances are your running mechanics are flawed! Most commonly this is due to over striding and excessive pronation when the foot strikes the ground. Pain in your tibia tells me that it is receiving too much mechanical stress. Every time a runner takes a stride they absorb a force equivalent to 2.5x their body weight! Therefore, it is critical that a runner is using proper technique to dissipate the stress. Having a run gait analysis can be great indicator to learn what you need to specifically correct. In addition, I also recommend a general movement analysis such as Functional Movement Screen (FMS) to address any imbalances in the body.
Corrective strength and conditioning programming. Using the results of your running and movement analysis you can begin to address the structural needs of your body. The best analogy, I can give you is to think of your body as my first car. When I was 16, my first car was a beat up old Subaru Legacy that that had about 150K miles on it. One day I tried to see how fast I could get it up to on the highway. As I pressed down harder on the accelerator, I reached a point when the car started to vibrate and shake uncontrollably. Little did I know, the wheels (your legs in this analogy) were out of alignment. Despite having more throttle to give it, I was forced to slow down to regain control. The chassis of the car was too unstable to handle the maximum potential of the engine (your heart, lungs, muscles). I had to take my car in the shop (gym) to align my tires and get my car to perform at its best potential.
Monitor your training and build your training volume slowly. After you have gone through a strength protocol, I would begin to integrate running slowly into your weekly training. Begin with high quality short sessions where form and technique is the primary focus. Drills that reinforce better running techniques should be a large part of the training session. You should build better running form first, and then you can begin to build volume. Think in terms of time instead of miles. A conservative progression is to add no more than 10% every other week to your training volume. Consider hiring a coach to help you build out a running program with periodization to maximize efficiency as you build back up
Assess footwear and running surfaces. I recommend that you use shoes that contribute to better running form. Everyone’s needs are completely different but in general I recommend shoes that help you maintain a midfoot strike and avoid heel striking. If you discover that you are a pronator in your gait analysis you may consider a stability shoe that provides arch support. Finally, my last suggestion is to avoid hard surfaces at all costs. Running on trails or in the grass is much more forgiving than the hard asphalt.
It is my goal to help broken down runners just like you! My approach is educate and empower athletes to fix themselves using sustainable solutions. Together we can get you back to enjoying running again. If you are a runner who has experienced shin splints and want to discuss your situation specifically, I would be happy to help you out. My coaching services include gait and movement analysis, periodization programming, strength and condition, and more. Please send an email to CoachDavidWinton@gmail.com for more information.
Train Well my friends!