INTRODUCTION

You’re starting to notice a pain in the lower leg in the shin. The pain starts with a little ache when you run. You think to yourself ‘it’s nothing serious, I’ll ignore it’. Another couple of weeks of running adding lots more stress to the lower leg, you’re now noticing the pain developing into a sharper more painful sensation. Almost tender to run.

The worst case scenario is you continue to run through the pain thinking you can ‘run it off’ because of that you develop stress fractures of the tibia (which is the shin bone) which puts you out of action for up to 12 weeks. You have to dramatically modify your daily activities and your running routine is well and truly out of the window.

Before you become one of the 1 in 5 people that experience this issue, is there anything you can do to mitigate the risk factors and make your body stronger, reducing the risk of ever experiencing Shin Splints?

Well… yes!! That’s exactly what we’re going to take a look at in this episode. So let’s look in greater detail into another common running injury, shin splints…

WHAT ARE SHIN SPLINTS?

Also known as Tibial Stress Syndrome (TSS), shin splints show up in the body as pain down the lower leg, front or inner part of the shin bone (Tibia). With repetitive stress from running causing the tissues around the shin bone to pull at the insertion point of where the muscle attaches to the bone. This causes inflammation and tenderness.

The pain can be a dull ache pain, a pain that gets worse when you run possibly, tender to touch with some swelling in some cases.

Most cases of shin splints are minor and can be healed with some modification of exercise intensity allowing the area to rest and recover. Lowering volume and intensity of your work will generally see you back to your old routine in a matter of weeks.

In severe cases, shin splints can develop into stress fractures that cause long term issues such as weakness in the shin bone. This makes it more likely that stress fractures will happen repeatedly. You may have to give up running in some serious cases.

Running lots, on hard surfaces is a major risk factor. You are basically increasing the stress going through the shin bone, muscles and tendons which then increases the damage in the short term to this area, if you don’t allow adequate progression or the right volume for you then you are much more likely to suffer from shin splints. So if you’re road running a lot or you plan to increase your mileage there are some factors we need to consider to help you avoid causing yourself an injury. Shin splints are another common running injury that can be avoided. So… How do you avoid getting shin splints?

HOW TO AVOID SHIN SPLINTS

To first understand how we can avoid shin splints we need to understand what increases our risk of getting this injury. As is the case with every episode in this common running injuries series, the theme of strength training, listening to your body and not overdoing it are two main themes that run throughout most injuries.

I know it may sound boring to say the same thing each episode ‘make sure you strength train and make sure you listen to your body because you don’t want to overly stress it out but it really is that simple. If you start strength training a number of different targeted exercises to increase the stresses your body can cope with you will reduce your injury risk because your body can cope with more stress/loads.

Also, learning to understand when you are pushing too much and when to ease off in your weekly schedule is going to reduce your injury risk because your body will have adequate time to adapt to the training loads as well as the demands of your everyday life.

Let’s quickly bullet point the risk factors and then go into a bit more detail on how to mitigate each risk factor.

The main risk factors for shin splints are:

• Increasing your mileage or total training volume. More stress going through the body creates extra demand the body may not be able to cope with, ultimately something has to give.

• Poor running form. Over pronation or supination can cause the muscle and tendon tissues in the lower leg to overwork to stabilise the over-pronation or supination. This creates injury over time.

• Tight calf muscles can cause an issue in the shin because the shorter muscles on the back of the lower leg extend the muscles on the front of the leg. This stretching of the tissues on the front of the leg when running can aggravate and damage them.

• Muscle imbalance in the calf area. This is quite common as we tend to have a dominant side that is stronger due to us standing and favouring that side. When we have an imbalance in our calf area this causes bio-mechanical issues in ur running form. So, flexibility and strength of the calf area plays a prominent role in this injury.

• Being overweight is a risk factor. As I mentioned in previous episodes our bodyweight can contribute to excessive demands of muscle and tendon tissues. When we are overweight our muscles and tendons need to generate greater forces to move our body. This repetition of greater forces needed places high stress on the body which results in injury over a period of time.

• Transitioning to minimal/barefoot shoes without strengthening the feet and stabilising muscles. The transition from cushioned trainers to minimal ones needs to happen over a long period of time (3-9 months) with appropriate strengthening of the foot and stabilising muscles. Our feet are weakened by wearing cushioned trainers so we need to progressive switch to minimal, I made this error when I transitioned to minimal trainers 5 years ago. I paid for it with a lot of pain and soreness. I couldn’t run for 3 weeks after thinking I could just go out and do one of my usual mid-week 5km runs in my minimal shoes.

This list includes the most common risk factors. Some people suffer from a few of these and some people only suffer from one of these issues.

To help avoid this injury there are some general things we can do that will reduce your risk of getting shin splints. Improving your knowledge of running injuries will help give you the motivation to avoid them. We all want to run injury free don’t we? Put the work in, you’ll spend less time injured it really is that simple.

The first thing you can do to lower your risk of getting shin splints sounds really simple but it’s probably one of the harder skills to develop… Listen to your body, understand what your body is capable of and what is a realistic training load. When you know this about yourself, don’t overload your body, progressively overload with adequate rest periods. It is one of the most common things I hear from clients about how they suddenly increased their running mileage. When I hear how much they increased their running in such a short time it usually makes me cringe in fear for their body and wonder of they didn’t cause themselves more damage. This is where a tailored training plan from a professional running coach is worth every penny. We are professionals after all. As a coach this is what I deal with day in day out. Don’t pick a random plan from Google or any other running site, it’s essential you do you and not what worked for someone else.

The second thing you can do is to check your running form. This is something I say often, I know it may sound boring me repeating this regularly. There is method to my madness. If you improve your running form you are instantly going to balance out your body whilst the movement energy transfers through you, the forces going through your body will be much more efficiently dissipated and utilised. Quick shameless plug, I don’t put this in to constantly promote my services I promise but if you do need help with your running form then contact me.

Let’s get into specific exercises you can do to decrease your risk of shin splints. There are the usual single leg exercises that I’ve mentioned throughout this series that target those sleepy glutes and stabilise the hips.

Really simple exercises that will reduce your risk of shin splints are:

Heel walking - Self explanatory this one. Walk around on your heels with your toes elevated. Stay nice and tall and lifting the toes as high as you can to really squeeze the shin muscles. Do 30-50 steps, repeat this for 3 sets. You should feel a burning/working feeling on the shins. Those are the muscles we want to strengthen. So simple, it’s hard not to include this one in your training.

Calf raise walking - Walking around on your tip toes to strengthen those stabilising muscles in the lower leg. If you do this barefoot you you will gain extra strengthening benefits of the arches of the feet. You may feel the arches fatiguing or possibly even cramping if you don’t do much foot work. Do 30-50 steps as with the heel walks and for 3 sets.

Calf Raises - Another incredibly simple exercise that can be done absolutely anywhere so there is no excuse to not do calf raises. Standing tall, rise up on to your tip toes lifting the heels as high off the floor as you can get them. Slowly lower the heels to lightly tap the floor and drive them back up. Do 25-30 reps for 3 sets. Nice and simple but incredibly effective bodyweight exercise.

Toe ups - This is an exercise that the Knees Over Toes Guy obsesses about. If you’re not familiar with him, he’s an Instagram sensation with a huge following. He has suffered numerous knee issues, he puts his full recovery down to two exercises backwards sled walking and then toe ups. Toe ups strengthen those stabilising muscles along the front of the shin. To perform them, stand against a wall leaning into it keeping the legs straight. Lift the toes and dig the heels in to the floor. Lift the toes forcefully so you can feel the muscles along the shin bone working. Do 20-60 second holds for 3 sets.

Mobility work helps to reduce your risk of shin splints. You can do two stretches to the front of the shins and the big toes.

The first stretch includes kneeling on the floor with knees close together, the toes tucked under so the big toes are stretching. Then sit the hips towards the heels, if you can sit the hips on the heels without pain or discomfort then rest here. If you get discomfort, stay inside your comfort zone and build up to working towards the heels. Sit in this pose for 30-90 seconds. Do this daily.

The second stretch would be in the same kneeling position with slightly different foot position. The tops of the feet would be on the floor or the mat beneath you. Then you can slowly sit on the feet stretching the muscles along the front of the lower leg. You can continue to walk the hands back behind the hips which increases the stretch and pressure on the shins so ensure you don’t push too far. You should be able to hold for 30-90 seconds without pain or your feet tingling.

We have four specific body weight exercises that are really simple to include in your weekly training schedule as well as two very simple daily stretches to work on your lower leg mobility. Work these in to your week and you’ll stand a greater chance of avoiding shin splints.

Let’s summarise this episode. Remember, if you put the work in to be proactive it will mean you spend less time being reactive to injuries.

SUMMARY

• If you are over your natural bodyweight, reducing your bodyweight will reduce your risk of shin splints as you will be putting less force through the muscles and tendons, they will work a lot less and be able to better cope with the demands placed on them.

• If you’re currently transitioning or planning to transition to barefoot/minimal trainers please be kind to your body. I made that mistake and was way too aggressive and impatient which caused me 3 weeks of pain! Progress slowly with the switch to minimal.

• If you feel that you have poor running form, or you’re feeling aches down one side and not the other this is a good indication something is going a little wrong when you’re running. Check your form, I’m going to do another updated podcast on running form and how to improve your running efficiency. If you would like me to look at your form and help you, send me a message today. I’m looking forward to hearing from you.

• We have four specific strength exercises that will focus on that lower leg area. This will strengthen the lower leg and allow greater forces to travel through your body. Add these into your weekly training to reduce your risk of injury. When you feel like you’re making progress you can increase the amount of time you spend in each exercise, you can also increase the amount of sets.

• Work on the mobility of your lower leg which will help the range of motion you have in that area. Tight tissues tend to cause issues so let’s make them nice, supple healthy tissues. Runners tend to avoid mobility work or yoga because they find it boring. I understand it has a different ‘feel’ but it is hugely important to help keep your body in optimal health. You only have to look at elite runners and athletes that dedicate daily time to work on mobility and recovery.

I hope this episode has given you lots of knowledge on the subject of injury and specifically shin splints. The more you know, the more you are able to do to reduce your risk of injury.

Personally I obsess about the body and trying to optimise my physical and mental health so I can go deep into the details. I’ve tried to summarise as best as I can but I do love to talk about these subjects. You must have found it interesting because you’ve got this far in the episode.

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You can contact me through the following:

Email ashfoster1983@gmail.com

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Thanks for listening to the Run Better podcast, I shall speak to you in the next one my fellow runners!