By: Carleigh High, BS, SPT
You’ve established a running schedule and are sticking to it. It’s tough but you can feel it getting easier as you progress. Then one day you notice an ache in your shins, but it’s not bad so you continue with your plan. Over the next few days the pain gets worse and now it really hurts to run. You don’t want to admit it but you hear yourself saying “I think I have shin splints.”
What are Shin Splints? ‘Shin splints’ is a generic term to describe any pain in the lower leg, often pain caused by repetitive impact. ‘Shin splints’ can include many different diagnoses including muscles strains, tendonitis, stress fractures, artery entrapment, and compartment syndrome (Beck, 1998). Most often, however, shin splints refers to medial tibial stress syndrome (MTSS; see description below), but given the wide range of possible causes it’s important to consult your doctor if there is concern for other serious pathologies.
MTSS is a strain related injury due to repeated tibial bending and affects 5%-35% of runners (Newman, 2013). While new or returning runners are often the victims of these types of injuries, veteran runners can also suffer from MTSS.
Now What? If you have shin pain it’s important to speak with your doctor to first rule out any injuries requiring further medical attention. More often than not the healing process involves some rest. REST? This is a tough word for runners to hear, and an even tougher one to follow. Eating well and getting enough sleep often help your body to recover quicker, and depending on the cause of the injury orthotics, splinting, shoes, and muscle training may also help. The use of compression socks is another option that can help recovery. While every situation is different, Newman reported “recovery to the level of presymptomatic running volumes took 6-10 months” and that is a long time for any runner to rest.
Can I prevent it? Currently, the specific risk factors associated with MTSS are inconclusive, yet Newman reminds us that “conditioning of neuromuscular and bone adaption systems is clearly important within current understanding about the pathology of MTSS.” To help our bodies adapt to the various demands and stresses of running it’s important to begin slowly and work to incorporate any drastic changes. The 10% rule is a common method of slowly increasing mileage to allow the body some time to adapt. This rule recommends not adding more than 10% of your previous week’s mileage to your next week’s mileage. Cross training and other activities besides running often help the body be better able to adapt and can actually lead to stronger running. Rest days are also crucial in order for your body to recover and get stronger for the future.
Moving Forward be sure to establish a training plan that works to build towards your goals, but don’t be afraid to change or modify it as the need arises. Learn to listen to your body, it can tell you a lot.
Beck, Belinda. Tibial Stress Injuries An Aetiological Review for the Purposes of Guiding Management. Sports Med 1998 Oct; 26 (4): 265-279.
Newman P, Witchalls J, Waddington G, et al. Risk factors associated with medial tibial stress syndrome in runners: a systemic review and meta-analysis. J Sports Med. 2013 Nov; 4: 229-241.