A few weeks ago when I asked people what the number one challenge for beginner runners was, several people responded with injuries of various types. Amongst the most popular (wrong word, I know!) was the dreaded shin splints. As I promised at the time, I will be following up on your responses and getting opinion and expertise to help us overcome these challenges for beginner runners. So, I asked Sally Maple from Port Melbourne Physio and Pilates to give me some expert advice on shin splints, what they are, why they occur and how we can treat them. Here goes….
So what are shin splints?
It is basically a common term used to refer to shin pain experienced by runners or walkers, with the pain occurring either side of the main lower leg bone (the tibia). Usually the muscle on the outside of the shin (tibialis anterior) muscle gets tight and puts load on its bony attachment to the tibia, creating pain on the outer part of the shin. The muscle on the inside of the shin bone (tibialis posterior) can be affected too, and this is often related to over pronation of the foot, commonly known as flat feet. In severe cases of shin splints swelling can also occur, and if left untreated this can lead to compartment syndrome, which requires urgent medical attention.
I personally suffered from shin splints a few years ago and I remember that the pain was excruciating. I would get 200 metres from the house and have to turn round and come back. It was so frustrating. Having laced up my shoes, got ready and out of the door, the last thing I wanted to do was turn back, but it was just way too painful to keep going.
One runner I spoke to, Amber, had a similar experience to me. She said, "When I first started running I battled with them for quite a while. I assumed it's due to either poor form (how my foot is striking the ground), going too hard too soon or incorrect footwear (or a combination of these). It was really counterproductive - I'd go for a run then be out of action for a few days, then run again, then out of action. It was hard to make progress."
That’s a pretty rubbish experience and as Amber says, its hard to make any progress when you are not able to run! From what I have seen, shin splints are not uncommon amongst beginner runners and so imagine the number of frustrated beginner runners out there who want to improve or even just get out and run, but can’t. When I mentioned Amber’s experience to Sally, she was not surprised and said that Ambers' diagnosis was probably right.
Why do we get shin splints?
Usually we get shin splints for several reasons, and often people who are new to running will present with several or all of the following contributing factors:
1. Inappropriate footwear - running in old/worn out shoes, that have lost their cushioning, or not running in the correct type of shoe for your foot type
2. Running on hard surfaces - concrete, asphalt, i.e. pounding the pavement. When first starting to run its better to start on grass or gravel running tracks to build up tolerance.
3. Too much load too soon - going from nothing to running 5 times a week or dramatically increasing your total running distance over a week. Or if you are a regular runner but you have several weeks off while traveling or sick and then you jump straight back into your previous running load
4. Poor running technique - over striding, low cadence (steps per minute) or weak core/glutes leading you to drop your hip or cross legs over during gait will increase load I the shin muscles
5. Inadequate recovery - not cooling down properly post run (eg with a walk, stretching program/foam roller or getting into the sea water) to help your muscles recover and loosen up, will lead to tightness and overload of the shin muscles.
So what do we do when injury strikes?
One option is to use Dr. Google to find out what the hell we should do! One runner I spoke to said "I did Google a lot though and it seemed to be a common story when first starting out so I didn't think it was too serious - more annoying than anything else. I assumed that as my body got more used to running the shin splints would cease."
I asked Sally what she would suggest (aside from googling….) and she gave me a nicely crafted list of treatment options but stressed that treatment probably means addressing more than just one of these:
1. Physiotherapy - massage and dry needling to shin muscles and calves to reduce tension and take load off the shin bone. Your physio may recommend a short rest from running until acute symptoms settle down, and will advise you on stretching, recovery, strength programs etc.
2. Running assessment - this can be with your physio or running coach to determine if your running technique may be a contributing factor, and to assess for areas of muscle weakness or tightness that may be contributing, or if foot biomechanics are an issue (such as over pronation).
3. New shoes - if your shoes are old or work out, or if you're unsure if they are the right shoe type for you, a free running assessment at The Running Company in Clifton Hill is a great option. They will video your running gait on treadmill to assess foot biomechanics and determine which shoe is best to correct your biomechanics. You can then purchase the best shoe for you from them, easy!
4. Stretching program - your physio can show you the best stretches to prevent shin splints, particularly ones for your calves, ankles and hips.
5. Strength Program - if your running assessment has shown up any areas of weakness e.g glutes/core - strengthening program such as Clinical Pilates may be necessary to build up your core, improve your leg strength and balance, and therefore improve your running technique.
6. Manage running load - a supervised program with a running coach is the best way to ensure you're not overloading your muscles too quickly, to prevent injury
7. Recovery post run - make sure you stretch, use ice or walk in sea water for ten minutes post run to loosen your leg muscles and assist in recovery
8. Referral to podiatrist - if your biomechanical assessment shows a significant problem with foot biomechanics that new running shoes may not be able to address, your physio will refer you to a podiatrist for a full foot assessment and potentially orhotics.
Amber, is following the advice that Sally mentions above and said, "I had a bit of a break from running recently as I have been flat out with work and time poor. Just got started again and have been expecting a case of shin splints but so far, so good. I try to take it easy and build up distance slowly in order to avoid them. Currently including short walking breaks into my runs - even if I feel I don't need them - so that I can avoid the dreaded shin splints!"
So there you have it, a quick guide to shin splints, what they are, why they occur and how we can treat them. It is definitely one of the common injuries that beginner runners get and is one of the most frustrating injuries out there. I will leave you with the honest, truthful words of Amber, after I asked her whether her shin splints had been frustrating….
"**** yes! It was really counterproductive - I'd go for a run then be out of action for a few days, then run again, then out of action. It was hard to make progress."
I don’t want you to feel like this! If you are in Melbourne and are having issues with your shins when running, or if you're new to running and want to make sure you prevent injuries such as shin splints, contact PMPP on 96817255 or firstname.lastname@example.org to book a physiotherapy appointment with one of their highly experienced physios.
Are you ready to run? If the answer is "YES!" then sign up here for your own running coach and personalised monthly training plan to get you running stronger, longer and faster. I will get in touch straight away and we can begin working on getting your running to where you really want it to be!