“This year will be different”, you told yourself. You started out the summer eager to get back into the running scene.  It’s been years since you’ve been running but you’re feeling encouraged seeing the runners trotting along the coast, and who wouldn’t want to be outside running in the summer sunshine? So you pulled your old running shoes out of the closet and got your running playlist cued up and you were off.  In just a few weeks you feel some discomfort and pain at the front of your shins. You think, “Running is fun they said, but why do my shins hurt”.  

If you’re a runner yourself you most likely can relate to this common overuse sports injury called medial tibial stress syndrome (aka Shin Splints).  Incidence rates for shin splints range from 4% to 19% in athletic populations and 4% to 35% of military population.  It’s very typical for people to experience symptoms of shin splints and then they rest and it goes away...until they decide to return to running again. Let’s take a look at the ‘blueprint’ of the symptoms and contributing factors for this overuse injury and learn how to resolve your symptoms for good!

Symptoms and Simple Self Diagnostic Tests:
Symptoms of shin splints are felt primarily in the lower ⅓ of the tibia bone (shin) on the inside.  When determining if your symptoms are shin splints you can identify this through palpation, hop tests, symptom behavior.

Palpation- palpation is intentional touch to the body, in this case the bone and muscle.  It’s commonly tender and sore to touch along a portion of the middle tibia (shin bone). If your symptoms are more specific to one location this may be indicative of a tibial stress fracture - which you should see your doctor for further follow up. 

Hop Test - hopping on one leg, if you experience soreness but no pain in the same spot that was palpated, this can provide additional information for diagnosing. So if you have shin splints and you hop up and down, it probably won’t hurt, but if you have a tibial stress fracture that’s developing, that will hurt. Which you should hold off on running until further follow up with your doctor.

Symptom Behavior - As simple as it may seem, being able to identify when symptoms occur, how and where you feel them and how long they last can provide loads of information on your potential injury and areas of involvement and give feedback on the direction to go for resolving symptoms.

• Beginning of a run feels stiff or painful and then warms up later in the run tends to be typical for more acute or “new” in the grand scheme of symptom development. 
• If your leg and symptoms don’t appear to “warm up” throughout the run this can indicate more of a “chronic” long term overuse injury. 

After completing these self diagnostic tests and you believe your symptoms are still shin splints, it’s time to consider what could be some contributing factors or causes to your symptoms.  It’s one this to identify symptoms and name them with a diagnosis, but if you want to reduce the symptoms and make lasting changes to return to activity pain free, finding the root cause of the problem is very important. 

The 3 main contributing factors for developing shin splints are: 

• Training Volume
• Running Technique
• Strength and Mobility

Dramatic Increase in Training Volume:

If you have recently begun a running training program and increased your running frequency, time running, running intensity, terrain or any combination of these can be a contributing factor. 

We recommend for some runners that reducing the load strategically can be helpful for symptom management. Now this doesn’t mean laying on the couch every day eating bon-bons and it’s also not saying maintaining your same mileage and reducing it by 1-2 miles to say it’s “less” than before.  If you’re in need of further guidance on how to strategically train with your symptoms, reach out to a trusted physical therapist. 

 Running Technique: 

Running requires a lot of repetition and when your technique is less than ideal, overuse injuries and unwanted nagging pains can occur. For many runners who develop shin splints it’s during the heel strike or stance phase of the gait cycle because the anterior tibialis tendon cannot absorb deceleration forces.  This can be seen when there’s an increased tightness of the calf muscles which will increase forces of the anterior tibialis tendon and can be magnified in uphill running.  It also can be more challenging during downhill running because of the demand of  increased eccentric forces to control the forefoot loading. Getting a running analysis can be helpful for a trained professional and movement specialist with a trained eye to observe your running techniques and mechanics. It’s invaluable when you have knowledge of how you’re moving and are given the tools for form training, A lot of the time it’s subtle to the average eye but can make a huge difference with little cues or tips to be more efficient.

Side Note: Consider your shoes and the number of miles you’ve run in them. It’s recommended to replace your shoes about every 350 to 500 miles (560 to 800 kilometers).

Strength & Mobility:

The strength within your ankle and lower leg can be a piece to the puzzle, plus your thigh muscles (quadriceps and hamstrings), hip muscles and core strength can contribute to developing symptoms of shin splints.  When our bodies lack strength for a particular movement or muscle the body finds a way to compensate and continue to make it happen, even if it’s inefficient or incorrect.  Initially we may be able to get away without pain or injury but overtime those muscles can be overworked and the muscles that we’re less strong to begin with continue to remain weak.  Seeking out a trusted physical therapist or strength coach to build a customized program specific to you and your needs will bring your running to a whole new level. 

 Calf Smash

A helpful place to start is with soft tissue through the calf complex. Be mindful to avoid aggressive soft tissue and foam rolling over the tender areas of the shin bone. 

Anterior Tibialis Muscle Stretch

  In summary, shin splints occur when there’s training errors such as dramatic changes in training volume, not ideal running mechanics and strength and mobility deficits. Remember, you said “This year will be different”. The good news is with this blueprint you have more information to equip you with smarter training and where to seek the guidance to get rid of these injuries for good and you can make this the year your running will thrive without pain, you’ll build strength and confidence as you take on the rest of this year in stride. 

Don’t wait to live your best life, we’d love to help you reach your goals and be a part of your transformation!

Most people don’t know how to stay healthy and fit without getting hurt. At Inside Out Strength and Performance we provide a clear plan to get you in the best shape of your life, without getting injured, so that you can be active and confident that you’ll feel your best for years to come.

We help North County San Diego’s active adults and runners dealing with pain or injury get back to living a pain-free, strong, and confident life.

We are the Strength Docs who help active adults and runners live a strong, confident, and pain-free life. Fill out our contact form here to get a clear plan and get started.