As Marathon season approaches, many people are excited to begin their long-distance training. However, one of the most common concerns among runners is how to prevent shin splints. Shin splints are a common injury that can occur during long-distance running. Unfortunately, many people are unaware of what shin splints are, how they develop, how to treat them, and most importantly, how to prevent them. In this blog, we will discuss the two different types of shin splints, what causes them anatomically, effective treatment options, and how to prevent them if you plan to start a running program. We aim to help you stay healthy and keep you moving.
First, let's start with the two types of shin splints: anterior or posterior. The difference between them is the location of pain, which is caused by the specific muscle group affected.
Anterior Shin Splints:
Anterior Shin Splints tend to be more common and involve pain along the front (anterior) part of the shinbone, typically on the outer edge.
Anterior shin splints affect the muscles at the front of the lower leg, primarily the tibialis anterior muscle. This muscle is responsible for dorsiflexion of the foot (bringing the toes upward) and is heavily involved in activities like walking, running, and jumping.
Posterior Shin Splints:
Posterior shin splints involve pain along the inner (posterior) part of the shinbone, closer to the calf muscles.
Posterior shin splints primarily affect the muscles and connective tissues at the back of the lower leg, including the posterior tibialis muscle and the flexor hallucis longus muscle. These muscles play a role in controlling the movement of the foot and stabilizing the arch.
Now that we know the two different types, what actually causes shin splints?
Shin splints are caused by repetitive stress on the shinbone and the tissues that attach muscles to the bone. For instance, during long-distance running, the muscles on the front and back of the shin bone contract every time your foot hits the ground. This can lead to irritation or inflammation where the muscles of the shin connect to the bone. The irritation and inflammation cause sharp pain during physical activity and impact, and sometimes a dull ache after exercise. The area of pain is usually a couple of inches and can be sore to touch. However, it typically improves with rest and doesn't usually show signs of swelling.
If you do notice any swelling or if rest doesn’t improve your symptoms, it is important to speak to your GP or physiotherapist. Sometimes, shin splints can be mistaken for a stress fracture and requires different treatment.
So what are the major contributing factors causing Shin Splints?
Overuse or Overtraining: Rapidly increasing the intensity, duration, or frequency of exercise, particularly high-impact activities like running, can strain the muscles, tendons, and bone tissue in the lower leg.
Biomechanical Issues: Flat feet, improper footwear, or irregularities in running or walking gait can lead to uneven distribution of stress along the shinbone, increasing the likelihood of shin splints.
Muscular Imbalances: Weakness or tightness in certain muscles, particularly the calf muscles and those surrounding the shinbone, can disrupt proper biomechanics and contribute to shin splints.
Hard Surfaces: Exercising on hard surfaces, such as concrete or pavement, can exacerbate impact-related stress on the lower legs.
How Do I Prevent Shin Splints?
Strength Training: If you're someone who runs long distances, it's important to start a strength training program that includes ankle and calf strengthening exercises. This is your first line of defense, as building strength will make you more resilient and better able to handle stress and strain without getting injured. For injury-specific exercises, we recommend speaking with your local physiotherapist as exercises can vary depending the type and severity of your shin splints.
Soft Surfaces: Mix things up by running on softer surfaces such as trails instead of just on concrete or pavement. Trails provide more cushioning and put less stress on the lower leg muscles. You can also try using a treadmill, although for longer distances this isn’t always everyone's favourite.
Good Footwear: Invest in good footwear that provides proper arch support, especially if you're prone to shin splints. Visit a local running store to get fitted for shoes that are best suited for you.
Insoles: Consider using insoles if you have flat feet and have experienced shin splints in the past. Insoles can support the arch of your foot and reduce the load on the muscles in the posterior shin, lowering your risk of developing shin splints.
Running Assessment: Consider getting a running assessment to check your technique. Most physiotherapy clinics offer assessments where they record you running on a treadmill and review the components of your gait and any biomechanical factors that may be contributing to your shin splints. This typically results in a treatment plan and exercises to address the underlying issues.
What happens if I already have shin splints? How Should I treat them?
Recovery from shin splints requires patience and usually a multifaceted approach:
Rest: This is the most important but everyone’s least favourite option. You must reduce the volume and load on the lower leg muscles to allow them to recover. This may be reducing your running distances to a more manageable level or temporarily halting impact activity to reduce pain. Your physiotherapist will help explore options with you to decide what path will work best for you and your training.
Ice Therapy: Applying ice packs to the affected area can help alleviate inflammation and pain. Aim for 15-20 minutes of ice therapy several times a day.
Strength Training: progressive strength training for your calves, the muscles of the anterior shin, arches of your feet and outer hip are beneficial while you “rest”, they can help increase resiliency of the injured muscle groups so return to activity doesn’t result in another flare up. For injury-specific exercises, we recommend speaking with your local physiotherapist as exercises can vary depending on the type and severity of your shin splints.
Gradual Return to Activity: Once the pain subsides, gradually reintroduce activity, paying attention to proper form, footwear, and surface. A Return to Run Program is always a smart choice, there are great ones all over the internet and your physiotherapist should be able to guide you. Slow progressions are key!
If you or someone you know is struggling with shin splints, or have had shin splints in the past and want more prevention tips, book an appointment with one of our physiotherapists. You can book online at www.portalberniphysiotherapy.ca or call us at 250-723-5112.