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Running injuries are at best painful and at worst require physical therapy and time off from running. Shin splints are a really horrid-feeling injury that can take us off our feet completely, and are especially common when we first start out.

If you’ve been feeling stabbing shin pain, read on while you rest those legs. Sports scientist and footwear specialist Emma Kirk-Odunubi tells us how we can prevent them in the first place, and what to do if you’ve been experiencing them.

Quick shin splints facts

• Injury name: Shin splints
• Area affected: Shin and calf
• Time off from running: 1-6 weeks
• Recovery period: up to 8 weeks

What are shin splints?

The term ‘shin splints’ can be commonly used to identify pain on the shin bone. The technical term for this is the tibia. It is one of the most common injuries experienced by runners, and is especially prevalent in newbies.

What are the symptoms of shin splints?

Initially, you’ll likely feel a persistent ache along the inside of your shinbone during or after a run. Early on, the pain might disappear with rest. If you keep running on it, it will start to linger after runs as a dull ache. The affected area may also feel tender to touch.

Shin splints vs feeling sore

If you’re new to running, it can be easy to confuse shin splints with general muscle soreness. However, shin splints could lead to a more serious injury if not immediately noticed. How can you tell? While both might leave you wincing as you walk up and down the stairs or sit down, muscle soreness will be felt only in your leg muscles. Shin splints are felt on the front, lower portion of your leg.

Shin splints or stress fracture?

Another injury shin splits are sometimes confused with is a stress fracture. This is also known as MTSS (Medial Tibial Stress Syndrome), and is also sometimes referred to as shin splints. MTSS is exercise-induced pain along the lower end of the medial tibia (inner shin bone). You will be able to feel the pain if you press along the inner shin over a 3-5cm area.

To make sure that you treat the correct injury, it’s important to see a physio to identify your specific issue. If you’ve ruled out bruising or stress fractures, there’s a good chance that the discomfort you’re experiencing is shin splints.

What causes it?

There are a whole host of things that can contribute to shin splints. Ultimately, it usually occurs when we have a muscular imbalance, especially when we’re first starting out on our running journey. Here are some things that can contribute to it:

• Over–pronation
  When your foot makes contact with the ground, the foot moves through a ‘pronatory’ movement. This movement isn’t inherently bad, but over-pronation results in more stress on the tissues, ligaments and tendons further up the leg, which can lead directly to shin pain.
• Incorrect footwear
  If you’re a new runner, you might not have invested yet in a great pair of running trainers. If you’ve been running for a while, you might not have replaced your trainers yet. A lack of proper cushioning, either by design or by wear, can increase impact on the shin bone.
• Overtraining
  Increasing our training load too quickly puts a huge amount of physical stress on our bodies, and our shins often bear the brunt of this. This might be adding distance too fast, or doing too many runs in quick succession.
• Lack of strength training
  Muscles work in pairs. If there is an imbalance in the strength or function of one of the muscles, then issues can occur. Most of us need to be doing strength training alongside running to fix those imbalances.
• Excessive stride
  When you run, you need to make sure your leading leg doesn’t stride too far out in front of your body. The further in front that your leg strikes the ground, the more ground reaction force is absorbed by the body. The shin bone is often where this force is concentrated, which can lead to pain.

How do I avoid shin splints?

As with all running injuries, this will depend on the why we got the injury in the first place. Usually, a combination of the following things will help with shin splints:

• Reducing pronation
  This can be done via insoles that are shaped to help keep our feet more stable as we run. If you’re hoping to run for a long time, I’d highly recommend foot strengthening exercises to reduce the amount that you pronate in the first place.
• New footwear
  Whether you’re a new runner or need a new pair of shoes, go and treat yourself to a proper fitting and gait analysis. Our running form can be improved massively by the right pair of running trainers.
• Strength training and stretching
  Generally, strength training and proper stretching is always a good idea. Specifically, you need to work on your lower leg strength.The tibialis anterior sits along the front of the tibia and its key role in running is to slow down the plantarflexion of the foot on initial contact. If the muscle on the back of a calf is too tight, this will force the muscle on the front (the tibialis anterior) to work harder. In simple terms, making sure that both legs are equally strong will help keep shin pain at bay.
• Manage your training load
  If you think that overtraining is at play, you need to have a look at how much running you’re doing. If you’re just starting out, be sure to follow a proper training plan for beginner runners, which will make sure that you build your intensity in a sustainable way. If you’re following a training plan for a race and shin splints have popped up unexpectedly, you might need to try a different plan with a lower total mileage or distance.
• Build toe strength
  Your big toe joint is the strongest lever in the foot when used effectively. It is very common for big toe joints to be either hyper-mobile or immobile, both of which can cause muscle imbalances and weaknesses. Working on the mobility and strength of your toes and feet is crucial in reducing shin pain. Use exercises such as towel grabs to strengthen the toes, and make sure that you mobilise and roll out your feet and toes regularly.

Is it bad to run through shin splints?

Unlike other running injuries, the pain caused by shin splints is sometimes bearable enough to carry on running. But this doesn’t necessarily mean you should. As shin splints are an injury caused by a repetitive movement, it’s key that this movement is removed in order to help them heal.

Most physios and medical professionals will recommend rest in order to combat the issue. During this time, you can use cross training methods such as cycling or swimming to stay on top of your training without the impact of running outside.

Running while suffering from shin splints is not advised since this would put more strain on the leg muscles, cause extra discomfort and damage, and could even result in a stress fracture of the shin bone.

How to treat shin splints

As with all running injuries, it’s a good idea to consult a physiotherapist to ensure proper treatment of your pain.

Generally, most physios will recommend resting until your shin splint pain goes away. They may also say that you can do other, low impact activities such as cycling while you recover. Once the pain has subsided, consider all of the above causes and make any changes necessary before you head back into your running schedule. They are likely to reoccur if you don’t make changes.

How can I prevent them?

Here are two great exercises to prevent shin splints:

• Tibialis anterior raises
  Stand with your back against a wall, walk your feet out about half a metre from the wall. Keeping your legs straight, raise your toes off the ground while keeping your heels down on the ground. This engages the shin muscle and will help increase lower leg strength. Perform three sets of 10-12 reps to start with, and then increase to 20 reps per set.
• Eccentric calf raises
  Place a tennis/lacrosse ball between your heels. Move into a calf raise and keep the ball between your heels. Lower back down to the floor for a slow count of five. Repeat this 15-20 times over two or three sets. This will encourage you to use your big toe joint while giving calves some much needed strength. Increase the range by doing it on a step and dropping the heel further.

Can poor running form cause shin splints?

Heavy Heel Striking

Running with a strong heel strike can cause increased dorsiflexion, which increases the activities of the foot and anterior leg muscles.

The stride of a heel striker is generally longer and the knee is extended. This can result in overuse of the muscles and stress on the bone, which can cause pain in the front of the leg.

Tight Calf Muscles

Tight calf muscles are one factor that contributes to forceful heel strikes. The gastrocnemius and soleus muscles, which go along the back of the lower leg, make up the calf muscles.

The range of motion of the ankle and heel is affected if these are tight, which in turn causes tightness in the Achilles tendon. Running requires more energy when these areas are excessively tight, which increases leg strain and pain.

Overpronation

Running with inward-rolling ankles, otherwise known as overpronation, can lead to shin splints because these movements twist the tibia. This overstrains the muscles along the tibia and causes inflammation in the muscles at the front of the lower leg.