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Running is a sport that requires intense physical focus and determination. It can give you time to clear your head, relieve stress, and give you some much needed time to yourself! But, as much as we want to push ourselves on the pavement, runners need to be able to listen to their bodies to determine when something isn’t quite right.
Shin splints, or medial tibial stress syndrome, is a frequent complaint for runners. We spoke to Warwick Gordon of Run 360 to get the inside scoop about what shin splints are, how they form, how to prevent them, and how to treat them. Gordon is a fully licensed member of the ISCP (Irish Society of Chartered Physiotherapists) and currently practices as a Clinical Specialist in Musculoskeletal Physiotherapy.
Shin splints can mean the difference between running a spectacular race and enjoying every step, or injuring yourself to the point of having to take time off to recover. Learn the signs and listen to your body in order to avoid the stress of a shin splint!
Shin splints occur when micro-tears form along the muscle behind the shin bone, called the tibialis posterior. The tibialis posterior is the central muscle in the lower leg and is responsible for stabilizing the lower leg.
According to Gordon, if this muscle gets overloaded while trying to control the landing of your foot as you run, little micro-tearing can occur between the muscle interface and its insertion on to the shin bone.
“There’s two reasons that this is going to happen,” says Gordon. “You’ve either got poor biomechanics putting extra strain on that tibialis posterior, or you’re loading your body too rapidly for the body to adapt.”
Poor biomechanics refers to the way that you run. For example, you might be prone to the over-pronation or over-supination of your foot when you run, that is, the tilt of your foot outwards or inwards when you run. Over a period of time, this would put a heavy strain on your tibialis posterior.
Shin splints can often plague beginning runners who build their mileage too quickly or experienced runners who rapidly change their workout regimen without giving their body time to adapt. So, if someone wants to go from running 10k per week to running a marathon and increases their mileage to 50k per week, the muscle will not have time to strengthen to accommodate the new weight.
As a general rule, beginning runners, or those trying to build their mileage, should do so gradually by about 10% per week to avoid injury.
Two occurrences that are sometimes lumped together when referring to lower leg pain while running are shin splints and stress fractures. It is important to know the difference because different problems require different solutions.
Shin splints are micro-tears along the muscle and its interface with the shin bone. A stress fracture is a fracture of a bone caused by continuous mechanical stress.
“So, if you think about holding a ruler and you bend it and bend it, it creates little white lines in it — that is a stress reaction, and your body tolerates that to a normal amount. But it [depends on] how rapidly it’s happening,” says Gordon.
“If you’ve got poor biomechanics that puts all of that bending on your bone, or you ramp up your mileage too rapidly, and the rate of that bending becomes too much, it goes from being a normal reaction [that gets] rebuilt and replaced, to [something] happening too quickly, and [the bone] breaks down and it goes from a stress reaction to a stress fracture,” says Gordon.
There are a couple of factors that can differentiate a shin splint from a stress fracture. First is location. If you press down directly on the bone with your hand and it creates pain, that is a sign of a stress fracture. If you press on the muscle and the pain occurs, it might be a sign of a shin splint.
Also, when you have shin splints, they tend to warm up with exercise. So, they can be a bit sore to start with, but as you get running, they tend to become less and less painful. But, they then become sore afterwards.
With a stress fracture, the pain will steadily escalate. You might begin your run with little pain, but the more you run, the worse it gets.
“And if it gets really bad, you’ll generally end up with a bit of night pain. Similar to what you would get with an actual fracture,” says Gordon.
“If it’s a biomechanical cause, you need to have that evaluated by a physical therapist as a minimum,” says Gordon
If you are concerned that you do not have a full grasp on what is causing your shin splints, physical therapists will be able to pinpoint what is causing your pain.
“[Physical therapists can] look higher up in the kinetic chain into what’s happening with the knee, the hip and the pelvis because there might be something that’s happening higher up that’s resulting in the shin and the foot being overloaded,” says Gordon. “Or there might be something that’s happening locally in the foot, so you have to look at all of those segments and how they’re acting together.”
If the reason for your shin splints is that you have increased your mileage too much and too quickly for your body to adapt, you might have to back off on the running. A great option to relieve the stress on your tibialis posterior is cross-training. Try cycling or swimming to get rid of some of the impact on your shin.
Gordon recommends some gentle massaging of the surrounding muscles to alleviate some of the pain. To get to this hard to reach muscle, he suggests sitting with your leg crossed up on the other knee and then rubbing your thumb down the tibialis posterior (behind and around the shin bone) to gently knead into the tight bands. Also, ice the affected area for 10 to 15 minutes after your run. Repeat this step about every two hours.
To stretch and strengthen the muscles around your shin, try these exercises.
By Bri Doherty
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