Many runners have experienced shin splints at some point during their running years. I had it a couple of times in high school during track season and it put me on the sidelines. It was very uncomfortable to run. And, on some days, it was even uncomfortable to walk.
Some have only experienced shin splints once while others have recurring episodes. Some are able to continue running while others are stopped dead in their tracks because it’s far too painful to continue running.
What are Shin Splints?
Shin splints are also known as medial tibial stress syndrome. It presents as pain along the front or inside of the shin bone (tibia). Shin pain can be due to a number of things, including
- Tibial stress fracture
- Compartment syndrome
- Imbalance in lower leg musculature
- Excessive pronation of the foot/ankle
It’s important to figure out the cause of your shin pain because not all of the above conditions are related to shin splints. And treatment is very different for each.
A stress fracture is not shin splints, but pain can be similar. So if you’ve tried treating the shin splints, but it’s not improving, you may want to look further into a stress fracture. It is confirmed with x-ray or MRI. Stress fractures need to be unloaded with crutches and/or a boot. And you definitely need to stop running.
Compartment syndrome is also not shin splints. The condition is caused by excessive pressure in the lower leg compartments. The pain typically only presents itself with exertion and can be extreme. In severe cases, surgery is needed to release the compartments. My wife actually had this condition in high school and needed all 4 compartments released in both legs to relieve symptoms.
The imbalance refers to the muscles in the front of the lower leg and the muscles in the back of the lower leg. The theory behind the muscle imbalance is that the imbalance results in muscle being pulled off of the bone. As you can imagine, this results in inflammation and pain. This typically occurs when runners progress their running too quickly. Remember, you need to give the body time to adapt to the stresses of running. This is particularly true for newer runners. It takes new runners longer to adapt to increasing mileage and intensity.
Pronation refers to the natural rolling in of the foot and ankle. Excessive pronation or over-pronation means that the foot and ankle roll in too much. This causes increased stress along the tibia, which can result in shin splints. Check out this post on foot and ankle biomechanics for more information.
Treatment for Shin Splints
Depending on the level of pain, you may need to stop running, especially if the pain is severe and gets worse with running. For a case that is not as severe, you may be able to continue with running. However, you’ll want to decrease mileage and possibly run on softer surface.
Determining whether you can continue to run depends on what the pain does while running. If the pain gets worse during, you need to stop. The body is letting you know that you’re causing damage. If the pain is there but doesn’t increase, you can continue but proceed with caution. This is not the time to be doing long runs and hard workouts.
And remember, always gradually increase mileage, especially when returning from injury.
Exercises will depend on the cause of the shin splints. For people with shin splints, I typically find tightness in the gastroc/soleus (muscles in the back of the lower legs). I also find weakness in the hips. The tightness in the gastroc/soleus muscles places direct stress on the tibia. Weakness in the hips indirectly causes stress on the tibia because it can cause the leg to collapse too far inward (over-pronate).
Here are some stretches for the gastroc and soleus.
If you want to truly lengthen the tissue, you need to hold the stretch 3 minutes and perform that 5-6 days per week. And need to maintain that for 10 weeks. Otherwise, you’re not changing the tissue length.
Foam rolling the lower leg muscles is also helpful. Here is a good one for the gastroc and soleus.
Check out my post on static stretching and foam rolling for more details
Don’t forget about the strengthening component. Like I said, I find many with weak hips. If you don’t address this issue, you’ll continue to have lower leg problems. Check out this post for some good hip strengthening exercises.
Cross training is an effective way to maintain cardiovascular fitness in the event that running isn’t possible or needs to be reduced. There are many different types of cross training options, including elliptical, cycling, rowing, swimming and aqua jogging. Choose one that does not increase pain. This may mean going with one that has no impact like swimming or aqua jogging.
Inappropriate shoe wear or broken down shoes can contribute to shin splints. If you have more than 300-500 miles on your shoes, you may need to look into another pair. Or if you’re in minimal shoes or shoes with a low heel drop, you may need to consider if you they’re appropriate for you.
If the exercises and/or shoes are not helpful or only moderately helpful, that’s when I start to look at orthotics. Check out the truths of arch support for more information regarding orthotics.
If you want even more information on shoes and orthotics check out the running shoe series. I also have an ebook for sale that goes into more detail.
Taping or compression of the lower leg can also be helpful. The compression allows support for the inflamed area and can give significant relief. Keep in mind that this does not fix the underlying cause though. Use to help with pain, but not to fix or mask the problem. Compression taping, compression socks and even kinesio tape can be helpful.
You may need to look at your running form and make some adjustments, particularly if you tend to over-stride. Increasing your cadence will help reduce the load on the lower leg. If you want some additional information on running form check out this post.
Icing and anti-inflammatory drugs are also commonly used to help with the inflammation and pain. However, don’t depend on these to get you through a workout.
Unfortunately, it’s hard to say how long recovery will take. It all depends on how well you rest and what is causing the problem. I’ve seen runners ready to go at 4 weeks, but I’ve also seen it take 3-4 months and even longer.
Keep in mind that you’ll probably need to address multiple areas to treat this condition. Just stretching or just strength training does not usually resolve everything.
Many runners, myself included, find it very difficult to stop running. Keeping the mileage up and continuing to do hard workouts will prolong the recovery, even if you’re addressing the problem with exercises, shoes, etc.
Seek Help If Needed
If you’re having a hard time resolving the issue and you’ve ruled out a stress fracture and compartment syndrome, it may be time to see a physical therapist. We have additional tools, including our hands, that we can use to improve the healing time. We also provide that outside view of your movement patterns that may be contributing to the pain. So don’t feel afraid to reach out to us!
Remember to give your body time to heal. The human body is truly amazing at healing itself. You just need to give it the opportunity.
Join the Team
Subscribe to get the latest news by email