- My second post is here! Actually, this will be my first actual post. My first post was more of an introduction but I am excited to post about an actual injury that plagues many, not only, runners but athletes as well. The infamous “shin splints”. The lower leg pain that many people do not understand why it happens to them. I even had a patient today tell me about one of her other friends that was trying to give her some tips on how to treat shin splints but her friend also mentioned that they really never go away for as long as you are running. First and foremost I want to let everyone know this is completely false information. Before I dive into how “shin splints” can be treated, fixed and prevented I would like to get into the word itself.
“Shin splints” as most people call it, is typically referred to as a lower leg pain that occurs when you first start running. It is common to get an injury like this in the running community most often. In my line of work my fellow AT and I prefer not to call any type of lower leg pain “shin splints”. We see that it is too often mistaken for other types of lower leg pain or injuries that occur with people who run a lot. There are so many types of lower leg injuries that they all could not be categorized as “shin splints” because it is too relative of term to be used for completely different types of lower leg pain. If anything, the one type of lower leg injury that I would have to refer to as a shin splint would be the pain and tightness that many runners begin to experience on the front lateral (outside) part of the lower leg. Still, I’d like to refer to this type of injury as a tibialis anterior strain or even a type of biomechanical overload of the tibialis anterior muscle.
The tibialis anterior muscle is that same muscle that gets really tight and painful on the front lateral side of the lower leg that people like to refer to as “shin splints”. This muscle becomes tight and irritated with a certain type of gait. Gait for all of you common non medical folks is how you walk, run or ambulate moving forward. A very common running gait that people make the mistake of doing is an overstride heel strike. Now do not go and tell everyone that heel striking gait is bad this is a very common misconception. Heelstrike is where your foot is pointed up in dorsiflexion and hits the ground with the heel first then rolls through, most people walk this way. A lot of people attribute heel strike to being a bad way of running but it is not, it is more about where you land with that heelstrike. In my clinic it is probably most common with heelstrikers to overstride which is the foot placement out in front of your body making a really big stride out in front of you center of mass (CoM). A lot of fancy words here to describe this kind of gait but you can refer to the pictures for a reference. You could always google or YouTube overstride and heelstrike but it might lead you to some rabbit holes on why heelstrike is bad but it could help identify if this is your problem.
Now then, overstride has been shown to be an improper manner of running that leads to many running injuries because of the impact forces it has on the body. These can lead to so many injuries and the most common one is the “shin splints”. Again, heelstriking is not a bad thing but if you suffer from the strain on that anterior musculature then you might want to switch to a midfoot running style. Midfoot running is when you land right in the middle of your foot where your arch is and the foot is completely horizontal when you hit the ground. This type of gait unloads that strain on the tibialis anterior and can even help you avoid overstriding in the process. By not picking up the foot up into dorsiflexion you avoid using so much of the tibialis anterior muscle and should be able to run pain free. This is not always an instant fix but typically solves the “shin splints” dilemma. Depending on severity and training regimen it may take some time to get used to it and you can even film yourself to see if you still overstride and heelstrike. Special note, when you start running midfoot you are going to find that the muscles in the back of your lower leg will be incredibly sore the next day or two. This is normal but these muscles can take more load than the tibialis anterior muscle and a foam roller and some stretching will also help with the soreness.
As always if you have any questions, complaints or concerns feel free to leave a comment and I will answer as soon as I am able to. Hope this helps with those who suffer from “shin splints” and if it does not you may be having another issue at hand so don’t hesitate to see your healthcare professional before it gets worse.
– SA running ATC (athletic trainer certified)