Shin Splints from Running – The (Almost) Complete Guide
What are shin splints?
“Shin splints” is a term that is used for any type of pain in either the front. side or the back of the lower leg. Shin splints from running is the most common cause of shin pain, but joggers and walkers can also develop shin splints or shin pain because of the repetitive stress placed on the lower legs.
What causes shin splints?
Shin splints are usually due to “too much, too soon” or the body not able to adapt and recover from the repetitive impact from running.1 2 There are several types of shin splints, based on the location of the pain.
Runners can develop shin splint pain if they:
- Increase their running mileage too quickly
- Run on a surface that is excessively sloped to one side
- Run on hard surfaces like concrete
- Run on uneven surfaces (poorly paved road or trails)
- Have overpronation where the arch of the foot collapse and the shin rotates inward (medially)
- Run too many hills
- Have running shoes with less cushion or support
- Have a prior lower leg injury
Medial Tibial Stress Syndrome Shin Splints
Runners that have pain in the inside part of the shin usually have Medial Tibial Stress Syndrome (MTSS) which is do to inflammation and irritation of the muscle (medial soles) that attach to the tibia (larger shin bone). With the repetitive impact from running, these muscular attachments can cause micro-tearing when the muscle attaches to the bone. If the micro tears don’t have a chance to heal, and more micro tears occur, then more pain can occur.
Anterolateral Tibial Stress Syndrome Shin Splints
If the shin pain is on the outside or front of the shin, then usually the anterior tibialis muscle attachment to the tibia is the source of the pain. The mechanism is the same as with medial tibial stress syndrome (microtearing at the attachment of the muscle to the bone).
What else can cause shin pain in runners?
Stress fractures, which are micro-fractures in the tibia, can also cause shin pain in runners. So it’s important that if you think you have shin splints and they are not getting better with treatment, or if your shin pain is getting worse, that you see a sports medicine specialist to make sure that you don’t have a stress fracture in the tibia.
Because of the way the body loads weight on the tibia, a tibial stress fracture can require a substantial amount of time off of running and on crutches. IF you have a stress fracture, its also important to have a physical therapist or running form expert look at your running stride and biomechanics to see if there are changes you need to make to your running stride to prevent future stress fractures or other running injuries.
Your doctor may also want to test you for osteopenia or osteoporosis, which is low bone density if you have a history of recurring stress fractures. Osteopenia and osteoporosis are more common in women, but also can be found in men, and it’s important to treat the underlying cause of the low bone density.
Chronic Exertional Compartment Syndrome
Chronic Exertional Compartment Syndrome 3 (CECS) and Popliteal Artery Entrapment Syndrome (PAES) are two rare causes of leg and shin pain in runners that are due to either compression of the popliteal artery in the back of the knee or by increasing pressure in one of the four soft tissue compartments in the lower leg. Both of these conditions can be difficult to diagnose since the runner usually only has the pain or symptoms while running, but as soon as they stop running, blood flow improves or the swelling the soft tissue compartment improves and the symptoms go away.
Sciatica or herniated disc causing shin pain
Sciatica or a herniated disc can also cause referred pain into the leg and can sometimes mimic the pain from shin splints as well. So it’s important to have a good sports medicine specialist on your team to help figure out these potential problems if you are not getting better.
You can find a primary care sports medicine doctor in your area thru the American Medical Society for Sports Medicine (AMSSM) website.
Do I have to stop running with shin splints?
You don’t necessarily need to stop running if you have shin splints, but you do have to monitor your pain and may need to limit how far you run or how often you run. It’s also important to work on proper running form while dealing with shin splints so that they don’t happen again.
What are the best treatments for shin splints?
I usually separate the treatment of shin splints from running into the “Acute Treatment” and then “Prevention” phases. In the acute treatment of shin splints, we are trying to reduce the pain and inflammation from the micro-tears in the muscular attachment to the tibia.
Acute treatment of runners’ shin splints
This initial acute phase treatment of shin splints usually means decreasing your running mileage, using ice to reduce inflammation after a run, and working on specific stretching exercises on the leg muscles.
Ice massage for shin splints
Applying ice for ten to fifteen minutes to the shin after a run can help decrease the pain and inflammation.
Trigger point massage for shin splints
Trigger point massage is another helpful method for treating shin splints and uses a massage ball to apply pressure on tight muscle areas. You can do the trigger point massage with a massage ball or with a foam roller or massage gun.
A massage gun can be helpful for proving consistent pressure on the shin muscles if you feel you can’t properly foam roll the shin muscles.
Myofasical release by a provider trained in Active Release Technique (ART) can also be helpful in the acute treatment of shin splints.
Prevention Phase for Shin Splints from Running
The prevention phase for shin splints from running and then looking at improving running form and adding strengthening exercises. The strengthening exercises are not only for the muscles in the lower leg but also for the thighs and glutes as well.
I’m a big fan of using There-a-bands or stretch cords to help strengthen the tibialis anterior in the front of the leg as well as heel raises to strengthen the calf muscles as well.
How long does it take for shin splints to heal?
If you’ve just started having pain or shin splints from running, and take action quickly, you may only need to cut back on your running for a week or so. However, in most cases, since the shin pain is chronic, it can take from four to eight weeks to get back running pain-free after shin splints.
How to use kinesio tape for shin splints
Some runners have had success with using Kinesio (or KT-tape) for their shin splints from running. Although the research on how effective taping is for shin splints is a little mixed, I’d still suggest trying the kineso tape for a week to see if taping makes a difference for you.
Using compression sleeves for shin splints
Compression sleeves are another option for runners dealing with shin splints and compression sleeves have become more popular in runners over the last five to ten years. Compression sleeves decrease muscle vibration while running as well as adding some compressive forces to the lower legs. The combination of the decrease in muscle vibration and compression may slightly change running biomechanics 4 and is thought to possibly be the reason why some runners that wear compression stocking have decreased pain after running.
Do I need new running shoes because of my shin splints?
If you are still having problems with shin splints, you may want to try a different pair of running shoes that give a little more support and prevent over-pronation of the foot and rotation or twisting of the shin. If you have never been fit for a pair of running shoes, its probably time to head to your local running shoe store.
The best exercises for shin splints from running
The best exercises for shin splints from running are exercises that strengthen the tibialis anterior and the calf muscles. There are several exercises that can strengthen these muscles:
Calf raises are done to strengthen the soleus and gastrocnemius muscles in the calf. Start off with doing the calf raises on both feet and as you get stronger, you can start doing the calf raises on one foot on each side. Try to do three sets of twenty calf raises.
For an advanced version of the calf raise for shin splints, use a weighted back pack or hold dumbbells in your hands as you perform the calf raises. At the gym, you can also use either the seated or standing calf raise machine. The seated calf raise machine will focus on the soleus muscle while the standing calf raise machine will target the gastrocnemius muscles.
Ankle Dorisflexion Exercises
The ankle dorsiflexion exercise helps strengthen the tibialis anterior muscle in the front of the shin. You can do the ankle dorsiflexion exercise either with bodyweight or with a resistance band.
To do the bodyweight ankle dorsiflexion exercise, stand on the step of the stairs as if you were going to walk down the stairs. Keep your heels on the step, but the rest of your foot off the edge of the step. Slowly point your foot down towards the next step and then bring the toes and foot back up by extending and then bending at the ankle.
Start the step ankle dorsiflexion exercise on both feet and then advance to standing on a single leg as you get stronger.
Banded Ankle Dorsiflexion Exercise
The Banded Ankle Doriflexion exercise also targets the tibialis anterior muscle. This exercise requires a resistance band tied at one end and the other end looped around the mid foot. Tighten and stretch the resistance band by bringing the toes and forefoot towards the rest of the body. Try for a total of 20 repetitions on each side and try to complete three sets.
The best stretches for shin splints
Stretching of the lower leg muscles can also help with shin splints in runners. The most common stretches are plantar flexion stretches (pointing the toes down or away from the body) for the tibialis anterior muscle in the front of the shin and calf stretches for the muscles in the back of the calf.
How can I prevent shin splints?
Taking a common-sense approach to your running is the best way to prevent shin splints. Don’t increase your running mileage too quickly. Watch the types of surfaces you run on since uneven surfaces can contribute to developing shin splints. Make the leg exercises and stretches a regular part of your shin splint prevention program.
Fixing any other muscle imbalances and weaknesses is also important for preventing shin splints from running. Strengthening the glutes and hamstrings is also important.Research