Shin splints also known as medial tibial stress syndrome, it is a chronic overuse injury and is common in the running community. The pathology of this injury is the traction on a muscle – mainly the tibialis posterior and soleus muscles.
There are a number of signs and symptoms that are associated with this injury. Pain is often felt in the inside of the tibia and is accompanied with tenderness on the border of the tibia. The pain generally warms up with exercise and often reaches a point of “stiffness” on the tibialis anterior muscle. Pain may also be worse the following day.
Causes of Shin Splints?
Shin splints is a chronic overuse injury and is often experienced in running populations. Unfortunately, it is multi-factorial and there is not one specific explanation as to the origin of your pain. Common causes include:
- Overtraining – Drastic and disproportionate increases in your training load which stresses the lower limb to an extent that it cannot recover appropriately leading to a chronic injury.
- Changes to your regular training – sudden changes that your body is not accustomed to such as increased hill training or the introduction of off-road running when your body is used to road running.
- Gait abnormalities- Unnatural gait patterns may be a result of structural abnormalities (e.g. leg length discrepancies; scoliosis) or due to weakened muscle groups (poor ankle, knee or hip stabilisers). Both of these factors can result in excessive and unnecessary stress on your lower limb and contribute to shin splint pain.
- Inappropriate training- improper form and technique in the gym or in training, as well as inappropriate exercise selection may contribute to your shin splints. Excessive sets and reps of one particular exercise in the gym may be contributing to your shin splints.
- Training surface- hard surfaces such as roads or courts are associated with more force going through your foot and lower limb with each foot-strike. Perhaps the surface that you train on is inappropriate.
- Inappropriate foot-wear- old worn out shoes do not provide appropriate cushioning and can change the biomechanics of your running gait, factors that will put excessive strain on your lower leg. Similarly, new shoes that may also not provide enough support or cushioning may result in your foot improperly striking the ground and straining the lower limb.
- Injuries- previous injuries to any part of your body involved in running- back, hips, knees and/or ankles to name a few, that have not been properly rehabilitated may be contributing to your shin splints. They are associated with muscle weaknesses and gait abnormalities that you might not even be aware of that alter your running pattern and force distribution
What exercises can I do?
It is clear to note that this injury is can be multifactorial and hence all factors need to be considered when treating the injury. Due to the nature of this injury if one does not see relief with the following exercises it is essential that you consult a health professional “Biokineticist” for the correct treatment for you.
Initially, one should decrease the amount of running and focus on stretching of the muscles surrounding the lower leg especially tibialis anterior and your calf muscles (gastrocnemius and soleus).
Examples are as follows:
Calf wall stretch
Stretch the calf muscles by keeping your heels flat on the ground and let your front knee travel forward and touch the wall. See how far you can move your foot back and still touch the wall without your heel lifting. Increase your flexibility by trying to ‘beat’ the mark that you currently set!
Kneeling tibialis anterior stretch
By having your toes pointing away from you and applying a downward force by pushing your bum onto your heels, you can get a great stretch for the tibialis anterior muscle.
Strengthening exercises can commence as soon as pain has decreased. Emphasis should be placed on corrective exercises (depending on the person) as well as strengthening of the lower leg and hip musculature.
Examples are as follows:
Calf raises with a ball in between your heels
This movement targets the calf muscles as well as the tibialis posterior. Do slow reps that are controlled and try to move in your whole range of motion.
Side plank into clam with a resistance band
To target those stubborn glutes, as well as working the lateral pelvic stabilisers, this movement addresses your obliques and glute medius as you go up into the plank position, progressing into the clam.
Resistance band dorsiflexion
Using a resistance band that is anchored to something solid, perform a dorsiflexion movement by pulling your toes up to you and controlling it back to starting position.
Reverse lunge into high knee
The reverse lunge movement forces one to eccentrically contract the leg muscles that will help us in the long run to deal with force absorption, lessening the load on the body during running. Going into the high knee position strengthens the hip flexor while challenging the opposite glute and balance. Do them nice and slow!
As you get stronger, slowly introduce walking, then progress to very light jogging. Try not to increase your walking/running distance by more than 10% each week and stay away from inclines initially.
If it is a recurring/chronic issue, consult a health professional near you.
Prepared by the Binokinetics team at the Sports Science Institute of South Africa (SSISA)
SSISA’s Biokinetics practice has a special focus on Orthopaedic & Neurological Rehabilitation, using scientific and evidence-based exercise programmes geared to improve function, performance and quality of life. The team also offer an intensive running programme for athletes of all levels to improve their abilities. Read more about SSISA Biokinetics
Please note that information found in these articles does not constitute medical advice. If you are experiencing an injury or condition of any kind, it is always advisable to contact a medical professional for advice on your specific symptoms.