One of the most frustrating things is wanting to run or play sport and being limited by niggling pain that doesn’t seem to go away. Shin splints, also known as “Medial Tibial Stress Syndrome (MTSS)” is an umbrella term for pain in the shin with running or activity, that may not be debilitating but can be the cause of much frustration and annoyance. It is a very common injury seen in runners and athletes in a variety of sports and seems to pop up every pre-season and go away in the off-season. The good news is you don’t have to put up with shin splints forever!
Do I have shin splints?
Shin splints often presents with pain in the bottom third of the shin bone, mainly on the inside border. Your shins may be tender to touch with a dull, achy feeling when running. It may occur after a certain point during training – for example, 20 minutes in or after 5km – but eventually if not managed well, it can cause pain before, during and after your run or training session. If you have shin pain and are continuously pushing through it because it doesn’t go away, or you’ve been told to live with it, look no further because you may have been given the wrong advice! It’s important to seek advice from a health professional to avoid progression into more severe symptoms or injuries such as a stress fracture. It is also important to note that not all shin pain is shin splints! As a rule of thumb, if in doubt, get it checked out!
Why do shin splints occur?
The cause of shin splints is multi factorial and may be happening for a number of reasons. One of the biggest and most common causes we see is the all too common training or load error – doing too much too quickly! A quick change in run intensity, volume or running surfaces (hilly or hard surface) can be enough to cause shin splints.
Other common causes of shin splints include:
- Tight calf and shin muscles
- Change in running surfaces (hills, hard surfaces)
- Weakness in calf, hip and knee muscles
- Inappropriate footwear
- Flat feet, poor foot arch
- Poor running technique
How to stop shin splints? Can they be rubbed out?
You don’t have to live with shin splints forever! There are numerous ways we as physiotherapists can help and there are also ways you can help yourself. Understanding the cause of your shin splints is the first step to getting rid of the pesky pain. The next step is to deload, address the causes and slowly get back into doing what you love.
YES!!! massage, dry needling and rolling does help, BUT… it is more effective when combined with addressing the underlying cause of your shin splints. As a stand alone, your symptoms will most likely keep returning.
Because shin splints often occur from an overload, modifying your load will be very important. This is where most runners and athletes get caught up because from personal experience, we don’t want to stop! It’s important to understand you don’t have to stop training entirely. Some deload examples might be – cutting out hilly and hard surfaces – running on grass or soft tracks, reducing running volume and/or speed and cross training – swimming, upper body workouts, bike. The amount of deloading required depends on each individual but should not be ignored!
2. Address other causes
Once you have determined why you are getting shin splints and have started to deload from your activity, addressing your contributing factors is the next step to being pain free! Here are some ways we can help you address these factors:
- Tightness in calf and shin muscles: Utilising massage, dry needling, foam rolling, trigger point ball and stretches helps to reduce tension and pain
- Training errors: addressing any load error is important to get rid of and prevent shin splints from reoccurring. Avoiding sudden spikes in load, intensity and volume and factoring in adequate rest days are imperative
- Supportive shoes: ensuring you have shoes that are supportive and suits your running style and sport to avoid excessive loading of the shin bone with impact
- Strength and control in calf, hip and knee muscles: Building load capacity and strength in the calves and hip/knee muscles with a tailored program is important to improve tolerance to running and decrease the loads transferred through the shin. Your physiotherapist will set you up with the appropriate exercises based on your assessment.
- Running technique errors: Improving running technique may be beneficial in optimising the loading and impact on your shins. For example, overstriding during running is a common technique error associated with shin splints, so reducing overstride can reduce stress on the shin
- Improving foot arch: Using taping (low dye) and strengthening foot arch muscles to support the arch of the foot will help to optimise force transfer through the shins. Sometimes use of orthotics may also be beneficial
3. Slow return to run
So now you’ve deloaded and addressed the causes of your shin splints, it’s time to slowly get back into doing what you love. If you do too much too soon again, guess what? You might end up with shin pain or another injury! A gradual reintroduction into training and higher impact activities is important to keeping you pain free for good!
Other pain management strategies…
Ice and compression can be very helpful at reducing pain and inflammation, especially after exercise when your symptoms might be present or worse. So, while you are deloading and addressing the causes of your shin splints, use these strategies to help keep your symptoms at bay.
If shin pain has been limiting you or keeps coming back, get a comprehensive assessment to determine the cause of your shin pain so you can be pain free again!