In the previous article on shin splints we discussed what shin splints are and the causes of shin splints. Check out that article first and then come back to this one (links open in a new window)
By now you should have a good idea of what causes shin splints, and that they actually are. With any injury it’s best to see a specialist, such as a physio but it is also important to stay informed by yourself, so you reduce the risk of shin splints and other running related injuries.
TREATING SHIN SPLINTS
We will focus mostly on how to prevent shin splints in this article but let’s get the treating out of the way first. Once you’ve got the injury you have to manage it properly so you can get back into training as soon as possible. NHS has a simple, yet effective, guide to treat shin splints at home:
Rest is first in the RICE approach. Rest and recover throughout before going back to training. To keep your fitness levels up try swimming, cycling and keep up with your strength training.
I believe injuries give you the time to work on your technique and other weaknesses in your body. You may actually come back stronger. Don’t let injuries bring you down, they can be an opportunity.
If you can run for a few hundred metres without any pain, with your physio’s advice, you can actually work on refining your running technique. One of the reasons of shin splints and many other injuries is actually the way we run. So, when injured, if possible, use this time to document yourself and practice a bit of the running elements. You’ll find all the running information you need on this website, through articles and videos.
To document yourself read articles such as this one or read books such as POSE Method of Running and Natural Running. These are 2 excellent books to start learning about running technique and body mechanics and understanding what causes your running injuries.
Ice is the second in the RICE approach. Ice helps to reduce the inflammation. When there’s inflammation ice is probably a good idea.
3. Switch to low impact activities
Reduce your training load, but if this is still painful continue training by cycling or swimming, rock climbing or anything else that takes the load and impact off your legs.
4. Pain relief
NHS recommends over-the-counter painkillers, such as paracetamol and ibuprofen, to help relieve the pain, if you need to. This wouldn’t personally be an option to me, but it’s an option nonetheless.
PREVENTING SHIN SPLINTS
It’s great to know how to treat shin splints once it hits you, but if you go back and do the same things that caused the injury in the first place you’ll be back to square one. The idea is to prevent, rather than treat. This is what we will be talking about now.
Let’s see how we can prevent shin splints from happening in the first place, or at least reduce the risk or the severity of the injury if it does happen.
5. Gradual progress
Because one of the main causes of shin splints (as explained in the previous article), especially for beginner runners, comes down to increasing mileage too much too soon, I think this should be our first point of discussion.
As a beginner, your muscles, tissues and bones haven’t had the time to adapt to the stresses of running.
Existing bone tissue is broken down and a denser, stronger bone tissue is formed. This is the work of osteoclasts and osteoblasts respectively.
However the bone must first be weakened, as it happens when osteoclasts break it down, before it can be strengthened, built back up. This process takes a bit of time and if you increase your mileage too much too soon there isn’t enough time for the whole process to take place.
The bone keeps breaking down at a higher rate than it is built back up and, because the bone formation can’t keep up, small bone fissures develop. These small fissures on the bone can eventually lead to stress fractures.
As a general rule try to increase your training load by no more than 10%, even less if you feel any pain. You must be sensible about this if you want to continue training and not spend a few months swimming instead of running.
Review your running and training schedule and ensure it’s not overloading your body.
6. Revise your running form
By now you should be familiar with my approach to running injuries. Running injuries don’t just happen, they have a cause, and most times the cause is the way we run, our running form.
Causes of shin splints related to running form were discussed in more detail in the previous article: 11 Causes Of Shin Splints In Runners. In a nutshell the main running form mistakes that cause shin splints are:
a) Landing in front or ahead of the knee joint or landing in front of the body
b) Heel striking and over striding – they come hand in hand
C) Toe landing
These are the main causes of shin splints from the running form perspective. Thus, to reduce the risk of shin splints you should consider:
1) Shortening your stride and landing underneath your hips.
As you run, if you look down and see your feet you are probably over striding. By landing under the hip you will neither heels strike nor landing on your toes.
Fig1. Landing under body
2) Transitioning to a softer, more controlled foot strike: midfoot strike.
This should happen automatically once you’ve shortened your stride and land under your hips. You should think more of point 1. and let this bit to come naturally. It’s impossible to land on your heels if you land under the body. It is possible to land on your toes though. The aim is to land with the middle of the foot and allow the heel to lightly “kiss” the ground softly.
3) Pulling the back foot under your body as opposed to pushing off with your back let to move your body forwards.
This “push off” is the power running style we discussed in the previous article. This aggressive style of running leads to “pounding the ground”, dropping the body weight heavily on the front foot and causing a lot of injuries, including knee injuries and injuries to the Achilles tendon.
If you ask me the power running trend should be exterminated.
Check out our article on running technique elements which are accompanied by videos for a more detailed explanation of the lighter running form.
There are many drills aimed at helping you shorten your strides. Running drills, which you can also use for warm up, are one simple way to train your body when you’re by yourself. Try using the following exercises:
- butt kicks
- high knees
- running backwards
- side shuffles
Of course you can do all this and still not achieve the desired result. An exercise we perform regularly with our runners is pulling the ankle under the hip from a standing position. It’s straight forward:
1. Stand with your feet hip width apart and imagine a straight line going from the side of your ankles up under the hip (not from the heel, but from the ankles, and not under the buttocks, under the hip, that’s slightly forward of the buttocks)
2. Lift your left ankle straight under your hip. Straight up, not forward, not backwards. You will notice the left knee moves forwards (not up). If you can’t see your knee, it’s too far back. As you lift the ankle under your hip let the knee move forward, like horses does with their front legs. A check point is to roughly align the left ankle with the back of the right knee. This will prevent you from kicking the ankle behind you.
3. Repeat this drill from a standing position for as long as you need to on both sides, then try running a few hundred meters while focusing on pulling the ankle under the hip one at a time.
To make it even better, as you stand and perform the drill, bend your knees and shift you body weight slightly over the balls of your feet, with the heels slightly touching the ground. This is your Pose stance, and the stance you should find yourself in while running.
You can find more drills in the POSE Method Of Running book.
7. Run barefoot
Naturally people will land mid foot when barefoot. You don’t have to run barefoot all the time, just 30 sec here and there where it’s safe and you don’t have to worry about sharp objects.
I sometimes do this with my clients and they immediately realise how heavy they actually land and run. Within minutes their running form changes for the better. It becomes more controlled as their strides shorten and they begin landing under the body with a nice, soft mid foot strike. When they put the shoes back on they maintain that feeling.
There is some research that suggest that barefoot running, or barefoot running style, spreads out impact stresses among muscles, so that no area is overloaded. But more research is needed to decide whether barefoot or minimalist running actually reduces the risk of injuries. There are some debates on this topic.
However, if you do intend to try minimalist running, as with any change in your training regime, it should be gradual, whether you choose to go barefoot or use minimalist shoes.
8. Strenthen tibilias anterior
The tibialis anterior muscles are positioned on the front side of the lower leg. If you sit and pull your toes towards your head you can feel and see those muscles contacting.
The tibialis anterior muscles are responsible for flexing the foot upwards and, because they are usually underdeveloped in non-runners, may contribute to shin splints if they’re weak.
A simple exercise to begin strengthening the tibialis anterior is toe raises.
a) You can be sitting upright with your legs stretched out in from of you, or even sitting on a chair with your feet flat on the ground.
b) Extend or point your toes as far as you can and then pull them and the foot up towards your shin. Hold for a few seconds, feel the muscles working.
c) Release and bring your toes to the starting position.
Do 2-3 sets of 10-12 repetitions on each side
9. Stretch and strenghten tibialis posterior
The first thing to do when you suffer an injury is to check with a specialist. In the meantime it’s also good to have a bit of knowledge yourself. This is what these articles are for. They inform you about the causes of injuries so you spend less time and money on physios and more time training, running and crossing finish lines.
The tibialis posterior tightens because it might be weak in the first place. To have something to stretch you first have to strengthen.
As we discussed in our previous article, one of the causes of shin splints is weak calf muscles but also excessive rotations forces on the foot. Strenghtening the tibialis posterior and the calf muscle as a whole can reduce the rotational forces, which can be either oversupination or overpronation. These excessive rotational forces usually come with a heel striking gait and landing in front of the body.
The eccentric heel drop strengthens your calf. It also helps with Achilles tendonitis, two birds with one stone.
The tibialis posterior stretch is similar to the classic calf stretch against the wall with a little tweak, the back knee is bent.
10. Vary the surfaces you run on
Running on softer surfaces such as grass or dirt trails or even treadmills as opposed to concrete, may reduce the stress and impact on your muscles, joints, and bones.
11. Check your shoes
Worn out shoes can also lead to shin splints. As a general rule you should replace your running shoes every 300-400 miles (400-600km).
Sam Murphy and Sarah Connors “Running Well”
Danny Dreyer with Catherine Dreyer “Chi Running”
Nicholas Romanov “POSE Method Of Running
Nicholas Romanov with Kurt Brungardt “The Running Revolution”
Ross Rucker and Jonathan Dugas, Runner’s World “The Runner’s Body”
Danny Abshire “Natural Running”
Very Well Fit
Running shoes guru