Shin Splints

Not all shin splints are created equal

​There are actually 2 common types of “shin splints” and it’s important to differentiate between the two.

Anterior Shin Splints

​The type that people most commonly refer to involve a muscle on the front of your shin, the tibialis anterior (I’ll refer to this as anterior tib. going forward).
 
This muscle helps you raise your foot up. But it also controls how quickly your toes hit the ground with each step. It’s what keeps your feet from slapping the ground when you walk.
 
If you overstride (take large steps out in front of your body), this puts more stress on this muscle. As this process repeats over the course of a run, this muscle can get irritated, and that’s when you feel the “shin splint.”

​​The easiest fix for this is increasing your cadence, or how many steps per minute you take (this helps you take shorter, smaller steps and land more under your body).
​ 
Running in minimalist or barefoot shoes can also reduce how often you’re dealing with this as it changes the way your foot hits the ground and reduces the stress on the tibialis anterior muscle.

IF YOU DECIDE TO TRANSITION TO MINIMALIST RUNNING SHOES YOU NEED TO DO IT GRADUALLY

​Slowly cycle your old shoes out and the new shoes in (and train in a variety of different shoes). If you’re getting pain in your Achilles, slow down the transition even more, and make sure you’re doing regular strength training.
 
Strength training is one of the best ways to improve your running and to help your muscles handle the stress of whatever activity you’re doing.

Posterior Shin Splints

​The second type of “shin splint” tends to be more serious. This one involves your tibialis posterior muscle. This muscle attaches to the inside of your shinbone, and travels down to support the arch of the foot.

Pain with posterior shin splints is usually felt deeper/more inside vs right on the front like the first type.
 
During running, this muscle can also be overloaded, causing irritation and pain.

The reason this type of “shin splint” can be more serious is because the pain can indicate a bone stress reaction.
 
It can be difficult to differentiate muscle pain from bone pain in this case, and thus it’s always a good idea to talk to a physical therapist if you’re experiencing any of these symptoms.

In a bone stress reaction, the bone isn’t handling the load very well – it’s breaking down faster than it can rebuild.
 
If not taken care of appropriately, a bone stress reaction can progress to a stress fracture.

And a stress fracture means more time in recovery and less time doing the things you love.

Short-term Solutions

There are some things you can do immediately to turn the dial down on the pain given either type of shin splint, but they have to be understood and used as part of a longer-term solution.

Failure to do so typically results in an ongoing cycle of relief and re-injury.

​Which often leads to discouragement and frustration, ending in people giving up on their sport or activity of choice.

And it's sad because it doesn't have to be that way.

If we build up our strength and endurance over time, focusing on being consistent with exercise, we can get out of this cycle.

And that's where the short-term solutions come in - they can help us turn the volume down on our pain enough to stay active and be consistent.

So things like taping, bracing, NSAIDSs, orthotics, massage, IASTM, foam rolling, etc. can be helpful in the short-term, but ONLY if in service to the larger goal –
making your whole body stronger and more resilient.

Alone, none of these fix the problem. They treat symptoms rather than root causes.

The Long-term Solution

All injuries are overload injuries – that is, you took on more than your body could handle.

To get over an injury and to avoid future injury you need to make your body stronger and more resilient.
 
Balancing aerobic training, strength training, and recovery is the key to make progress without getting injured again.
 
To dial it in, you’ll have to change up the training load.
 
Training load is a combination of intensity (how hard your workouts are) and duration (how often/how long your workouts are).
 
It’s typically best to progress duration before intensity.

When you do add intensity, back off how often/how long your workouts are and then build the duration back up.

​And make sure you’re getting enough sleep, quality nutrition, and varying intensity so you can recover (you don’t have to go hard every workout every day).

​Nutrition is particularly important in the second type of shin splints. These often result from a combination of poor nutrition and too high of a training load.

Keep Moving

​Through all of this, keep MOVING!
 
Often, pain will arise from big changes in training load.
 
For example, maybe you were consistently running 30 miles/week and then decided to up it to 50 miles/week and BOOM - shin splints.
 
Instead of taking a complete break from running and resting it, try dropping it back down to 30 miles/week.

If you can run without pain (or with pain that’s stable and predictable and not getting worse), then you can slowly add on weekly miles (weeks-months) until you're able to consistently hit your new weekly goal of 50 miles.
 
If it’s the case where you need to limit your movement of the painful or injured area, then be creative in keeping the rest of your body moving.
 
This is where cross-training is a great option (and honestly should be a regular part of any exercise plan).

Continuing to move and stay active will help you recover more quickly and help you avoid some of the loss of strength and endurance that typically accompany injury. 

Bottom line: Get and stay strong, build recovery into your training, and make sure you're fueling your body!