Running is good for your fitness and overall wellbeing, but that is not to say that it doesn’t pose certain wellness risks. Runners commonly experience injuries such as shin splints, but what exactly are shin splints, where do they come from, and how can they be treated? We spoke to Rebecca Christenson, a physiotherapist at Pure Sports Medicine, in order to get shin splint savvy.
1. What Are Shin Splints? According to Christenson, ‘Shin splints is actually a bit of a misnomer and should really be referred to as “exercise-induced leg pain”, as I will explain. The most common type of exercise-induced leg pain is medial tibial (shin bone) stress syndrome (MTSS) which doesn’t exactly role off the tongue, but is a more accurate term. The other two main types are a stress fracture or compartment syndrome.’
She explains, ‘MTSS occurs when the muscle that inserts just behind the shin starts to pull away from the bone. There is a sheath around the bone called the periosteum, and this can get inflamed as a result of the pulling away, and cause pain. If this inflammation of the periosteum persists, because someone continues to run without attempting to treat it, then it may go on to cause a stress fracture. A stress fracture is not like a traumatic fracture that occurs suddenly. It is a continuum. So it may start with a worsening of the inflammation around the periosteum, and then slowly go into the bone itself.’
2. What Causes Shin Splints? ‘All three types of exercise-induced leg pain come under the category of “overuse injuries” (which are the most common types of running injury) as opposed to trauma,’ says Christenson. ‘Biomechanics (how our movement is controlled in relation to our joints and muscles), training or the environment (running surface and footwear), or a combination of all these, can make someone vulnerable to developing an overuse injury. MTSS results from a repetitive overload and the pelvis, and all the joints from the hip down to the foot may potentially contribute to the onset of symptoms.’
‘One of the most common causes of MTSS is excessive or poorly controlled pronation (flattening of the foot),’ Christenson continues. ‘Pronation is a normal movement that occurs in the foot to help with shock absorption. Efficiency during running relies on achieving the right amount of pronation and supination. Things like fatigue, tight calves and gluteal (bottom muscle) activation can have an effect on the control of the foot as it hits the floor. Footwear and the surface that you are running on are also important factors.’
3. How Do You Treat Shin Splints? Christenson details, ‘There are effectively three different types of exercise-induced leg pain, and each has quite different treatment. MTSS, which is probably the most common, would involve: correct training errors – this may relate to volume/intensity or lack of recovery, checking footwear is appropriate and correcting biomechanical problems – the pelvis and all of the joints in the leg have the potential to contribute to MTSS and each patient will present slightly differently and will need to be thoroughly examined.’
Christenson adds, ‘Some patients may need to be referred to a podiatrist. Correcting timing and control issues with certain muscles groups, and restoring appropriate flexibility to the joints and muscles of the lower limb may also be part of the treatment. Clearly because exercise-induced leg pain is a type of overuse injury, there is usually some need to temporarily alter training. With the right treatment, your time away from running will be kept to a minimum and you will be advised to cross-train to maintain as much of your fitness as possible. We want to get you back running as soon as possible!’
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