This is the first post in a new series I’m writing, called the “Why Me?! Running Injury Guide.” Injury is a sad reality of competitive running, but it doesn’t have to mean the end of your training. If you take a proactive approach by finding out the true cause of the pain, instead of just treating the symptoms and taking time off like the doc prescribes, you will come back stronger and less likely to get injured again. Throughout this series I will explore the most common running injuries, their potential causes, and how to rehab yourself. Now, if your foot falls off or if bone is poking through the skin, go see a doctor. But more often than not, a reduction in volume, some mobility and strength work, and a slow return to running will get you through recovery road. As always, please feel free to contact me with questions about specific injuries. I’m happy to help a fellow runner in need!
First up, the dreaded shin splints…
While often thought of as a newbie affliction, shin splints don’t discriminate. It’s one of those annoying injuries that just about every runner gets at some point in their athletic career. I’ve been running for over 10 years and still, every time I ramp my mileage back up after a big race, I get sore shins for a week or two. The main player in shin splints is the Tibialis Anterior muscle, which turns into a tendon that wraps over the foot and under the arch. Its main job is to dorsiflex the foot and support the arch.
I wish I had a one-size-fits-all magic cure for shin splints, but every runner is different, and the individual cause of injury is different. But there are gait and training patterns I see over and over that tend to contribute to tibial pain. Here are a few of the more common ones:
Too much, too soon: Increasing volume too quickly causes of 90% of running injuries (made up stat, but it’s a high percentage). Your aerobic system adapts far quicker to training than your muscles, tendons, and ligaments do. The shin muscles are much smaller than the beefy calf muscles so they can’t handle the shock of high volume as easily. Patience is key when building up the miles. The general rule of thumb is to increase time or mileage by 10% every week, but really, the slower the better. Taking a recovery week every 3rd or 4th week also gives the body a chance to repair and adapt to the new stresses.
Overstriding: Forefoot, midfoot, or heel? There is no one “ideal” foot strike, but there are stride characteristics that will make you more likely to get injured. Forefoot runners get calf and achilles injuries more often, and heel strikers are more likely to suffer shin splints. When you land on your heel with your foot way out in front of your body, you experience a braking sensation which prevents the natural pronation required for toe off. Your anterior tib muscle has to work eccentrically to prevent your forefoot from slapping the ground, creating a lot of tension through the front of the shin.
Restricted big toe or calf: When your big toe doesn’t move through it’s full range of motion the foot has to rotate out so you can complete your stride. Most people end up pushing off the lateral side of the big toe (telltale sign: maybe you have a big callus there?). Same thing with a tight calf: you will have reduced ankle range of motion, forcing the anterior tib to pick the foot up to get it out of the way so you can complete stride without tripping over yourself.
Okay, so your shins hurt. Now what? None of my solutions will make the pain go away overnight, but if you are proactive with mobility work, the steps below will help you return to running stronger and pain free.
- Reduce running volume by at least 50%. Hold it at that level until your pain decreases significantly. Increase mileage again sloooowly. Let pain be your guide.
- Look at your stride: Have a friend film you running on a treadmill or track. Are you landing on your heels way out in front of your body? One easy way to correct this is to focus on increasing your stride rate, or the number of steps you take per minute. A shorter stride will force your foot to land more underneath your body, allowing for a smooth heel to toe transition and lessening the load on the shin muscles. Count the number of steps you take in one minute of running. Now try to increase that number by 10%. So for example, if you ran with 150 steps in a minute, increase that to 165. If you get too distracted during a run to continually count your steps, like I do, you can download a metronome app or find songs that have 160-180 bpm (In case you were wondering, T.Swift’s “Shake it Off” is 160bpm. Perfect!).
- Work on lower leg mobility: Using a foam roller or lacrosse ball to break up the anterior tib muscle will go a long way in reducing shin pain. It’s best to work above and below the pain, not directly on the sore spot. If your AT is tight, chances are high that your peroneals are also tight. They run down the outside of your calf, assist in dorsiflexing and everting the foot, and connect to the anterior tib tendon under the arch via fascia. If one is cranky, the other probably is too. And if you discovered any restrictions in your ankle, calf, or big toe start working on those babies as well!
- Try compression socks or kinesio tape: The jury is still out on whether compression gear actually works, but it certainly won’t hurt. The theory goes that compressing the muscles during a run will reduce vibration (stress) and aid in blood flow. Kinesio tape works by taking stress off of an overworked muscle and allows healing to occur. Both are cheap and might give immediate relief, but it’s just a bandaid for the problem. You need to find out what is causing the injury to prevent it from happening again.
Shin splints are usually a fairly minor injury in the grand scheme of running injuries, but if your pain gets to the point where it prevents you from walking normally, or if the pain is only in one pinpoint area, it may be time to see a doctor to rule out a stress fracture. I’ve had one. It’s not fun. To sum it all up: stay diligent with mobility work, find out what’s causing your pain (usually a simple case of being too eager), be smart about increasing mileage, and your shin splints should be gone within a few weeks!