Shin injuries in runners are both common and frustrating. What is often called “shin splints” is actually a broad term (like runner’s knee) to describe several potential diagnoses. In mild cases, the pain is rather broad and may not limit activity, while in severe cases the shin pain may become pin-pointed and increase with not just running, but with all weight-bearing activities.

There are several risk factors for shin pain with running. First, females tend to have more shin injuries than males. While there are several hypothetical reasons for this, ranging from bony malalignment to altered running mechanics, there is no clear consensus at this time. Second, novice runners (or those runners who have been running for four years or less), have a higher risk. It is commonly believed that novice runners are more prone to training errors, equipment errors, and running form errors than more experienced runners. Finally, a more flexible foot type, having had a previous shin injury, and having an increased body mass index are all risk factors for several shin injuries. It is important to note that not all risk factors are equally weighted and, without a thorough evaluation from a physical therapist, may or may not be related to your specific injury.

Common symptoms of shin injuries include:

  • Gradual onset of pain that usually gets progressively worse
  • Pain to the muscle, tendon, or shin (tibia) bone
    • The most common location is pain to the inside of the shin closer to the ankle than knee
  • Pain that increases with running and eventually all weight-bearing activities
  • Pain that is, at first, relieved with rest/activity cessation
    • Overtime, the pain may not be relieved with rest. This is a sign of a more serious injury that requires an evaluation by a physical therapist

Tips:

  • If you are new to running, check out some trusted sources on how to get started safely. For Beginners Only is one resource that is well-respected.
  • Do not increase your mileage by more than 10%-15% per week.
  • Do not increase mileage and intensity (speed) simultaneously. Rather, once you attain a weekly running volume that you feel is sustainable, and then start to mix in speed work.
  • Every 2-3 weeks, reduce your volume and intensity by 20% and replace running workouts with cross-training workouts. Cross-training can be as simple as taking a long hike to riding a bike, swimming, or using an elliptical machine.
  • Run in proper shoes. Purchasing shoes from a running shoe specialty store may help.
  • Listen to your body. It is better to miss one workout than to miss a race.
  • When in doubt, get it checked out! Find a physical therapist near you!

Exercises:

While many shin injuries have multiple risk factors, a physical therapist can help identify the specific exercises and interventions that are best for your specific injury and your unique needs.

Shin exercises may include:

  • Calf raises
  • Calf stretches
  • Balance exercises
  • Ankle strengthening
  • Hip Strengthening
  • Running form drills

Shin injuries are common and frustrating. Shin splints is a term than encompasses many specific conditions, ranging from medial tibial stress syndrome to bone stress injuries to exertional compartment syndrome. A physical therapist can help diagnose the underlying risk factors and interventions which are best suited to your individual needs.

By Jeff Taylor-Hass

Jeffery.Taylor-Haas@cchmc.org

@JeffTaylorHaas