Shin splints is a term that, in essence, simply refers to lower leg pain. It is a common injury amongst runners, especially long distance runners, but it can manifest in anyone whose prime activity involves running or jumping.

Typically, shin splints are divided into three separate conditions.

Anterior compartment syndrome (ACS) – this is pain felt on the front of the shin. When we exercise our working muscles need an increased amount of blood to provide the oxygen they need, as this blood supply increases so does the size of the muscle. A thin but tough layer of tissue called fascia that keeps the muscles separate and contained surrounds muscles. As the working muscle expands, the fascia must stretch to accommodate, however in the case of ACS the fascia does not expand sufficiently, causing an increased pressure in the muscle and pain.

Medial Tibial Stress Syndrome (MTSS) – typically felt on the inside of the shin, directly on the side of the bone, this condition is caused by stress between the outer layer of the shin bone and tendon attachments. Typically seen in runners with ‘flat feet’ where the constant rolling inwards of the feet pulls on the shin bone via the tendons causing an irritation and inflammation of the bone.

Stress Fractures – constant repetitive impact gradually leads to a weakening of the bones and small hairline fractures appear causing a great deal of pain. This does not only occur in the shin but is also seen in the heel and up into the neck of the thigh bone.

What are the causes of shin splints?

• Poor running biomechanics – when you run what does your foot do? We don’t often give this much thought… we just run! There’s a lot that should happen in the split second your foot is in contact with the ground.
• Using the wrong shoes – for sports or activities that involve repetitive impact, make sure your shoes are giving you the support and protection you need.
• Muscle imbalances, restricted joint movement, especially around the foot and ankle.
• Sudden changes to your training – what type and level of training are you doing? Have you progressed gradually to this level? Sudden increases or a sudden change of surface you are training on will over-stress your lower limb.

How can I prevent shin splints?

• Warm up properly before every training session.
• Spend plenty of time stretching at the end of your session, especially your calf and shin muscles.
• Try to avoid excessive running on roads. Stick to grass, tracks or cross-country.
• Ensure your shoes are giving your foot the support it needs. For runners, make sure you have shoes specifically fitted to your running style and be aware of when to retire them, generally between 500-700 miles.
• Keep well hydrated.
• Spend time training in other sports to vary the training effect, especially sports which involve lateral, side-to-side, movements.

The most important point to consider with these injuries is to listen to the messages from your body. If you feel any new ‘niggles’, aches and pains, especially in the lower leg, don’t ignore them. These are overuse injuries and the body needs rest to help them recover. It is a common trait of the long distance runner to ignore these signs for fear that resting will affect future goals, but think about the big picture, eventually, if left unchecked these pains may develop into a debilitating condition that may prevent any running for several months.

Bridge to Health are offering running assessments for anyone who is concerned with their training and the risks of developing injury, followed by any relevant treatment and rehabilitative exercises. Please contact the clinic for more information.