Take Away

Q. Can my running shoes cause shin splints?

A. Shin splints, the catch-all term for lower leg pain that occurs below the knee either on the front outside part of the leg (anterior shin splints) or the inside of the leg (medial shin splints), are the bane of many athletes, runners, tennis players, even dancers. They often plague beginning runners who do not build their mileage gradually enough or seasoned runners who abruptly change their workout regimen, suddenly adding too much mileage, for example, or switching from running on flat surfaces to hills.

The nature of shin splints, also known as medial tibial stress syndrome (MTSS), most often can be captured in four words: too much, too soon.

It’s one of the more common beginner running injuries.  About 30-40 percent of all beginners experience shin splints.

The reason it’s so common among new runners, has to do with what causes shin splints. There’s not a consensus among doctors about the cause, but for a long time it was thought to be a soft tissue injury—either small tears or inflammation of the muscles that attach near the shin or of the periosteum (a thin sheath of tissue around the shin bone). But, studies have now found that the pain is actually a bone injury, not a soft tissue injury. In fact, if you ignore shin splints it’s possible for the pain to progress to a full-blown stress fracture of the bone.

At a basic level, what happens when we train and put stress on our bones is that the bones respond to that stress. In much the same way muscles rebuild from training, bones do too. When we run, the tibia or shin bone bends slightly from impact. When we rest after our runs, it’s able to rebuild and get stronger.

For that to happen, though, you have to give your body time to rebuild. So when new runners go out and run too much too quickly—without giving their bones (and muscles) time to recover—the shins become overstressed. Experienced runners are less likely to have this problem, because they’ve slowly built their system up to handle the stress of running.

Upping your mileage or intensity too quickly can cause shin splints, but so can other things that overstress your lower legs. Poor running form, such as over-striding, can force the shin to absorb more shock. And, weak calves or hips won’t do a good job of bracing the shin bone, putting more stress on it. A correlation between weak hip abductor and shin splints has been found in multiple studies.

The injury is also more common among women, who tend to have lower bone density, and among individuals with a higher body mass index.

While shin splints may simply seem annoying, once you feel pain on the outside of your shin, it’s important to treat it before it turns into a chronic injury.

The onset of shin splints can be insidious.. You may experience once or twice a little pain along the shin bone, but it may not progress into a serious injury yet. However, when the frequency of experienced pain increases, it is not unlikely that you already have developed shin splints.

If you can pull back on your training and address the root of the problem right away, then it may be possible to not miss too many days of running. But, if you run through extreme pain, then you risk a more serious injury. It’s hard to know exactly where that line is.

Generally, the pain should never exceed a 4 on a 1-10 scale. It’s best to rest some and decrease running, then add it back in slowly once the pain is gone.

While icing can certainly help general recovery, there’s actually very little scientific evidence to support its effectiveness in curing shin splints.

In addition to giving your body time to rebuild and recover from the stress you’ve been putting on it, what’s important is to address any additional reasons you may have been over-stressing your shins, such as weak hip abductors leading to an unstable core. While people often want to do exercises to strengthen the shin muscles directly, that isn’t necessary going to fix any form issues that were causing the problem.

What you really need to work on is hip strength and calf strength. The calves and hips help to brace the shin and leg bones against the impacts of running. Athletes suffering from shin splints can incorporate a regime of exercises like clamshells (laying on your side), donkey kicks (on all fours push one leg straight back), calf raises, and hip thrusts (one-legged bridges on your back).

I also recommend that you work on running form issues, of which over-striding, is “the most common flaw.” I also advise athletes to up their running cadence and work on 'quick feet', which can help bring your legs under COG
and prevent over-striding and over-stressing the shin.

Scot BrockbankComment