Everything You Need to Know About Shin Splints

Every Runner Knows The Battle

Every Runner Knows the Battle

Shin splints are the bane of many runners—a sharp, persistent pain that challenges even the most committed runners. It's that internal debate every runner knows well: do I push through or take a break? With around 9.5% of runners experiencing shin splints annually, it's a battle that's all too common.

In this post, I want to help answer some of your key questions:

• What exactly are shin splints?
• How do they happen?
• Which type of shin splints do you have?
• How can they be treated?

What Are Shin Splints?

Shin splints, or in the medical world, medial tibial stress syndrome (MTSS), refers to pain in the shin resulting from repeated stress and strain.

Google defines it as:

"Pain in the shin and lower leg caused by prolonged running, typically on hard surfaces."

It's a decent definition but quite simplified. Just so we’re all on the same page, the shin is the bone that runs from your ankle to your knee—known scientifically as the tibia. With shin splints, it's the tibia that takes the damage.

Now, for a more technical definition:

"Medial tibial stress syndrome (MTSS) is an overuse injury characterized by diffuse tibial anteromedial or posteromedial surface subcutaneous periostitis, usually in conjunction with underlying cortical bone microtrauma." [Franklyn M, Oakes B.]

This technical definition can be overwhelming, so let me simplify it for you: It’s pain in the front or middle of the shin due to bone irritation from repetitive stress—commonly from running.

Types of Shin Splints

There are actually two types of shin splints, each with distinct causes.

• Anterior Shin Splints

• Posterior Shin Splints

Distinguishing between the two types of shin splints is crucial because each type has a different underlying cause. In 2012, researchers Franklyn and Oakes studied what triggers each type, providing us with some detailed, medical-heavy explanations—but I’ll simplify them for you.

Anterior Shin Splints

Anterior shin splints are caused by a "bowing effect" on the tibia:

"Tibial flexion from contraction of the two heads of the Gastrocnemius and the Soleus muscle causes tibial bending moments during the push-off phase of running." [Franklyn M, Oakes B.]

When running, the contraction of the calf muscles propels you forward. The attachment of these muscles to the tibia creates a slight "bowing" effect, causing repetitive microtrauma to the shin bone, leading to a stress reaction.

Posterior Shin Splints

Posterior shin splints result from tension in the muscles and fascia connected to the tibia:

"Tension in the tibial attachment of the deep fascia in conjunction with the origins of the powerful action of the soleus and gastrocnemius muscles proximally."[Franklyn M, Oakes B.]

Basically, when the calf muscles contract, they create tension on the fascia, pulling it away from the shin bone. This repeated shearing force can also lead to a stress reaction on the bone.

Location of Pain: How to Identify Shin Splint Type

The first step to solving shin splints is to identify which type you have.

The easiest way to differentiate between anterior and posterior shin splints is by identifying where the pain is located:

• Anterior Shin Splints: Pain is located at the front lower third of the shin.

• Posterior Shin Splints: Pain is located on the inside of the shin, near the calf muscle.

Causes of Shin Splints

Several factors can contribute to the development of shin splints:

Biomechanical Factors

Certain biomechanical issues can increase the risk of developing shin splints:

• Foot Structure: Runners with flat feet or high arches may be more prone to shin splints [2].

• Muscle Imbalances: Weak calf muscles or tight Achilles tendons can contribute to the development of shin splints [2].

• Running Technique: Improper running form, such as overpronation or excessive heel striking, can increase stress on the lower legs [3].

Training Errors

While anterior and posterior shin splints have different causes, they do share a key commonality: both are overuse injuries. Overuse injuries develop gradually over time as a result of repetitive stress, and they often begin subtly before progressively worsening with continued activity.

As runners, we're familiar with overuse injuries—in fact, around 90% of running-related injuries fall into this category. Considering each mile you run involves roughly 2,500 steps, with each step absorbing 3-4x your body weight, it's no surprise that your body needs the right strength and alignment to absorb the impact.

• Sudden Increases in Training: Rapidly increasing running distance, frequency, or intensity without proper adaptation can lead to shin splints [4].

• Inadequate Recovery: Insufficient rest between training sessions or neglecting proper cool-down and stretching routines can contribute to the development of shin splints [5].

Environmental Factors

• Running Surface: Training on hard or uneven surfaces can increase the impact on the lower legs, potentially leading to shin splints [6]. Some people experience shin splints with a change of surface, for example, running on a treadmill all winter, then going outside and running on a road or trail.

• Footwear: Worn-out or inappropriate running shoes that don't provide adequate support or cushioning can contribute to the development of shin splints [6].

Individual Factors

• Previous Injuries: A history of lower leg injuries can increase the risk of developing shin splints [7].

• Body Composition: Being overweight or having a higher body mass index (BMI) can put additional stress on the lower legs during running [7].

How to Treat Shin Splints (General Guidelines)

Now that you understand the different types of shin splints, let's dive into some treatment strategies:

Manage Your Running Volume: Due to their overuse nature, shin splints aren’t something you can just ignore. It’s essential to keep your running volume steady or even decrease it. If there’s no improvement after a few weeks, it’s time to try cross-training.

Strength Training: Weight training can be highly beneficial to building stronger muscles and bones. Just as muscles adapt and grow, so do bones. Incorporating strength training helps make bones more resilient to the repetitive stress of running. To help you build strength effectively, I've created a Strength Training for Runners program specifically designed to address common running-related injuries.

Targeted Muscle Strengthening: Strengthening the specific muscles that absorb force during running can make a big difference. Focus on the lower legs, hips, and core to distribute impact forces more evenly.

• Tight Muscles: Addressing tightness in certain muscles can help alleviate shin splint pain. The gastrocnemius and soleus muscles in the calf are often tight in runners with shin splints. Additionally, the anterior tibialis and posterior tibialis muscles can also become tight due to overuse, especially in runners with flat feet or overpronation.
• Weak Muscles: Muscle weaknesses can also contribute to shin splints. Intrinsic foot muscles, responsible for arch support, may be weak, leading to additional stress on the shin. Similarly, hip and glute muscles play a crucial role in stabilizing the lower body, and weakness in these areas can negatively impact biomechanics. Even the anterior tibialis muscle, while tight, may also lack strength in some runners.

Running Form Adjustments: Improving your running form can also help. Biomechanical errors in running form can significantly contribute to developing shin splints. Some common errors include:

• Lower Extremity Alignment: Issues like the inward collapse of the knees during running increase stress on the lower leg and can contribute to shin splints.
• Overpronation: Often associated with valgus knees, overpronation causes excessive rotation of the tibia, which can also increase the risk of shin splints.
• Pelvic and Core Control: A pelvic drop results in a tilt of the pelvis during the stance phase, altering the distribution of forces through the lower leg. Additionally, excessive vertical movement of the body's center of mass can increase impact forces.
• Foot Strike Patterns: While I'm not big on foot striking a certain way, excessive heel striking can increase impact forces through the lower leg, potentially leading to shin splints.
• Cadence and Stride Length: Overstriding or running with a low cadence can increase impact forces on the lower legs.

Aim to land with a midfoot strike and a slightly flexed knee. These adjustments can reduce the load on your shins, decreasing the likelihood of pain. If you’re unsure about your running form, I offer an Online RunRight Running Form Analysis service, which provides detailed feedback to help you optimize your running technique and prevent injuries.

Wrapping Up

Shin splints are a common, yet manageable condition that many runners face. Understanding the causes, types, and treatment options is key to overcoming this issue and preventing it from recurring. With the right strategies—such as managing training volume, incorporating strength exercises, and making adjustments to running form—shin splints can be effectively managed.

I hope you found this helpful. Understanding your injury is key to effective treatment and prevention. Remember, shin splints are common, but they're also manageable—especially with the right training and recovery strategies.

If you have any questions, feel free to drop a comment. Stay healthy and keep running strong!

For those dealing with shin splints, I’ve developed a Shin Splint Exercise Program for Runners that targets these exact issues and helps strengthen the muscles and bones involved.