Written by: James Smythe
As someone that used to be obese, one of the most rewarding parts of my weight loss and fitness journey has been running. However, it has been a bittersweet love affair, and I have been plagued with running-related injuries, specifically shin splints.
When I first started running there were never any issues, having my body adapt to running outdoors meant that I limited my mileage, but once I had learned to pace myself based on my fitness level, my mileage went up, and the injuries started to happen.
Shin splints are the most common running injury, and it is a catch-all term for lower leg pain that occurs below the knee either on the front outside part of the leg or the inside of the leg. It is reported that it affects 13% to 17% of all running-related injuries.
The medical term for shin splints is medial tibial stress syndrome (MTSS) and the term can cover a range of ailments, which includes issues with the bone and muscle.
Bone-related damage is the most common problem affecting around 90% of shin splint suffers, and this is irritation of the bone which can lead to stress fractures or even a cracked bone. The more you run on the injury, the more severe the damage will be.
Muscular issues are usually exertional compartment syndrome (ECS) and is characterised by a tightening in the shin that worsens during exercise.
The causes of shins splints can be boiled down to 2 key factors, poor form and too much too soon.
I am not a trained professional in sports or medicine so all my advice is from personal experience, but I hope my mistakes and lessons learned will help new runners avoid unnecessary injuries in the future.
The basic concept of running sounds simple, put some trainers on and go for a run, what's easier than that? Sadly, it is not quite as simple as that, the process of pounding the pavement puts a tremendous amount of stress on both the muscles and bones in your legs. Common form issues include:
After 3 rounds of shin splints, and 2 years of self-diagnosis I finally paid to see a physiotherapist—within 30 minutes he had identified a significant mobility issue with my right ankle. He believed it to be footballers ankle which is a small break in the ankle that has then calcified and restricts forward motion of the shin. As a result of this, my knee and shin would twist inwards when I ran.
As I was stubborn, when I was training for my first half marathon, I ignored the shin pain because it was disappearing within the first 30 minutes of running, but each time I ran, the pain got a little worse. I ended up not being able to run for 6 weeks prior to the half marathon. At the event, I ran too quickly and was out for around 4 months after that. I suspect my case was a microfracture; I was hobbling around for a week after the event.
Stretching before a run or workout is one of the things most people neglect, while at the same time being one of the most important things you can do to minimize injuries. Stretching will help improve mobility and therefore reduce issues with poor form.
You should ease into stretching, don't bounce or force it, and it's usually better to do it after your run when your muscles are warm. Surprisingly enough, pre-workout stretching has been shown not to reduce injuries. But in the end, you should always do what you are comfortable with. If you are doing stretches pre-workout you should try and do dynamic stretches where you move as you stretch. These include legs swings, frog walks and high kicks.
In order to learn how to do specific stretches, I would suggest watching YouTube videos of your chosen stretch, written explanations can be confusing.
Foam rolling has become very popular in recent years; it's a bit like a sports massage on yourself. It is supposed to help with myofascial release and is designed to work out the "knots" in your muscles.
What is Myofascial Release?
A fascia is a form of connective tissue that wraps and bundles muscles (myo) together. Myofascial adhesions can develop through stress, training, overuse, underuse, movement imbalances and injuries.
Foam rolling is an excellent pre-exercise alternative to stretching, it will wake up the muscles and increase blood flow before your workout which ensures your muscles react better. It promotes oxygen flow and helps with performance and recovery.
It has also been shown to increased range of motion by 4.3% which will help reduce injuries further.
When you are foam rolling, it is OK for it to be uncomfortable, but if a spot is very sore, it is best not to spend too long on that area. If something is swollen from damage applying heavy pressure to it is not going to help.
If you ever look for injury advice on the running Sub-Reddit, you will likely be told to run slower and to improve your cadence (steps per minute). With our comfortable shoes, we have become adapted to heavily strike on our heels due to reduced feedback from the ground.
This landing is not energy efficient, and the high force is driven up your leg causing excessive force on your knee. If you have any mobility issues, over-striding will cause a rotation in the knee, twisting the shin and damaging the bone or muscle.
By slowing your pace, you will reduce the severity of your heel strike and likely shift some of the weight to your mid-foot. This is more biomechanically efficient and less energy will be lost in the landing. Taking smaller strides helps reduce damage caused flexibility issues in your legs due to a reduce range of movement.
Once you have learned to take smaller strides, you can start by improving your cadence which is just the steps per minute you take. So, you are trying to speed up by taking more steps rather than striding further.
Many everyday runners aim for 160-170 steps per minute – but this is something you should gradually increase over time. Many sports watches such as the Garmin Forerunner 235 will provide cadence information when you sync your activity.
As you run your muscles will adapt to the process, but you can aid this further by building up the muscle in your leg. In particular, stronger calf muscles will help reduce the stress on your shins.
This goes hand in hand with the muscle building. I am quite fond of weightlifting, but it can be tempting just to focus on aesthetic muscles rather than the body as a whole, working in an office is also terrible for creating imbalance issues. If you sit in a chair all day, it is quite common to develop anterior pelvic tilt where you bum ends up sticking out too much.
In my case, my quads were more developed than my glutes and posterior chain, while I squat a lot my poor form and mobility issues had caused those muscles not to develop as much.
You don't just have to run to get better at running, improving your overall cardiovascular fitness and endurance will greatly improve your running performance. It is advisable to mix up exercises, which will also help with muscle imbalances. I will typically alternate between cycling, running and the elliptical machine at the gym. I find the elliptical at the gym to be a good alternative to running, it feels like it offers many of the same movements as running, with absolutely no impact issues. When I use the machine, my weight goes over my tiptoes, and I can see my calves being worked out considerably.
This is possibly the easiest trick to help prevent shin splints, and someone just getting into fitness may love the fact that they should limit the exercise. Naturally, once you start running, or commit to running, it is very tempting to quickly ramp up the mileage, far beyond what your body is ready for. In order for your body to adjust to the new exercise routine, some people recommend to increase running 10% per week, others say this is outdated.
When you are starting out you want to run on a consistent basis and just gradually increase you distance. Stick to the distance you can run for a few weeks as you adapt, then increase. Alternatively couch-to-5K is a good gentle introduction to running.
For me, I am paranoid about shin splints. I only run outdoors once a week at the moment, as I train for a marathon this year. I will then run on the treadmill twice a week, even though a lot of runners say treadmills are bad for you, I have found them to be useful in my training and avoiding injuries. The trick I use is to focus less on speed with the treadmill but the incline.
I will start out with walking at a 15% incline, then transition to running at 10km/h (6.2mph) at a 2% incline, I will then gradually increase the incline until I am happy with the level of exertion. I use my Garmin with a Bluetooth heart rate monitor to accurately monitor my heart beat so I can work out in specific training zones. Running slowly on an incline reduces the impact on my legs, promotes me to take shorter strides, which in turn improves my cadence outside. It will also help develop your calf muscles more.
There is not a tremendous amount you can do to recover from shin splints apart from rest. The length of recovery will vary, if it is a stress fracture you are going to be out of action for a longer period of time. Therefore, it is best to deal with the shin splints as soon as you notice them rather than ignore them.
Along with rest, it is possible to use ice to reduce any swelling you may have following a run.
Anti-inflammatory drugs such as ibuprofen are an option to deal with any muscle swelling. They are fine when resting if you follow the label, but not recommended if you are continuing to run, as it may mask the pain and cause you to damage your shins further.
Menthol topicals, like CopperGel are great to relieve temporary pain as well. CopperGel is clinically proven to combat muscle and joint pain and is trusted by many professional athletes. Check out this guide to topical pain relief for more info on topicals.
It feels like there is an awful lot of things to do just to avoid injuries, but you can boil most of the advice down to regular stretching and slowly easing yourself into the exercise allowing your body to adapt. This basic advice can be applied to any other sport or exercise you may start too.
I am James Smythe from MightyGadget.co.uk, I am a UK based tech blogger and fitness addict that is very keen on running and cycling. I regularly test and review fitness technology and love being able to track all my stats, even though I rarely use the data to improve my performance.