Prevention is always the best medicine when it comes to running injuries. Shin splints are similar to most running injuries, in that the most effective way to prevent them is to respect the laws of adaptation. This means, firstly, listening to your body.
If you are feeling pain when running, it’s because your brain has decided, that a particular area of your body needs protecting. Usually, but not always, this is because too much stress, or load, is being accumulated in the painful area, and you are not leaving enough time in between stresses to allow the tissues to adapt.
So the key to injury prevention is gradual, patient loading.
Now, if you’ve gone past the prevention phase and are in the painful phase (and lets face it, if you’re reading this, I imagine you’re in this phase already) the next sections will be helpful for you.
Ice works really nicely as an analgesic. Rough guidelines of 10 mins every 2 hours, if needed, are adequate (Remember to wrap ice in a damp towel to prevent ice burns).
The goal of running re-education is to assess an individuals running style, and see if, through subtle changes to biomechanics, you can unload the tissues (bone, muscle, ligament), whilst not jeopardising performance or simply creating another injury elsewhere in the body.
If none of the below techniques are working for you, then it may be time to see an osteopath for some advice. Often it is impossible to see the problem from the inside…
1. Increase Cadence or Shorten Stride Length
There’s no set stride rate you should aim for so have a play around with it. Generally, go for 5%-10% more than your current cadence and see what happens. You can always gradually increase it from there and re-assess the ‘experiment’.
The theory behind increasing your cadence is to prevent your from over striding so if it is easier to think about it in these terms then simply try to shorten your stride length ever so slightly. What this does is gets you landing closer to your centre of mass and with a straight tibia, as opposed to your tibia flicking out ahead of the knee.
2. Increase Step Width
Trying to move the load from the inside of the shin, to achieve less varus (side bending). Generally, asking people to have some daylight between their legs or imagine running on either side of a yellow parking line, gets the right changes. This doesn’t necessarily need to be a long term change but long enough to allow the painful tissues to recover.
3. Change The Direction Of The Ground Reaction Force
Again, we are trying to decrease the anterior tibia bowing. If we look at a pole vaulter, if he places the pole out in front of him with forward and downwards force it will create anterior bowing. However, if he plants the pole down with a backward and downwards force, it will not bow anteriorly, but posteriorly. Bad for a pole vaulter, but good in our tibial context! i.e the force will go more through the back of the tibia.
Any change in the direction of the ground reaction force, to a more backwards and downwards force, will decrease the load in the anterior tibia and may be enough for us to keep running without pain. How to do this?
Run Tall. Imagine you have a hook attached to the crown of the head and you are being pulled directly upwards. This helps decrease an anterior pelvic tilt, or a forward lean from the waist. Both of these latter postures lead to the centre of mass shifting forwards during stance. To compensate for this, you will have to over stride with the next step = more load on knee and shin area.
Other treatments that can be used in the fight against shin splints:
Orthotics can still be a great tool to offload an injured or sensitised area. It is vital to speak to a podiatrist who can assess and diagnose exactly what is loading and unloading from your foot into your leg while you walk and run in order to improve what is happening and to offload the painful structures.
Similar to orthotics but a more temporary solution from a run to run basis.
As mentioned last week, weak calves have been implemented in shin splints. So seems like a good idea to strengthen these muscles. Avoid calf strengthening where jumping or bouncing is involved for obvious reasons!
CHANGING THE SURFACE YOU RUN ON
Bit of a weird one this, intuitively you would think that running on softer ground, such as an athletics track, sand or grass, would be easier on the legs, but the literature suggests that when we run on softer ground our leg actually stiffens more to compensate for the softness, and the reverse is true when running on hard ground i.e. less stiff legs. However, in practice this seems to be less straight forward as it seems it is more the change of surface rather than specifically onto firmer ground and one to bear in mind if you find your pain is worse on softer ground. That or it may be that ‘shin splints’ are a cover for something else that is going on to cause you pain.