Shin pain vs “shin splints” in runners

Shin pain is often referred to as “Shin Splints”, but that’s not accurate. It can often lead to incorrect treatment and delayed return to running.

“Shin Splints” refers to a number of different pathologies, or injuries, that cause shin pain. They can affect muscles, tendons, bones and/or blood flow in the lower leg and generate an often debilitating shin pain.

But the only thing they have in common is the location of pain. They all have different causes, treatments, recovery times and rehab exercises.

The problem with just labelling all shin pain as “Shin Splints” is that it leads to misdiagnosis, bad assumptions and frustration.

Let’s assume runner #1 has a muscle-induced shin pain, while runner #2 has a tibial bone stress injury. Both injuries will get sore during and after running, both will hurt to hop and both injuries start to come on gradually (rather than a sudden pain after a fall).

While runner #1’s shin splints responded really well to massage, runner #2 might find that massage makes their pain a lot worse. But they both have shin splints, right?

What causes shin pain in runners?

Simply put, shin pain will happen when any structure in the area is overloaded for a prolonged period.

The two major causes of shin pain are a lack of stability in the ankle and impact forces acting on the tibia, or shin bone.

Lack of stability

A lack of stability at the ankle can come from the wrong shoe choice or old shoes, stiff ankles due to previous ankle sprains or injuries and inadequate muscle strength and control from the calf muscles.

As the foot lands on the ground, the ankle rapidly collapses inwards and pulls on the stabilizing muscles that attach along the shin bone. This can cause a condition called Tibial Periostitis, the most common pathology in the “Shin Splints” group.

Impact forces

The other major cause of shin splints is the impact force acting on the shin bone, or Tibia. This is typically due to increased force combined with a lack of recovery time after each run.

Increased force can occur with an overstride pattern of running (when the heel lands well in front of the body position) or a sudden increase in body weight.

After each run, the body needs time to repair the loaded areas. If this recovery time is lacking (and the time needed is different for everyone), the bone breakdown from one run is carried forward to the next run and the cycle of breakdown repeats itself.

This leads to a Tibial Bone Stress injury which can progress on to a stress fracture, another common cause of shin splints.

Managing shin pain

There are three components to successful management of shin pain – find and address the cause, control the loading on the area and manage the symptoms while rebuilding your running volume.

Find the cause

Finding the cause is best achieved with a visit to your local trusted health professional. They’ll be able to identify the underlying issue and provide the best treatment based on your situation. Sure, it might set you back $100 but it’ll save you weeks/months of frustration and life without running.

Control loading

Controlling the load on the area is done with a combination of reduced running training and improved running technique (you can read about running with an injury here, in glorious detail).

Reduce your regular runs to a duration that only causes minor symptoms or switch to a run:walk session with repeated cycles of short runs followed by short walks. This can help maintain some stimulus to the injury to encourage healing without flaring it up each time.

The simplest way to improve your technique and reduce loading on the shin is to shorten your stride. But rather than focusing on the length of your stride length (distance from one foot landing to the next), focus on speeding up your cadence (number of steps per minute). Listening to some upbeat music with a faster beat can help (I highly recommend Eminem’s Lose Yourself!)

Manage the symptoms

The last component is to manage the symptoms so they have less impact on your running technique. Because running less can still cause overload if you’re limping!

You can achieve this with a hand roller, used immediately before runs and later that day. You can even use it during runs if it’s a long run with a halfway stop.

The hand roller is more effective than a classic foam roller as you can’t apply too much pressure and inadvertently irritate the condition. It’s also convenient to pack in a work bag or gym bag.

Disclaimer for Shin Pain vs Shin Splints in Runners

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