With the Ealing Half Marathon fast approaching, many of you runners preparing for the race might have experienced this common runners’ niggle at some point during your training.
Claire Desroches, one of our resident personal trainers and sports massage therapists has written a comprehensive article that might help you get back to pain-free running.
So, over to Claire……..
“Back when I worked in a running shop – before becoming a personal trainer or therapist – I developed a pretty thorough layperson’s understanding of shinsplints; client signs up for London Marathon whilst drunk at the work Christmas party, starts panic training in March, in their old gym trainers (or, worse, casual fashion sneakers), develops stabbing pain in their shins. The solution, in my job, was simple: new trainers, well fitted, with adequate arch or motion support, and plenty of cushioning. “
“For many people, the above – a change in footwear – will be the most straightforward solution. However, it is important to understand what shin splints are, and to identify the root cause, in order to prevent this painful condition recurring.”
Shin splints, or medial tibial stress syndrome (MTSS) is a classic overuse injury, caused by excess repetitive load on the legs. Remember that “excess load” can refer to the actual load – rapid weight gain, sudden increase in training – or to lack of protection – inappropriate footwear, hard running surface, muscle weakness or inefficient biomechanics. Inadequate recovery also plays a role, as increases in training load can be mitigated, to a certain extent, with increased recovery.
More technically, MTSS is an inflammation of the tibial periosteum, which is the sheath of tissue that surrounds your tibia, or shin bone. There is some disagreement over exactly what causes this inflammation, but repetitive impact is certainly at the heart of the issue.
MTSS is usually described as a burning type of pain, or an intense ache, on the “inside” of the shin bone (i.e. the left side on your right shin); pain on the lateral (i.e. “outside”) of the shin bone is usually not shin splints, and could signal compartment syndrome, so do book in with a physiotherapist or osteopath if you have any doubts.
The pain can be dull or sharp, but it covers a fairly diffuse area of about three fingers’ width; a more localised sharp pain may indicate a stress fracture.
The pain usually starts soon after you start exercising, builds during the session, and usually improves during rest.
Rest is absolutely essential to recovering from shin splints. If you rest properly, you may be able to return to come impact after just a week or two. Ice the area after any exercise. Wearing compression socks or tights, and keeping the leg elevated may also help reduce inflammation and improve comfort.
Whilst recovering, you can swim, or use the cross-trainer or exercise bike, as long as none of these cause discomfort. Make sure you warm up, cool down, and stretch properly; tight calves can contribute to shin splints so make sure you stretch these well. You may also find that foam rolling helps release tension in the calves. You can also try and gently stretch the muscles in your shin (tibialis anterior and tibialis posterior); yoga poses like child’s pose or hero pose might be enough to stretch these if they are particularly tight, or get some light massage once the inflammation has eased down.
If your running shoes are old, worn out (look for wrinkles in the midsole – the usually-white bit between the outsole which contacts the ground, and the upper that encases your foot), or were purchased “off-the-shelf” without a gait assessment from a specialist, consider replacing them. If you can, visit a specialist running store or a podiatrist, who can advise you on what level of support you need. Be sure to try several different styles of shoe on, to see what feels most natural to run in. If you have a choice, pick the one with the most cushioning.
When you return to activity, be sure to keep up the good habits of warming up thoroughly, mobilising your ankles with motions like ankle circles, and stretching your calves. Ease back in gradually. If you are running outdoors, try to run on grass as often as possible, and avoid areas with a significant camber in the road so you don’t end up loading one leg more than the other.
Longer term, it is good practice to factor some cross-training into your training regime, ideally in the form of low-impact activities. Treat rest days with the same respect and dedication you would training days. Regular sports massage, or a fixed regular check-in with your therapist of choice, can help identify areas of tightness or weakness before they become a problem.