Shin pain is a common complaint amongst runners and can be a tricky condition to manage. One common cause of shin pain, often referred to as shin splints, is medial tibial stress syndrome (MTSS). This is a form of bone stress injury and we should generally avoid running with any level of pain either during or afterwards with MTSS, according to research. We also need to be aware of the risks of running though pain with bone stress injuries, as some of these can lead to bone stress fractures.

Now, for some good news! There are several ways that we can manipulate load and forces while running. If you are suffering with shin splints, below are some tips to get you back to pain-free running:

1: Run slower

Training at higher intensities has been linked to bone stress injuries so try bringing this down for a period to see if this eliminates symptoms.   

2: Increase step rate (Cadence)

This can be especially helpful if your cadence is already quite low (<165/minute). Just a 5-10% increase can significantly reduce load through the tibia (and other structures). You can use a metronome to help you hit the desired number. There are various apps you can use for this like ‘Runcadence’ or you can use Spotify playlists that can match music with the specific cadence you want to hit.

4: Consider stride width

A narrow running gait can put extra load through the medial tibia. If you feel like this could be an issue for you, you could experiment by trying to keep your ‘knees apart’ or ‘run wider’ to see if this helps to immediately modify or remove your symptoms. You may need to get a formal running assessment to see if this is an issue for you and to effectively implement these cues subtly with real time feedback.

5: Avoid hills

Uphill running increased load through the calf complex specifically, which can subsequently transmit greater forces through the medial tibia. So best to stick with flat running where possible, but of course, this will need to be assessed on a case-by-case basis.

6: Run on the treadmill

Consider treadmill running as this can reduce stress on the tibia compared with hard outdoor surfaces.  You could even consider a curve or self-propelled treadmill of you have access to one of these as they might reduce load even further.

These are all good options to facilitate pain free running with shin splints. If you are successful with some of this, that’s fantastic, but remember that reducing overall running volume for a period is also key for the management of this injury!

Ideally, we want to stop our sessions BEFORE pain comes back and build the bone load tolerance back up over time. This may involve some trial and error and we would suggest you seek the guidance of a physiotherapist if this is not settling within a couple of weeks.

 Remember: shin pain can be complex, so if pain is severe or persisting, we advise that you get this assessed by a Physiotherapist. We’d be happy to help.

Book an appointment with one of our physios here.

by: Sam Bellhouse, Registered Physiotherapist