Addressing Shin Splints During Track and Field Season
Shin splints, or medial tibial stress syndrome, are a common running overuse injury that involves inflammation of the tibia and surrounding muscles and tissues caused by repetitive stress placed on the lower leg. Shin splints commonly occur at the start of track and field season, when an athlete overexerts themselves or increases the frequency, duration, and intensity of their training too quickly such that the body cannot adjust to the stressor, leading to injury. Physical therapists can help athletes with shin splints recover pain-free movement, return to sport safely, and prevent future re-injury through a targeted exercise rehabilitation program. Check out our tips on proper running mechanics and ways to prevent shin splints this track and field season!
Understanding Shin Splints
Shin splints, or medial tibial stress syndrome, are a common running overuse injury that involves inflammation of the tibia and surrounding muscles and tissues caused by repetitive stress placed on the lower leg. Shin splints result from microdamage that accumulates along the attachment point of several lower leg muscles. Repeated contraction of these muscles, such as when running, pulls on the outer layer of the tibial bone, causing microdamage and inflammation of the bone and the muscles where they insert at the bone.
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If the body is not given sufficient time to recover between bouts of activity, this microdamage can accumulate and lead to shin splints. If ignored, shin splints can progress to stress fractures, a bone stress injury involving small fractures in the bones of the shin.
Symptoms of shin splints include:
Pain and tenderness along the inner side or front of the shin bone due to inflammation of the muscles, tendons, and bone tissue around the tibia
Sharp and throbbing or dull and aching pain in lower leg during or after exercise
Mild swelling
Pain that diminishes with rest but recurs with activity
Development of small bumps or lumps along the shinbone in severe cases
Shin splints commonly occur at the start of track and field season, when an athlete overexerts themselves or increases the frequency, duration, and intensity of their training too quickly such that the body cannot adjust to the stressor, leading to injury.
Risk factors for shin splints include:
Overuse from repetitive high-impact activities like running without proper rest or recovery
Anatomical abnormalities like flat feet or rigid arches
Inappropriate footwear, such as wearing worn out or non-cushioned shoes that do not provide sufficient support
Muscular imbalances such as weakness or tightness in the calf or anterior tibialis muscles
Deficits in pelvic, hip, or knee motion can place additional stress on the lower leg muscles
Training errors, such as a sudden increase in intensity, duration, or frequency of activity such that the body does not have time to adapt and too much stress is placed on the leg.
Incorrect running form, such as overpronating (ankle rolls in) or supinating (feet roll toward outside edge of foot) when running, which causes the front leg muscles to work harder to stabilize the feet.
Running on hard surfaces, inclined surfaces, or uneven terrain that strain the front leg muscles
Track & Field: Running Mechanics
Track and field athletes develop shin splints due to the high-impact nature of the sport. Track and field inherently require repetitive activity of the lower body, as the running stride involves unidirectional propulsion, generating power from ground reactive forces through the lower body. Maximizing the athlete’s stride economy and proper running mechanics is essential in order for the runner to be in the best position to absorb impact without placing undue stress on the lower limbs.
It is critical to avoid heel striking or toe running. Runners should aim to land on the mid-sole of the foot and roll through and push off through the toes. Keep arm swing low and short such that the feet stay beneath the body and close to the ground. Landing on the heel during the running stride places additional stress on the lower leg, while landing on the toes stresses the gastrocnemius calf muscle.
The soleus muscle also places a key role as the prime mover during the propulsive phase of running as the runner pushes off the first and second metatarsals to continue the forward running motion; the soleus muscle contracts eccentrically as the leg moves to push-off, which can create stress at the site where the soleus attaches to the tibia.
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Physical Therapy for Shin Splints
Physical therapy treatment for shin splints includes:
Pain management using ice, manual therapy, and soft tissue mobilizations to reduce pain and inflammation.
Targeted strengthening: The therapist designs a customized strengthening program targeting the muscles around the shins, calves, feet, core, glutes, and hip to address muscle imbalances, improve flexibility, and enhance overall lower limb stability and movement.
Strengthening the hip and gluteal muscles is important as these muscles control the function of the knee when running. Stronger hip and gluteal muscles prevent the knee from turning in, allow for proper tibia alignment, prevent the foot arch from collapsing, and allow for improved running mechanics overall and less stress on the shin area.
Gait and running analysis: The therapist conducts a gait and running analysis to assess for any deficits that place additional stress on the lower leg. Gait training helps athletes adopt a more efficient, biomechanically sound movement pattern, adjusting stride length, cadence, foot strike, and body posture to minimize stress on the shins.
Footwear assessment: It is essential to wear appropriate footwear for your sport and have shoes with proper support and cushioning. The therapist provides education on when to replace shoes and whether or not foot orthotics would be beneficial.
Modification of training regimen: The therapist can design a training program that allows for a gradual increase in activity to lessen stress on the shin and shin muscles such that they can adapt to the stress of activity over time without injury.
Cross training: Cross-training is a critical part of an athlete’s exercise program and is key to prevent shin splint re-injury. Cross training involves engaging in low-impact aerobic activities like aquatic therapy or stationary cycling to maintain fitness without placing additional stress on the shin.
Tips to Prevent Shin Splints
To prevent shin splints:
Gradually increase mileage. Shin splints occur when runners increase mileage or intensity too quickly without sufficient rest and recovery time between runs. Weekly mileage should never increase by more than 10% from week to week when running. A long run should not comprise more than 30% of the athlete’s weekly mileage.
Wear appropriate footwear. Alternate between multiple pairs of running shoes to increase the longevity of each and so that the small muscles of the feet do not adapt to identical stresses each day. Replace running shoes every 350-500 miles.
Run on softer surfaces. Running on hard surfaces like concrete places extra stress on the lower limb. Vary running surfaces between the track, the treadmill, or grass/dirt trails.
Take time for sufficient rest and recovery. Avoid running two days in a row. Rest days allow the muscles, joints, and bones to recover after a run and adapt to the stress of running.
Cross train on your days off from running, engaging in low impact aerobic exercise like biking, swimming, or aquatic exercise.
Strength train, targeting the anterior tibialis muscle, which runs along the front side of the lower leg and is responsible for flexing the foot at the ankle. Do heel raises or toe raises regularly to strengthen calf and shin muscles.
Check your running form, avoiding heel striking or toe running. Proper running form ensures correct alignment of the hips, knees, and ankles and prevents unnecessary stress being placed on the shin bone and muscles.
