Shin splints rehab framework

Shin splints are one of the most common running related injuries and yet are also one of the easiest to manage.

But when they strike they will grind your running to a complete halt (they don't have to).

Here's how I manage shin splints with runners and triathletes:

Let’s first get on the same page with what they are.

You know them by pain in the front of your shin with running or after a run.

They are typically an overload injury to the lower leg.

Multiple structures could be the source of your shin pain.

• Medial Tibial Stress Syndrome

• Bone stress injury

• Tendinopathy of Tib Ant

Shin splints are most commonly a tendinopathy in Tib Ant. MTSS is the start of a potential bone stress injury.

We need to rule out any bony issues before managing shin splints.

If you have pain along the shin bone that gets worse with running and jumping and gets better with rest. I would see a rehab pro now. That could be MTSS or a BSI.

If isolated to the muscle, warms up on your run and responds to strength training then it could be a shin splint.

Now that we have that out of the way let's talk about how I treat shin splints:

1. Change your shoes

Old shoes play a big role in my own shin splints. I know when it's time to replace my sneakers when I start to get shin splints.

Some research supports the idea that having more shoes can prevent injuries from happening in the first place.

This is due to the change in foot strike between different shoes.

So check how old your shoes are as a first step.

2. Reduce training load

Like many triathlon and endurance injuries your total training load plays a big role in the management of injuries.

Start by dropping any speed work/intervals and hills.

These are usually the culprits for shin splints.

For a few weeks stick to easy endurance work. You can build back up once your shin splints calm down.

It’s worth remembering that you should balance your recovery with your training load - do you need more rest and recovery?

3. Add some general strength

Typically you don't need a ton of specific strengthening for shin splints.

Instead a simple strength program is all you need.

For this think full body circuits (Tri Strong Method) - upper, lower and core.

To manage lower leg issues add lots of single-leg work focused on the calfs, glutes and hamstrings.

This will ensure you have a strong foundation.

4. Add some specific strength for shin

General strength will lay the foundation, but you can also try some specific shin and lower leg loading.

Some movements you might want to try:

• Toe raises/butt scratchers

• Single leg calf raise

• Step ups

• 3-way hip work

• Single leg hops

I'm not a big fan of only isolating the shins because they are rarely the reason you have shin pain.

Instead I will take the approach of strengthening the whole lower leg and integrating it into the rest of the lower extremity.

5. Other things that might help:

Usually all shin splints need is a short rest period and then you’re ready to progress back to running.

If none of the above helps then you can see a rehab pro for some supportive care.

Things like voodoo floss, needling, and soft tissue work might help decrease the pain. The best treatments are still rest, strength training and a gradual return to running.

Bottom line. The best treatment for shin splints is prevention

The habits I mentioned can be added long before needing them for shin splints.

Rest, strength training and gradual loading of running are key.

Sleep, nutrition/fuel, and allostatic load are important to consider as well.

A recap on how I treat shin splints:

• Change running shoes

• Review load progression

• Add some general strength

• Add some specific strength to lower leg

• Trial supportive care

What questions do you have about your shin splints? Reply and I will answer them for you!