The skinny on shin splints

A STEP TOO FAR Over striding due to poor posture when running can cause painful shin splints.


Physio Focus
Andrew O'Brien

As anyone who has ever done a Google search for ‘shin pain from running’ knows, the first 300 pages or so will be all about the dreaded shin splints. Google also throws up the following shin-splint definition: “Acute pain in the shin and lower leg caused by prolonged running, typically on hard surfaces.”
Now if you’ve ever heard one of my running-related rants (they are frequent, and sometimes include expletives) you’ll know that I disagree with the last part of that sentence. To my mind, runners blaming the surface for their injury woes is akin to swimmers blaming the pool. Which begs the question: if it’s not the surface, what is it that causes the pain?
Like most injuries, shin splints can’t be blamed on one thing alone, and there are different types of shin pain. For the sake of this article, I’ll focus on the one I see most frequently. Many beginner runners are heavy on their feet, you can hear them slapping the ground long before they arrive. In fact, the same can be said of many experienced runners – funnily enough they tend to be the ones who get shin splints as well! This heavy, slapping sound is a product of the heel hitting the ground out in front of you. As the heel hits the ground, momentum causes the rest of the foot to slap down suddenly.
Try something for me: Actively pull your foot and toes up and feel the muscles on the front of your shin tighten. Now try stepping forward and landing on your heel. The foot will slap down regardless of how hard you try to hold it up. Now do that quickly, three times a second, with an impact force of more than double your body weight for 30 minutes, three times a week. Any wonder the front of your shin gets sore?
So, if you know what is sore, and that it’s because you’re landing on your heels out in front of your body, then all you need to do is land on your toes, right? Wrong. Unfortunately for the last few years, running websites and magazines have obsessed over the pros and cons of heel striking versus forefoot striking, but somewhat missed the significant issue. That being, why you land where you do. The answers to this lie in video analysis; without watching someone run, it’s impossible to know definitively what they are doing wrong. However, let’s look at two of the most likely culprits.
Try the exercise above a few times in bare feet, then in runners. Which would you rather do for half an hour? Wear shoes? By wearing shoes with thick cushioning, it’s more comfortable to land on your heel with a straight knee, essentially encouraging the faulty movement pattern that leads to shin splints.
So now the answer is to take your shoes off? Yes and no. By taking your shoes off, you’re less likely to keep your knee straight and land on hour heel. But if you are already landing a long way in front of your body, all you will do is substitute shin pain for foot or Achilles pain. Added to which, very few people have the foot ‘hardware’ to cope with the forces without significant rehabilitation of the foot.
The bigger issue is landing so far in front of your body, what we call ‘over striding’. Watch Mo Farah and you’ll see that he lands almost directly underneath himself. Watch Mary from down the road and you’ll see that she lands a long way in front of her body. Now look at the other obvious difference; their posture. Mo stands tall, Mary hunches forward.
By leaning forward from the hips, you move a percentage of your body weight outside of your base of support and gravity means you need to work hard to stop yourself from falling over. If you feel like you’re going to fall forward, the simplest way to stop yourself is to take a big step forward … and over stride. Stand tall and that fear of falling is removed.
In short, if you get carried away by the good weather and take up running, don’t hunch over and watch the road; look around and enjoy the scenery! Your shins will thank you for it.

> Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.