When Running My Shins Hurt — Understanding Shin Splints
If you have ever ran or know someone who runs, you might come across them complaining about their shins hurting after or during a run. One of the most common injuries in running just so happens to be shin splints. Often times this can be a direct result from bad running form, fatigue or inflexibility in the calf muscles. This tightness can lead to additional stress on tendons which become strained or torn.
This can be heartbreaking as it may interfere with your running schedule, especially if you have just started. The correct term for ‘shin splints’ is medial tibial stress syndrome. Ignoring this as you continue to run may often lead to a more sharp pain and burning sensation during or after running. Continuing to ignore the issue will cause the tibial to go from stressed to fractured.
So what are the causes of this, and how do you prevent them from happening or getting worse without stopping you from running? If you’re past this point, then how can you get back into running form without aggravating shin splints?
What Is Medial Tibial Stress Syndrome (MTSS) a.k.a. Shin Splints?
The most common case of shin splints are caused by small tears in the lower leg muscles when they are being overused. Usually contributing to the problem are wearing worn-out shoes, lack of cushioning, as well as over-pronation of the foot and running on hard surfaces.
Since beginners are not used to stressing out and using the leg muscles, you will find beginners more susceptible to shin splints. On the other hand, long time runners returning from injury are also susceptible to shin splints. Often times this is due to increasing their distance or pace too quickly.
The nagging pain will often be concentrated on the front of the leg along the tibia. Pressing on the area will lead to experiencing pain or discomfort. This can be very frustrating and make a basic act, like walking or running, seem impossible.
Tightness or weakness of the lower leg muscles including the calves and others above the ankle tug at their insertion point. This causes a thin skin-like structure called periosteum that envelopes the tibia itself to get irritated. This helps distinguish between medial tibial stress syndrome and a true bone injury like a tibial stress fracture. Or at least this is what is proposed.
More recent and precise anatomical studies with advanced medical imaging studies, have shown that overuse injuries to the tibia exist on a spectrum of bone injuries. Low bone density has been found to appear at the location of pain, and after recovery, the pockets of low bone density tend to disappear. Whereas stress fractures will tend to have larger areas of low bone density surrounding the fracture.
Shin Splints, A New Hypothesis
Thanks to this new information, there is a new hypothesis on the root cause of shin splints. It is now hypothesized that repeated stress to the bone during running is not caused by straight-on impact, but rather when the bone is loaded and there seems to be slight bending of the bone. When supporting a lot of weight, your tibia will bend backwards slightly as it impacts with the ground, thus putting a compressive force to the medial side of the bone.
The body’s response to the bone stress is to remodel the tibia to be stronger and thicker. However, this can take several weeks to a few months to complete. Which makes sense as to why healthy runner don’t have a problem with bone stress after a long and hard run, and it is most common with less experienced runners.
Unfortunately, there is also a period when the bone is actually more vulnerable to damage when undergoing the remodeling process. Just how you would tear down some walls on a house you will remodel, your body does the same with old bone tissue. Already having weak bones or a small tibia can increase your risk for shin splints or injury.
In Depth, One Size Does Not Fit Most
As you can see, shin splints may actually be from more than one causation. This would explain why sports medicine specialists dislike using the term shin splints. This also has to do with the fact that the term denotes any other lower-leg ailment such as muscle strains, stress fractures, MTSS, and exertional compartment syndrome (ECS).
Often caused by weak or tight muscles that are unable to do their job. The targeted muscle groups of this causation are the tibialis anterior and the tibialis posterior.
Caused by overused injuries that the muscle becomes to fatigued and unable to absorb the shock of running. When this happens, a tiny crack is made as the workload is transferred to the bones. This is often misdiagnosed as shin splints. However, the difference is that shin splints is a muscle injure that fades away after warming up. Whereas, a fracture is a bone injury which then pain worsens as you run. Depending on its severity, an x-ray would be needed followed by four to six weeks of no running.
Medial Tibial Stress Syndrome
Caused by stress to the bone and injury to the bone tissue. Yet, this condition is still somewhat misunderstood by medical health professionals.
Exertional Compartment Syndrome (ECS)
A much more less common injury than the ones above, but also tends to happen on any part of the lower leg. Described as a tightening feeling in the sin that worsens as you exercise. Some describe the tightness in their legs like feeling they are about to explode. Although it can happen on any part of the lower leg, 80% of ECS cases are on the front part of the shin and pain free up until exercising.
How To Tell If It’s Shin Splints or Lower Leg Pain?