Medial tibial syndrome, more commonly known as shin splints, is one of the most typical complaints of runners and is a general catch-all term for any ailment occurring in the lower leg. This can range from mild inflammation of the fascia (connective tissue) that covers and connects the muscles of the lower leg to the bone (tibia) to, in the very worst cases, the fascia being under such stress that it actually separates from the tibia. This is extremely painful and a slow healing process is unavoidable.
There are two main causes of shin splints: too much impact to the lower legs and overuse of the lower legs on running. These are explained in more detail below.
Too much impact on the lower legs: If you are a heel striker, the repetitive shock of your heels hitting the ground causes too much impact to the lower legs and will irritate the fascia in the muscles of your lower legs, especially muscles in the shins. This repeated impact results in inflammation of the fascia and subsequent discomfort which will worsen if not addressed. Too much impact can happen if you are running in old, worn-out running shoes that are no longer supporting you adequately, extended downhill running or on a side-sloping street, running on a treadmill or on unstable surfaces such as snow or ice, and heavy heel striking.
Heel strike occurs when you run with your trunk upright, reaching forward with your legs as you stride so you are “over-striding”. Eliminating any heel strike whilst running will reduce the amount of shock to your legs. Try leaning forward from your ankles as you run, allowing your foot to strike underneath or even slightly behind your body, this allows you to land on your mid-foot and your legs to swing to the rear as soon as your feet hit the ground.
Overuse of the lower legs on running: Overuse is caused by pushing off with the toes, which then causes the calf and shin muscles to overwork. Each time your body weight is supported by your toes, your calves and shins are required to do much more work than they were designed to do. In effect, when pushing off with your toes you are actually increasing the workload to your calves and shins to be more than your body weight due to pushing up against the downward pull of gravity. This is simply too much work for a small group of muscles. Keen amateur runners may also be prone to shin splints if they run too far or too fast too early – before their legs are ready to sustain distance and speed. Not allowing muscles to warm up enough before increasing speed is also a culprit.
The best way to heal shin splints is to rest your overworked muscles. Another common remedy is to ice the shins for 15 minutes three times daily to reduce inflammation and try to elevate the legs several times a day. However, these are remedies providing symptomatic relief only and do not eradicate the root problem which is either overuse or stress impact to the lower leg.
Prevention is always better than cure so once your shin splints have healed and you are back on your feet again, try gradually strengthening your lower leg muscles by running slowly, doing calf raises or walking on your heels. This may help but it is by no means a guarantee of avoiding shin splints in the future. The best way to prevent it is by addressing the way you run, avoiding heel strike and overuse of the lower legs.