The Ultimate Guide to Female Athletes and SHIN SPLINTS
By Emily Pappas, MS
More often than not, when a female athlete goes through a period of lower activity (think summer break) and jumps into a high volume training period (hello pre-season 2x/day), dreaded shin splints show up with a vengeance.
This article intends to explain WHAT shin splints are, WHY the female athlete experiences them, and WHAT she can do to reduce her chance of experiencing them this upcoming season.
What are shin splints?
“Shin splints” is a general term to describe a broad array of pathologies that occur in the lower limb, usually after a significant increase in activity, such as the start of pre-season (1).
Simply put, shin splints like any injury occur when TOO MUCH FORCE is exposed to the body than its capacity to handle them.
Some of these injuries the result in the sensation of shin splints include:
Medial tibial stress syndrome
This is the most common type of shin split.
This pathology occurs when the muscle (Tibialis Posterior) on the inside of the tibia (shin bone) gets irritated.
The Tibalis Posterior is a muscle that attaches to the medial (inside) side of the shin). It’s tendon (think connection of muscle to bone) inserts on the arch of the foot at the navicular bone.
For athletes with a lower arch or “flat feet” that navicular bone drops and pulls on the tibialis posterior muscle, which in turn, pulls on its attachment on the shin, hence “tibial stress” and the dreaded pain of the shin split.
Without treatment or continued application of force on the body despite pain, this condition could potentially lead to a stress fracture of the tibia (1)!
Tibialis Anterior tightness or tendinitis
The meaty muscle on the front of your shin is called the Tibialis Anterior.
For athletes who tend to strike with their heels first with a sprint or run, more force is applied to this muscle. When such force is too great, this muscle gets irritated resulting in inflammation and those dreaded shin splints (1)
Compartment Syndrome
Lower limb compartment syndrome occurs when there is extra “pressure” in the lower limb. This sensation is often experienced in a numbness or tingles that occur up the leg usually during or after running.
This can either be due to something that just happened, like taking a shot to the leg with a lacrosse ball and there’s a lot of swelling, OR those muscles work so hard that the muscles themselves end up being swollen and there’s not enough space within the area to expand
This can happen just one time (acute), or every time an athlete runs (chronic).
The acute version could be serious as it ends up squeezing on the nerves and blood vessels that go down the middle of the leg.
The chronic version is no fun, but after a discussion with your healthcare provider, you can usually get through your season, or choose to have surgery to allow for more room in the lower limb.
Don’t worry. This is the rarest explanation for shin splints! (1)
Why do athletes experience shin splints?
For most athletes, the most common type of shin splints occurs when running volume ramps up faster than the body is ready for (2,3)
Running & sprinting whether on the track team or in a soccer game is a stress to the body!
Just think about the amount of load on the female athlete’s body every time she runs:
An athlete’s weight x gravity x number of reps (steps) x velocity of her movement = a whole lot of impact!!!
In fact, when a female athlete runs she can experience up to 8x her body weight in force!! (5)
AKA those dreaded shin splints.
How to treat shin splints
(1) DECREASE RUNNING VOLUME
The first step is to decrease an athlete’s running volume (stress) (2,3,5)
By dropping the volume down a bit, the athlete’s tissues are given the chance to CHILL OUT or reduce inflammation.
Some athlete’s may be encouraged to relieve some of the muscle tension and pain by foam rolling and stretching her calves and bottoms of her feet.
But remember, although this might make them feel good, this is just a short term fix of the SYMPTOMS, not the CAUSE of shin splints.
To help a female athlete get back on the field faster, she must address the CAUSE of her shin splints:
…..aka her body’s lack of capacity to handle that high running volume (and accompanying force).
“BUT I NEED TO RUN!!!”
Remember, chronic overload of the stress when an athlete is already experiencing discomfort (or shin splints) puts her at a HIGHER risk of further developing a more serious injury, like a stress fracture (1,3).
So does this mean the athlete needs to STOP running all together?
This is really individual! It is best to consult with your physical therapist or clinician to decide how much an athlete needs to decrease her running activity (this could be a few days or a few weeks depending on chronic the situation is!)
For most athletes, this means dropping down running volume & intensity to a level where MINIMAL discomfort is felt. Then slowly ADDING to this volume as long as the athlete remains PAIN FREE and is doing work to help PREPARE her body for the high loads coming her way……
(2) IMPROVE CAPACITY
While time away from running or the activity that causes shin splints gives the female athlete’s body time to reduce inflammation, she MUST do other types of training to:
1) maintain her current fitness level
2) better prepare her body to handle the high forces coming her way as she returns to the field or court
This is where STRENGTH TRAINING comes to play:
Strength training to build capacity
Stronger muscles / tendons have a higher capacity to handle higher loads. Stronger legs and feet muscles can handle the higher forces experienced during fast sprints or longer runs (2,3).
How often should the female athlete strength train when she is feeling shin splints?
Strength training is a stressor to the body and should be introduced in a way that is individualized to best allow the body to ADAPT based on outside training.
When running & sport volume is lower, strength training frequency should INCREASE to better allow the body to
maintain fitness levels (remember by playing sport less the athlete will DETRAIN and further DECREASE her capacity for loads)
Improve its strength to better prepare for higher loads experienced during running/ sprinting.
How can the female athlete incorporate running back into her training?
Once the inflammation has died down a little (aka LESS PAIN), athletes should begin GRADUALLY getting back into running.
The human body is ADAPTABLE!
This means, if you wants to run FAST, HARD, LONG, or at high intensities and AVOID the dreaded shin splints, she has to PREPARE your body for the stress of running
.
This can be accomplished by building her volume a little bit at a time (think going from 1 short run a week to 2 then 3 then 1 longer run).
By SLOWLY adding to the volume and intensity, the athlete will be better equipped to ADAPT to her training load and decrease her chance of experiencing those dreaded shin splints again!
Remember, strength training is NECESSARY to help MAINTAIN a higher capacity to handle forces
This means as running volume and sport play increases, strength training must remain constant.
Strength training is a very different stimulus than sport play. Without this stimulus, the human body does NOT maintain its lean tissue & force capacity through playing sport alone.
For female athletes who want to experience a shin-sprint free season, maintaining a moderate dose of strength training throughout the season is KEY.
Think:
3-4x strength training during off season or low competition season
2-3x as seasons commence
1-2x as seasons reach their most competitive period (like playoffs)
In Conclusion
The age-old wisdom of rest, ice, and return has to be improved upon!
The female athletes of today need more than just rest when shin splints show up.
Why?
Without addressing the problem of WHY the shin splints came about in the first place, the female athlete puts herself in the position to experience them again
References
Barton CJ, Bonanno DR, Carr J, et al. Running retraining to treat lower limb injuries: a mixed-methods study of current evidence synthesized with expert opinion. Br J Sports Med 2016;50:513-52
Kalkhoven, Judd Tyler, et al. “A Conceptual Model and Detailed Framework for Stress-Related, Strain-Related, and Overuse Athletic Injury.” 2019, doi:10.31236/osf.io/vzxga.
Lauersen, Jeppe Bo, et al. “Strength Training as Superior, Dose-Dependent and Safe Prevention of Acute and Overuse Sports Injuries: a Systematic Review, Qualitative Analysis and Meta-Analysis.” British Journal of Sports Medicine, vol. 52, no. 24, 2018, pp. 1557–1563., doi:10.1136/bjsports-2018-099078.
Napier C, Cochrane CK, Taunton JE, et al. Gait modifications to change lower extremity gait biomechanics in runners: a systematic review. Br J Sports Med 2015;49:1382-1388.
“YOUNG FEMALE ATHLETE.” YOUNG FEMALE ATHLETE, SPRINGER, 2018.
About the Author
Emily holds a M.S. in Exercise Physiology from Temple University and a B.S. in Biological Sciences from Drexel University. Through this education, Emily values her ability to coach athletes with a perspective that is grounded in biomechanics and human physiology. Outside of the classroom, Emily has experience coaching and programming at the Division I Collegiate Level working as an assistant strength coach for an internship with Temple University’s Women’s Rugby team.
In addition, Emily holds her USAW Sport Performance certification and values her ability to coach athletes using “Olympic” Weightlifting. Emily is extremely passionate about the sport of Weightlifting, not only for the competitive nature of the sport, but also for the application of the lifts as a tool in the strength field. Through these lifts, Emily has been able to develop athletes that range from grade school athletes to nationally ranked athletes in sports such as lacrosse, field hockey, and weightlifting.
Emily is also an adjunct at Temple University, instructing a course on the development of female athletes.