The Ultimate Guide to Female Athletes and SHIN SPLINTS

The Ultimate Guide for Female Athletes and SHIN SPLINTS

WHY you have them, WHAT you can do to treat them, and HOW to prevent your chance of getting them again!

By Jillian Seamon, MS, LAT, ATC  


It’s that time of year… the start of track and field season!

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You know what that means… shin splints!   Who here has experienced the dreaded shin splints before?

I’m here to tell you today, that you can come back from these better than ever or prevent them from ever happening in the first place!

 

Let’s start with what shin splints actually are.

 

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 track season (1).

Some of those injuries include:

 

Medial tibial stress syndrome

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This is the most common type of shin split. 

 

This pathology occurs when the muscle (Tibialis Posterior) on the inside of your tibia (shin bone) gets irritated.  

 

You can see on this diagram that this muscle attaches along the medial (inside) side of the shin, and then its tendon inserts into the arch of the foot, the navicular bone.  

 

If you have flat feet, or an arch that is always falling, 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, this condition could potentially lead to a stress fracture of the tibia!

 

  

  Tibialis Anterior tightness or tendinitis

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 Are you a heel striker when you run?

Meaning, does your heel hit the ground first, and then your toes push off?

The meaty muscle on the front of your shin is called the Tibialis Anterior, and when you run with your heels, this muscle can get helllllla tight and inflamed. 

Aka, shin splints for days. 

Compartment Syndrome

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 Do your feet ever go numb or get tingly when you’re running? 

All of your muscles and bones in your entire body are wrapped in something called fascia, which is very similar to a thick saran wrap. 

With compartment syndrome in your lower leg, imagine that your calf and shin muscles and those bones are all wrapped real tight with this fascia “saran wrap”. 

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 tight saran wrap to expand. 

This can happen just one time (acute), or every time you run (chronic). 

The acute version is very 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, in which basically, a slit is cut in the fascia (saran wrap). 

Don’t worry. This is the rarest explanation for shin splints! (3)

Why do you get shin splints?

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Maybe you’ve had shin splints in the past, and don’t want it to happen this season. Or maybe you are experiencing shin splints right now.

For most athletes, the most common type of shin splints occurs when your running volume ramps up faster than your body is ready for.

Running & sprinting whether on your track team or in your soccer game is a stress to the body!

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Just think about the amount of load on your body every time you run

your weight x gravity x number of reps (steps) x velocity of your movement = a whole lot of impact!!!

When that impact or stress becomes higher than your current muscle/tendon/ ligaments capacity to handle, irritation/ inflammation/ and soft tissue injuries occur.

AKA those dreaded shin splints.

How to treat your Shin Splints

(1) DECREASE YOUR VOLUME

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The first step is to decrease your running volume (stress).  

 

By dropping the volume down a bit, your tissues are given the chance to CHILL OUT or reduce inflammation.

 

You can also help relieve some of the muscle tension and pain by foam rolling and stretching your calves and bottoms of your feet. 

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But remember, although this might make them feel good, this is just a short term fix.

 

You still need to attack the CAUSE of your shin splints: your body’s lack of capacity to handle that high running volume.

 

BUT I NEED TO RUN!!!

 

I hear this all the time.  But remember, chronic overload of the stress puts yourself in a situation where you could be at a risk for developing a stress fracture or compartment syndrome

 

 (side note: especially as a female athlete, make sure you’re getting enough calcium and vitamin D to make sure your bones are strong!)

 

How much less do I need to run? This is really individual! It is best to consult with your athletic training or clinician to decide how much you need to decrease your running activity  (this could be a few days or a few weeks depending on chronic the situation is!

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(2) TAKE ACTION!

While your body gets the rest it needs to reduce inflammation, you CAN take action on improving your body's capacity to handle those higher loads again!

This action should include working on improving your strength and incorporating some running drills (technique):

1) STRENGTH TRAINING: 

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Stronger muscles / tendons have a higher capacity to handle higher loads. Stronger legs and feet muscles can handle the higher forces of your fast sprints or longer runs!

How often should you strength train?

Strength training is a stressor to your body and should be introduced in a way that is individualized so you can monitor your overall training load.  

For most females that are new to strength training, Relentless sport scientists recommend 2x per week for around 45 to 60minutes of training with a professional that can teach you efficient mechanics and introduce proper loading strategies.

2) IMPROVE YOUR RUNNING MECHANICS 

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The way in which you run affects how the force / stress of running is applied to your body!  More efficient mechanics = more even distribution of force applied to your muscles = lesser chance of over-stressing the system which leads to those damn shin splints!

These activities will be way less impact on your legs and will teach your feet, muscles, and mostly your MIND how to properly move your body!

How often do you work on your running technique?  

Maybe you’re not on the track team, but I am willing to bet if you are on on the lacrosse, soccer, or field hockey team, you run way more than you work on your technique.

 

Am I right??

 

What if I told you that by spending about 20-30 minutes 2-3 times a week for 6-12 weeks working on your running technique that you would decrease your risk, not just for shin splints, but for a whole plethora of lower body injuries?  

 

Allow me to introduce The Pose Method of Running (7).

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There are several studies (1,2,3,5) that show that running retraining alters lower extremity biomechanics.  Biomechanics is a big word to describe how your body and its parts move in relation to each other.

 

If we can adjust your biomechanics by retraining your running technique, that should make you less prone to the dreaded shin splint, AND help you to run faster and more efficiently (4,6,7)!

 

“But I’ve been running the same way since I was little!  Isn’t it too late to change it now?”

Nope.  

It’s never too late!  Sure, the early stages of re-learning how to run will be way more mentally tiring than physically, but I’ve seen it work time and time again.

 

 First, you need to learn the theory and reasoning behind the proper running technique (The Pose Method, which is a much longer post for another day)(7).  

 

Once you understand the concepts and what your body is supposed to be doing, it’s simple (4).  Just drill, drill, drill! Practice makes perfect!

 

“Ok, do I have to wait for this long post to come out, or are you going to help me right now?”

I’m going to give you some basic tricks to start.

  1. Find your “Running Pose” position, and always come back to it with every step.

  2. Running is falling forward, and then PULLING your foot off of the ground, let gravity help you!

  3. Always be in the ball of your foot, light and springy.

  4. Take shorter steps than you think.

  5. If you’re doing it right, you should feel your hamstrings working (and calves). (4)(6)

When can I start running again???

Once the inflammation has died down a little, you can begin GRADUALLY getting back into running.  

The human body is ADAPTABLE!

This means, if you want to run FAST, HARD, LONG, or at high intensities and AVOID the dreaded shin splints, you have to PREPARE your body for the stress of running.  

Build up your volume a little bit at a time, and before you know it, you’ll be fully back into it BETTER THAN EVER!

The age-old wisdom of rest, ice, and return has to be improved upon!

The female athletes of today need more than just rest!

Why?

Without addressing the problem of WHY the shin splints came about in the first place, you just put yourself in the position to get them again.

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A note from the author:I can speak from personal experience when I say that running the proper way WORKS! I had shin splints when I was on the track and field team in college and had to do running workouts, so I mostly stuck to throwing the javelin. After college, I got involved in a different form of competing and I couldn’t hide from running. I had to attack my weakness. I went through countless boring drills, and hours of running to a tempo (to help me shorten my steps). I learned not to hate running so much. I actually got kind of good at it! I’ve also worked with many athletes on their running technique, and they all have had similar outcomes. I promise it works people!If you are experiencing shin splints, I want to help! Fill out our assessment intake form and lets stop these shin splints once and for all!

References

  1. 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

  2. Breen, D. T., Foster, J., Falvey, E., & Franklyn-Miller, A. (2015). Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: a case series. International journal of sports physical therapy, 10(1), 85-94.

  3. Diebal, A. R., Gregory, R., Alitz, C., & Gerber, J. P. (2012). Forefoot Running Improves Pain and Disability Associated With Chronic Exertional Compartment Syndrome. The American Journal of Sports Medicine, 40(5), 1060–1067.

  4. Fletcher, G., Bartlett, R., Romanov, N., & Fotouhi, A. (2008). Pose® Method Technique Improves Running Performance without Economy Changes. International Journal of Sports Science & Coaching, 3(3), 365–380.

  5. Dunn, M.D., Claxton, D.B., Fletcher, G., Wheat, J.S., Binney, D.M., Effects of running retraining on biomechanical factors associated with lower limb injury, Human Movement Science, Volume 58, 2018,Pages 21-31.

  6. 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.

  7. Romanov, Nicholas S., and John Robson. Dr. Nicholas Romanov's Pose Method of Running: a New Paradigm of Running. PoseTech, 2004.

  8. https://posemethod.com/published-studies-research-articles/