3 Simple Exercises for Shin Splint Recovery

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Written by: David Burnett, BScH, MScPT, Registered Physiotherapist

Introduction

Medial Tibial Stress Syndrome (MTSS) is a common running overuse injury or repetitive stress injury in the shin area
Generally known as “shin splints”
Can be described as vague, diffuse pain along the middle aspect of the shin during and after activity
Prompt diagnosis and appropriate management of MTSS is imperative to help athletes return to full activity in a timely manner
Important to differentiate from stress fracture of the tibia

Extrinsic Risk Factors for developing MTSS:

Female gender
Increased BMI
Fewer years running experience
Training errors – increased volume/intensity too quickly

Intrinsic Risk Factors (*Best evaluated by a Physiotherapist*)

Biomechanical abnormalities
Muscle imbalance and inflexibility – typically tight and weak gastrocnemius, soleus, and plantaris muscles and weak hip and pelvic muscles

Things to note for runners:

Narrower base of support/step width increases shin loading and may increase risk of MTSS
Collapse of the foot arch increases shin loading and may increase risk of MTSS
Increasing step rate and reducing stride length reduce shin loading and may reduce risk of MTSS
- Increased likelihood of developing shin pain with step rate equal to or below 164 bpm
- Decreased likelihood of developing shin pain with step rate equal to or above 174 bpm
Softer footfall found to reduce impact forces of shin

Conservative Interventions may include:

Initial rest and ice
Modifications to training
- Improving stride width and preventing ‘arch collapse’
- Increasing step rate – quicker shorter strides
- Running with a soft, quiet footfall
Appropriate stretching and strengthening
Appropriate footwear
Manual therapy to correct biomechanical abnormalities
Graded return to activity

Sample Strengthening Exercises

***Note: These are not recipe exercises but rather examples – see your Physiotherapist for an individually tailored, appropriately graded exercise program!

Single Leg Soleus Bridge

Place the front of your foot on a step. Using your arms to support you, squeeze your butt cheeks together and push up into a bridge with one leg. Hold for 2-3 sec at the top. Don’t forget to breathe! Repeat both legs 3 sets of 8-12.

Bent Leg Calf Raise

Similar to a straight leg calf raise but bend your knee to around 30 degrees. Push up onto your toes focusing weight through your big toe. Use support if needed initially. Repeat both legs 3 sets of 15.

Step Ups

Place your foot on the step, push up with that leg and finish with opposite knee raised to 90 degrees. Return to the floor slow and controlled. Repeat both legs 3 sets of 8-12.

David Burnett, BScH, MScPT
Registered Physiotherapist

David joined GRSM in July 2016. David graduated with his MScPT from Leeds Beckett University and B.Sc. Biomedical Sciences from the University of Waterloo, while playing for the Warriors Men’s basketball team.

He has been working in hospital and multi-disciplinary clinic environments in the UK since graduating.

Dave previously worked as a Sport and Fitness Director in Sydney, Australia. In his free time, Dave enjoys keeping active through the gym, playing any and all sports and enjoying the outdoors.

Resources

Brindle, R.A., Milner, C.E., Zhang, S. and Fitzhugh, E.C., 2014. Changing step width alters lower extremity biomechanics during running. Gait & posture, 39(1), pp.124-128.

Crowell, H.P. and Davis, I.S., 2011. Gait retraining to reduce lower extremity loading in runners. Clinical biomechanics, 26(1), pp.78-83.

Hobara, H., Sato, T., Sakaguchi, M. and Nakazawa, K., 2012. Step frequency and lower extremity loading during running. International journal of sports medicine, 33(04), pp.310-313.

Luedke, L.E., Heiderscheit, B.C., Williams, D.S. and Rauh, M.J., 2016. Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners. Medicine and science in sports and exercise, 48(7), pp.1244-1250.

Newman, P., Witchalls, J., Waddington, G. and Adams, R., 2013. Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Open access journal of sports medicine, 4, p.229.

Meardon, S.A. and Derrick, T.R., 2014. Effect of step width manipulation on tibial stress during running. Journal of Biomechanics, 47(11), pp.2738-2744.

Neal, B.S., Griffiths, I.B., Dowling, G.J., Murley, G.S., Munteanu, S.E., Smith, M.M.F., Collins, N.J. and Barton, C.J., 2014. Foot posture as a risk factor for lower limb overuse injury: a systematic review and meta-analysis. Journal of foot and ankle research, 7(1), p.55.