When I started to increase my running in preparation for next years Brathay Windermere marathon (read blog here) I had an old and unwelcome friend return once more, shin splints.

Shin splints is a term often overused in connection with any pain in or around the shin and is a poorly understood term. In the physio world we call shin splints medial tibial stress syndrome (MTSS) doesn’t exactly roll off the tongue and so probably not surprisingly shin splints is still used more commonly. 

The problem arises when a chronic repetitive bending force is applied to the shin bone (tibia) and is very common in runners especially those that have rapidly increased their mileage, speed or running frequency. This causes a stress reaction within the outer layer of the bone and can be very painful.

Other causes of medial shin pain can also include overload of a muscle/tendon on the inside of your shin (Tibialis Posterior). 

Both of these conditions are usually triggered by a rapid increase in training load however certain characteristics of your running technique are thought to increase your risk of developing medial shin pain.

So I decided to turn the analytical spotlight on myself (something physios are notoriously reluctant to do) and did some filming of my running technique on the treadmill and whilst running overground.

So the most noticeable thing from looking at me from behind was that I had a tendency to land quite far on the outside of my heel on both feet. This means my foot has got a long way to travel in order for my foot to get flat (in physio speak we would call this an increased pronation excursion angle). Now over pronation has long been unfairly demonized as the cause of most running related injuries however my foot is not rolling in excessively it’s just it’s got a long way to travel in a short space of time. This can cause increased force to be applied to the inside of the shin bone and means the muscles on the inside if the shin work a lot harder both of which can lead to medial shin pain.

The other noticeable thing from the video is that I start to roll my foot outwards before I have fully pushed off through my foot.

In fact it looks like I don’t push off through my big toe at all, this leads to a less efficient push off part of my running cycle (in physio speak we call this low gear propulsion). This might also help to explain why my calf muscles feel so tight and fatigued after a run.

The fix in the end was rather simple I used the running cue of thinking about pushing off through my big toe. This helped reduce my shin pain really quickly and after practising this cue over the last 3 weeks it feels much more natural, my 5 km and 10 km times have dropped and my calf feel much more comfortable even after longer runs.

If your struggling with medial shin pain the 1st thing you need to do is get it checked out by a qualified health professional who has experience of treating runners. Call our reception on 01539 725220 or ​book online here. 

If you want to read more about our RunFit running assessment and retraining packages and how they can help you run pain free or improve your performance click here.