Do You Get Shin Pain After Running?
You’ve probably found yourself here looking for advice about whether to run through shin splints.
In fact, one of most commonly asked questions I hear about this type of running injury is: ‘can I run with shin splints?‘.
The short answer is – No.
I realise that’s not what you want to hear, but it’s important.
Let me explain why…
Research tells us that pain in the shin region of the lower leg makes up 12-18% of all running injuries.
Technically “shin splints” isn’t a diagnosis but rather an umbrella term that includes a variety of problems that can strike the tibial region, characterised by shin pain.
Can You Run With Shin Splints?
For many runners who try to continue running with shin splints, the best case scenario is that they prolong the injury as they’re not giving the injured tissue an opportunity to heal. The worst case scenario is that the injury develops from shin pain into a full-blown tibial stress fracture.
That’s not something you need in your life!
Here’s what happens as you develop shin splints.
First, the shin bone (tibia) will progress from being normally loaded, to slightly overloaded, to very overloaded. Eventually, if we carry on the process, it may eventually fracture.
During the ‘overloading’ stages the bone becomes painful as the outside of the bone develops tiny microscopic fracture lines.
As I mentioned above, the very end of the spectrum, if you continue running with shin splints, is a tibial stress fracture. At this point, because the bone was repeatedly overloaded beyond its tolerance it fractures.
A common culprit? The continued stress and loading that comes with running.
Shin Splints Symptoms
Pain on the inside border of the bottom one-third of the shin bone.
Initially, the shin will be sore to touch after running. If you continue to stress the bone, running with shin splints, the pain will start to appear at the start of your runs.
Eventually, if you don’t take care of it, the shin bone will be sore before, during and after running. When a stress fracture occurs, the runner will have difficulty hopping on a single leg because the pain will be too great.
How to Recover From Shin Splints
There are three key principles in recovery from shin splints:
- De-loading of the bone
- Addressing why the injury happened in the first place
- Returning to running with appropriate intensity
De-loading the shin bone
Because the shin bone is overloaded, the runner needs to quickly get off their legs. From personal and professional experience, this is difficult to do for the obsessive runner. We’d rather continue to run and will the shin bone to not be sore next time. But staying on your legs will only worsen the stress reaction and bring you closer to an eventual stress fracture.
In order to avoid the advancement of the condition, I recommend a minimum of two weeks off running, rather than running through shin splints. I inform the injured runner that they can cross-train (ride, swim, elliptical, aterG anti-gravity treadmill) during this time, but they cannot go for even a small ‘tester’ run, as even a small amount of running with shin splints can irritate their condition and set the recovery back.
After the initial two weeks of de-loading the shin bone, we will do a hop test and examine the shin bone for tenderness.
Typically the runner requires a second two weeks off, and in many cases up to a third two weeks off (total of six weeks off running). The hop test and examination are repeated at the end of four weeks, and then again if needed at the end of the six weeks.
This de-loading phase is a perfect time to focus on areas of your training like strength and conditioning that can be lower impact, and will benefit you greatly when you get back to running. I always like to re-frame times of injury as an opportunity to come back stronger!
Here’s a link to a great set of strength and conditioning routines for runners:
What causes shin splints?
Runners who address the cause of shin splints have a much greater likelihood of making a smoother and more prompt return to injury-free running and normal training loads.
Typically, those that don’t address the underlying causative factors will return to running and suffer a recurrence of their shin pain.
The typical causes of shin splints are:
Often a sudden spike in training load (frequency, intensity, volume, or a combination of the three factors) will result in an overload of tibial stress and cause shin pain. This is often the case for new runners, or those stepping-up distances and training for a first marathon. Failure to schedule appropriate rest between sessions, or take recovery/adaptation weeks is also a common mistake.
Poor running technique
If you have a tendency to overstride or run with a slow cadence, your foot will be landing too far ahead of your body with each stride. This causes you to experience more of a braking force with each foot-fall, and experience more impact as your foot meets the ground. As this impact travels up the body, often it’s the shins and knees which suffer from the added stress. This stress compounds over time, often resulting in injury. Learn more about how running form affects shin splints in this post.
Lack of hip stability
Although the site of injury is the lower third of the shin region, the root cause of shin splints can often be traced to the hips, and a lack of stability in the hip region. The glute muscles, in particular, are really important when it comes to creating strength and stability around the hips; when the glutes are weak or inhibited, the knock-on consequences can lead to increased stress on the shins as we run.
Inappropriate running shoes
Your running shoes have an important role in helping you run pain-free. Often runners who come to my clinic with shin splints will have been running in shoes which are either completely worn-out or were the wrong footwear choice for the runner’s foot biomechanics in the first place. This video will help you make an educated decision when it comes to running shoe selection.
For more detailed information on addressing these factors, I of course recommend picking up a copy of my book: You CAN Run Pain Free.
How to return to running after shin splints
If the injured runner has had the appropriate rest, then they are ready to make a progressive return to running.
It’s best for the runner to follow a prescribed return to run program. I give the runner a schedule every week and then fortnightly for the first four weeks of running — sometimes longer.
The time frames for my return to run programs are on a case-by-case basis, depending on the athlete’s goals, injury history, running volume and body condition. On a return to running program, it is critical that the runner perform self-checks on his or her shin for any tenderness to touch (just push the area), and occasionally do the hop test. Knowing that the answer to ‘can you run through shin splints’ is a firm no, it’s clear that at the first signs of a return of your symptoms, it’s time to ease-up on the running.
What if you feel shin splints returning?
If you feel the familar pain of your shin splints returning, remember that running with shin splints is a bad idea. You now know that this isn’t an injury you can run through.
You now have the benefit of experience to draw upon. You know what the warning signs of shin splints will feel like.
If you feel these warning signs, I would advise any runner to rest their shins from running for one week before retesting the hop test and the touch test. Listen to your body. Don’t do too much too soon, and don’t push through the pain.
All the best with your recovery from the pain of shin splints and your return to injury-free running!Last updated on April 24th, 2019.