Understanding shin spints:

causes, prevention, and rehabilitation for distance runners

Shin splints, medically known as medial tibial stress syndrome (MTSS), are a common injury among runners, particularly those participating in cross country. This condition is characterized by pain along the inner edge of the shinbone (tibia) and is often caused by overuse or repetitive stress on the shinbone and the connective tissues that attach muscles to the bone.

Causes of Shin Splints

  1. Overuse: The primary cause of shin splints is repetitive stress on the shinbone and the tissues attaching muscles to it. This is common in runners who increase their intensity or duration of training too quickly.

  2. Improper Footwear: Wearing worn-out shoes or shoes that don’t provide adequate support can contribute to shin splints.

  3. Flat Feet or Overpronation: Flat feet or excessive inward rolling of the feet (overpronation) can place extra stress on the shinbone.

  4. Running on Hard Surfaces: Training on hard surfaces like concrete can increase the impact on the legs, leading to shin splints.

  5. Muscle Imbalance: Weakness in the muscles of the lower leg, hips, or core can lead to improper biomechanics and increased stress on the shins.

Prevention of Shin Splints

  1. Gradual Training Progression: Increase the intensity and duration of your runs gradually to allow your body to adapt.

  2. Proper Footwear: Ensure that your running shoes are in good condition and provide adequate support. Consider visiting a specialty running store for a gait analysis and shoe recommendations.

  3. Strength Training: Incorporate strength training exercises for the lower legs, hips, and core to improve muscle balance and support.

  4. Stretching and Flexibility: Regularly stretch your calves, Achilles tendons, and hamstrings to maintain flexibility.

  5. Cross-Training: Include low-impact activities like swimming or cycling to reduce stress on your shins while maintaining fitness.

Strength Training and Running Progression Program

A four-week program to help a cross-country athlete return to competition after experiencing shin splints should focus on strength training, flexibility, and gradual running progression. Here’s a structured plan:

Week 1: Foundation and Recovery

  • Strength Training (3x per week)

    • Calf Raises: 3 sets of 15 reps

    • Toe Taps: 3 sets of 15 reps

    • Eccentric Heel Drops: 3 sets of 10 reps

    • Hip Bridges: 3 sets of 15 reps

    • Planks: 3 sets of 30 seconds

  • Flexibility (Daily)

    • Calf Stretches: Hold for 30 seconds, 3 sets each leg

    • Hamstring Stretches: Hold for 30 seconds, 3 sets each leg

    • Foam Rolling: Focus on calves, shins, and quadriceps for 5-10 minutes

  • Running Progression

    • Day 1: 10-minute walk

    • Day 2: 10-minute walk

    • Day 3: 5-minute walk, 5-minute light jog

    • Day 4: 10-minute walk

    • Day 5: 5-minute walk, 5-minute light jog

    • Day 6: 10-minute walk

    • Day 7: Rest

Week 2: Strengthening and Light Running

  • Strength Training (3x per week)

    • Continue Week 1 exercises, adding resistance as tolerated

  • Flexibility (Daily)

    • Continue Week 1 stretches and foam rolling

  • Running Progression

    • Day 1: 5-minute walk, 10-minute light jog

    • Day 2: 10-minute walk

    • Day 3: 5-minute walk, 15-minute light jog

    • Day 4: 10-minute walk

    • Day 5: 5-minute walk, 20-minute light jog

    • Day 6: 10-minute walk

    • Day 7: Rest

Week 3: Building Endurance

  • Strength Training (3x per week)

    • Add exercises like lunges (3 sets of 10 reps each leg) and side leg raises (3 sets of 15 reps each leg)

  • Flexibility (Daily)

    • Continue with previous stretches and foam rolling

  • Running Progression

    • Day 1: 5-minute walk, 25-minute easy run

    • Day 2: 10-minute walk

    • Day 3: 5-minute walk, 30-minute easy run

    • Day 4: 10-minute walk

    • Day 5: 5-minute walk, 35-minute easy run

    • Day 6: 10-minute walk

    • Day 7: Rest

Week 4: Preparing for Competition

  • Strength Training (3x per week)

    • Maintain previous exercises with added resistance as tolerated

  • Flexibility (Daily)

    • Continue with previous stretches and foam rolling

  • Running Progression

    • Day 1: 5-minute walk, 40-minute easy run

    • Day 2: 10-minute walk

    • Day 3: 5-minute walk, 45-minute easy run

    • Day 4: 10-minute walk

    • Day 5: 5-minute walk, 50-minute easy run

    • Day 6: 10-minute walk

    • Day 7: Rest

Summary

Shin splints are a common issue for cross-country athletes, caused primarily by overuse, improper footwear, and running on hard surfaces. Prevention strategies include gradual training progression, proper footwear, strength training, and maintaining flexibility. A structured four-week program can help athletes recover from shin splints and safely return to competition by incorporating strength training, stretching, and a gradual increase in running intensity. By following this program, athletes can rebuild their strength, improve their flexibility, and gradually progress their running to ensure a safe return to competition.