What causes shin splints and tips on how to run pain free

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. 

Richard’s case of festival shoulder

Spending a weekend in a tent, ankle deep in mud, in a field somewhere in North Yorkshire left me with several things.

  • a strong desire to buy a camper-van
  • a debilitating lack of sleep
  • a very sore and painful shoulder

Now this could have been brought on by some over-energetic dad dancing whilst raving into the early hours of the morning. But instead I think it was caused by a combination of lifting and carrying all our camping gear from the car to the campsite, holding my sleeping 3.5 yr old daughter for an hour whilst watching a band and then carrying all our gear back through thick mud to the car.

I woke up on Monday with a really painful and stiff shoulder wondering whether I’d be able to ride my bike to work never mind spend all day treating patients. I knew I needed to get my shoulder moving and after some Ibuprofen and paracetamol I could start to exercise and move it which helped to further reduce the pain.

I continue to be amazed at the ability of the human body to heal itself as long as we put it in the right environment to allow it to do so. Fortunately the following week I was on holiday camping with my family and a combination of early nights, being able to run every other day and relaxing on the beach not having to worry about work in combination with a few strengthening exercises allowed it completely settle.

We see a lot of people with shoulder pain with a similar story, instead of a festival shoulder it might be a 1st good gardening weekend of the year shoulder or a I’ve been painting ceilings for 3 days shoulder. Basically if we expose our shoulders to a level of activity and strain that they are not used to too quickly and don’t give the muscles and soft tissues time to adapt to this new level of load it’s going to get sore.

So the take home message is to try an pace yourself and introduce any new activities at a gradual rate to allow your body to adapt and in my case make sure we pack a lot less stuff next time we’re camping at a festival!

If your suffering from a painful shoulder and don’t know what to do about it call our reception team on 01539 725220 and find out how we can help. You an also book online by clicking here

Lisa’s hurting hamstring

Some of you will already know Lisa our practice manager. A few months ago Lisa completed the Keswick to Barrow walk along with Kerry one of our physios. They did amazing raising loads of money for some worthwhile causes as well as being the fastest all female team to finish.  

During her training for the walk Lisa had increased her walking mileage a lot in a short period of time and started to get some pain in the back of her knee. This got worse after the walk and was starting to be painful during and after a run.   

Now Lisa identifies herself as a runner it's part of who she is, part of her DNA. She loves running, and I mean really loves it, so much so she just carried on despite the pain. Sound Familiar? 

She even did the Grasmere gallop a 10km trail run a few weeks after the walk but found her knee pain was worse than ever after. It got so bad she even had to stop running, now. Now what do you call a runner who can't run?

A "ner"!!  

Now the funny thing is Lisa works in a physio clinic, she is surrounded every day by expert physios with loads of experience treating injured runners. We even have a RunFit service that that analyses and retrains running technique. And to top it all off Lisa gets free treatment as an employee.  

So it might surprise you to hear that Lisa didn't mention her injured knee to any of us. Not one little peep!  

Why I hear you cry!  

The reason is something we hear all the time from our clients.  

She was scared we would tell her to stop doing the thing she loves, running. This is despite the fact that she had already stopped running because she was worried about the pain and doing more damage.  

Lisa finally fessed up and told us her tale of woe. We listened to her story including what she wanted to achieve with her running (a sub 2hr half marathon). We assessed her and found a sore hamstring tendon inserting into the back of her knee (hamstring tendinopathy). Lisa was given some exercises to help calm down her pain followed by strengthening exercises to help build strength in her hamstring. We explained her problem and told her she could even start running again as long as the pain stayed at a low level and wasn't worse the following day.  

Lisa is now gradually increasing her running and strengthening exercises. She has a lot less pain and we have analysed her running technique and identified some areas she can work on to help reduce her risk of injury, improve her running and smash her 1/2 marathon personal best.   

Lisa has very kindly agreed for us to share her story and some of her RunFit analysis videos and we will be catching up with her over the next few months to see how she gets on.  


Our Team

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Richard Clarke


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Kerry Singleton


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