UKC

Hi everyone,

I’m hoping the collective wisdom of UKC can help a frustrated runner with advice regarding shin splints please?

I’ve been running for two years and was gradually building my mileage and elevation gain and hitting the trails in anticipation of a mountain ultra marathon. However, in February I made the classic training error of too much load through a combination of distance, gain and weight training. My final pre-injury week was 50 miles with 2500m of climbing – and then the dreaded shin issues started.

Since February I’ve tried to keep going with some exercise, from trying a couple of runs (Feb/Mar), jumping on a spin bike (not for me), some walks/short hikes (1-2x per week), strength training (2x per week) and calf work (~4x per week) – but the issue is still there. I also even took 3 weeks off walking/hiking entirely recently to no avail. I’ve not even been bouldering since Feb ☹.

The issue has moved around my legs from day to day, week to week – One day it’s the left leg, next day the right. One day a ‘spot’ of tenderness on the inside of the tibia, a few days later that’s gone and now there is a burning sensation in various different areas of the shin, then the ‘spot’ comes back. Back in Feb it was more a deep calf ‘ache’, now more tingling/pins and needles in various areas of the lower leg. Sometimes the issue is there, other times not. Sometimes a 2hr hilly walk can be fine, other times a 10 min walk sets it off. Some times even after days of doing nothing I’ll get persistent lower leg burning when sat down at work. The issue seems random, it moves about, and I can’t pin down a clear pattern.

All I know is I’ve been off running/hiking/bouldering for 3 months and it doesn’t want to get better. I can’t ever say the issue has even been particularly ‘painful’ – I’ve read stories of people breaking down at the side of the road in agony, best way I can describe mine is to say that it is ‘kind of just there’.

I’ve been to 2 different physios since February and am currently searching for a 3rd (Recommendations welcome! Willing to travel). The advice I’ve received from the physio has been “de-load the legs and do lots and lots of calf and anterior tibialis exercises every day” – which I’ve probably managed about 50% compliance with due to calf fatigue. I have always done ~30mins per day of foam rolling and stretching in the evening.

Does anyone have any insights into this – I’d love to hear your personal experiences? What did the physios prescribe you? Did you ever get over shin splints and if so how/how long did it take?

I’m starting to get very frustrated and dejected by this – I just want to be back out on the trails.

Thank you to anyone who managed to get this far - any help would be very much appreciated.

Shoes? 

Do much stretching, strengheninng? 

What surface do you normally run on?

 Checked for stress fractures?

I've not looked much into shoes but my road and trail shoes have always been the same brand and I cycle through the shoes, maybe something I need to consider?

I stretch and foam roll for ~30mins every evening. I strength train twice a week - squats, RDL, Glute Bridge, Core, Calf raises, Glute Medius work. I do physio exercises (calf raises and Tib Ant exercises)~4x week

Was running on the road 2-3x during the week and then on the trails Saturday and Sunday (50/50 split)  

Physio got me doing the 'Hop Test' at last appointment which was ~2weeks ago - 3 hops on each leg - and that was fine.

I have considered paying for a MRI but haven't made that leap yet

Thanks! 😊

https://www.amazon.co.uk/Trigger-Point-Therapy-Workbook-Self-Treatment/dp/1...

This book has helped me prevent running niggles turning into injuries that stop me running. Foam rolling is good, but if you have trigger points involved in your shin pain, you may need to get a small, firm ball to get to them.

I've never got much from using a foam roller , 30 mins sounds a lot 

Calf lowers got rid of my shin splints when it came along, I don’t use a roller much but a couple of pretty painful massages also helped free things up.

Anybody got advice on torn miniscus😏

Fellow long term sufferer here. Not what you want to hear but I have to be very careful about overuse. I can’t run back to back days for instance.

I got a physio to check my running gait and found that I ran slightly toed in on my offending leg and it swung across me very slightly (20mm) as I run. So t try to be aware of this when I run.

But what you describe isn’t what I would typically call shin splints. Mine are focussed on the lower inner shin edge and only there.

Thanks for the recommendation - i will check it out! 😊

It would only be around 10 mins of foam rolling on the legs and then 20 mins stretching every evening

Out of interest, what was the calf lowering programme that you were doing? Were you doing them everyday and then were you doing high reps/body weight or low reps/high weight? Did you do any other exercises (running/walking/cycling/swimming/climbing) whilst you were struggling with shin splints?

Currently, I'm prescribed:

-3 sets 25 reps body weight single straight leg off a step

- Alternating 3 sets 25 reps body weight single leg bent knee / 5 sets 5 reps with weight single leg bent knee

But I was finding that doing them everyday my capacity was going downhill due to fatigue and my calf's were burning.

I'm afraid I can't help with the torn meniscus ☹

That sucks and is my fear ☹

Yeah once I am back running again after this injury, this is definitely something I am going to be doing. Sounds like you got quite thorough gait analysis - would you mind who you used?

It was on the middle inner shin edge at the very start but it does seem odd that it moves around, I'll get specific spots that are tender to touch that then move elsewhere on the leg, other times burning sensation down the whole leg, other times burning sensation in a specific area, I'll get tingling sensations on the skin whilst walking 10mins down the road but then other times it will be ok. It also seems to move between legs so I will feel like one leg is ok and then I'll do something and it will come back in that leg

(I have absolutely no medical training, but...) do you think that there could be some sort of trapped / aggravated nerve issue going on here?  Might explain the 'mobile' nature of the sensations.

Have a look at this website but mainly he has a link for recommended physiotherapists that treat this type of condition.  There may be one near you.  Good luck.

https://www.running-physio.com

Hi 

it was a very straightforward and quick analysis which you could do yourself with a friend.

Get on a treadmill and start running…have them stand behind you with a phone held in a fixed position and video for 2/3 minutes. My physiotherapist (hands on therapy in Sussex) had an app that drew gridlines on screen to check height/alignment of hips, shoulders etc but suspect you can do without this.

I’m slightly bow legged on the offending leg and you could see it slighting toeing in and moving across compared to my “good” leg.

I can recommend getting Plantar Fasciitis as well. Takes your mind off the shin splints 😀

No medical training, but I’ve had shin splints in the distant past when I was upping running schedule too quickly and what you are experiencing I would be very surprised if it to was just that, if at all related. My shin splint pain never moved and was only ever on the shin.

I would suggest you go and see a GP and get appropriate tests/referrals as deemed appropriate. I’m not going to suggest what it could be, but let’s just say I experience very similar range of symptoms and variability like you have mentioned and it is not shin splints in my case.

Good luck. 

I was a competitive 400m runner in the early 90s and got bad shin splints, which I ended up having an operation on. My advice would be to have several weeks off and start back slowly from nothing. Or even better, sack off running and start cycling. 

A couple of point to consider...

1. Your symptoms don't sound like shin splints. SSs are micro-tears in the weak muscles on the outside of the shin bone. The pain doesn't move. If it does, the problem is more likely to be neurological, possibly due to some inflammation round the hip/lower back.

2. MRI is useful mainly when the cause of pain is pretty obvious and you want to just understand the extent of the damage. The problem is that an MRI scan will show up everything that's a bit out of the ordinary in your body and once you're past a certain age there are LOTs of things not quite perfect any more. Most of them are quite benign and cause no pain. An MRI scan can't identify which one of them is the source of any pain or discomfort unless it's fairly major and stands out, in which case a physiological diagnosis would have identified the root cause.

Usual disclaimers: I'm not a doctor or radiologist, but I've had classic shin splints from running and plenty of MRI scans (for other reasons) over the years.

I think this is something that I may need to look into

Thanks 😊

Thanks - I will check this out! 😊

Thanks for letting me know who you went with - I will have a look at their website. Definitely going to do a gait analysis, sounds super useful.

I have had the joys of Plantar Fasciitis a couple of years ago, wasn't pleasant lol My prescribed exercise for that was also calf raises. But both at the same time would be horrid!

Thanks 😊

Thanks for the advice - and from reading your reply and others it seems like something I need to do. 

Thanks 😊

That sucks ☹

I did take 3 weeks off with no walking or running, still did my strength training twice a week and physio 4x week. But my legs felt weak, I was also still getting the burning and tingling when sat down. I did try spin but i found that was also aggravating it too. But yeah I will start slowly with the running when I get back into it. I suppose I have not actually tried removing everything (including Physio exercises) to see what that does but as I sit down at work for 8hrs, to then sit down all evening just seems really rubbish.

Thanks 😊

I hadn't really thought about that with the MRI so that's definitely something to consider. All these replies are making me think I need to go to the GP to get checked out for something other than shin splints.

Thanks 😊

I wasn’t to prescriptive about it but 3x 30 about 3 times a week plus the odd stretch on steps/stairs when waiting around, ITB tightness can also throw up all sorts of issues so always worth keeping that stretched out.

I was cycling and swimming at the same time so rarely found overtraining a major problem.

It may well be that you have shin splints and that your body is adjusting to protect the lower leg and it is this change in posture that is causing a lower back issue leading to your other symptoms.

Might be worthwhile doing some Pilates style back exercises.