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Shin Splinting

Ah, the dreaded shin splints. Like chicken pox, awkward middle school dances, and pimples, it seems as though shin splints are often a necessary evil to enter adulthood. With the start of school sports, especially cross county and soccer, we are sure to see a rush of athletes with shin pain due to running.

What exactly are shin splints? Many online resources have resulted to classifying shin splints as “lower leg pain that occurs below the knee” or “pain along the shin bone”. Sophisticated medical specialists may call it “medial tibial stress syndrome”, “anterior tibialis stress syndrome”, tibial periostitis, and many other scary named –itisis and syndromes. However, we are staying old school and will stick with “shin splints”.

For our purposes, “shin splints” will be the term used for any pain along the shin bone. We will also lump non blunt-traumatic “compartment syndrome” in the bucket. So, compartment syndrome, stress syndromes, periostitis, etc. can be attributed to very similar biomechanical faults.

I like the use of the term shin splints because it is essentially describing what is happening biomechanically to cause the pain. The term “splint” as a verb can be defined as 1) to secure, hold in position, or support by means of a splint or splints and 2) to support as if with splints.

Shin pain occurs because the tibia-fibula complex is “splinting” to control for improperly dissipated torque from the body above or below it.

Walking and running efficiently and without pain or tissue damage requires us to dynamically support and control for rotational forces throughout the body. As one leg swings forward the pelvis rotates towards the forward leg as our trunk counter-rotates back in the other direction (opposite arm swing). Our head rotates opposite the thorax in order to keep the cranium stable and oriented forward. Even our eye muscles are working with each step to keep our eyeballs in the proper visual field. Improper control of rotation anywhere in the body can lead to shin splinting to control for the improperly dissipated torque.

When the foot hits the ground, we need properly controlled force at the hip to absorb the impact of the landing, a sort of loading the hip and glute muscle to spring out of the hip in to the next step. Improper absorption or propulsion at the hip could result in splinting of the shins to manage the rotational force.

As we move up the chain, improper thorax rotation as we run (including arm swing) could result in splinting of force at the shin. As a leg moves forward, humans are designed to dissipate the force by allowing the trunk to rotate and our opposite arm to swing. Improper rotation or arm swing contributes to poor rotational force dissipation from the leg, resulting in splinting to occur often at the shins, back, or neck.

Moving along up, as one leg goes forward, the trunk counter-rotates back the other direction and the head (should) stay forward and level. Improper neck and cranium control to manage the rotational forces below will result in splinting somewhere in the body. This may be head splinting (headaches), neck splinting (neck pain and tightness), back splinting (back pain), or shin splinting.

On a personal note, I dealt with shin splints for much of early 20s in college. They were the primary limiter of me running at my desired levels. It was not until I addressed my thorax and rib cage mechanics that I was able to completely address my shin splints. After dealing with shin issues for over 5 years, I can now say I have been shin-splint free for nearly a decade. I just had to learn how to properly dissipate torque!

So if you are feeling shin pain as you ramp up fall running (even if you are not in your awkward teenage years), find out how to better control your torque. To do so you will likely need to address areas other than your shins. As my colleague, Brian Benjamin often says, Rotate and Dominate!

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