“Ouch! When I touch it, it hurts!“ – Kunle Lawson

If you have ever run for sport or for recreation, you may have found yourself asking this question. And it, of course, can cover quite a bit of ground, but the thing we want to focus on is why we happen to feel this in our shins. Shin pain can be common in runners, in sprinters, in soccer players, in basketball players and anyone who runs consistently. Initially, the pain can be very mild and slightly annoying, but if ignored for a long enough period without treatment, it can lead to a litany of unwanted results, one of which includes not being able to run. There are several causes, some of which I will describe, and some remedies that each person can do to help avoid having to deal with this issue. 

In my experience, the four most common causes of shin pain or medial tibial stress syndrome (MTSS) are the following (in no particular order): inadequate/inappropriate shoe wear, rapid increase in training volume, biomechanical inefficiency, and changes in running surfaces. Multiple factors can occur simultaneously, but we will look at each one separately.

A rapid and sharp increase in training volume can lead to additional impact being placed on the body in general and on the shins in particular. Telling you that if you go from running 20 miles a week to 40 miles a week in two weeks’ time is a dramatic increase and increases the amount of stress on the body, you might say, ‘Well yeah, that seems obvious.’  It is, but sometimes we forget that increasing weekly mileage by more than 5-10% (depending on the runner’s experience) may be more than the body can adjust to adequately. It is wise to look at how much and how often we are training in a particular week to ensure we stay in a range that is comfortable. Moderate adjustments to weekly mileage are helpful. In addition to this, another way to increase volume without adding the additional stress of mileage on the body is to incorporate a form of cross training. No, I’m not telling you to go out and buy an Elliptigo (no sponsorship here), but cross training can improve the ability of the cardiovascular system generally at a lower impact cost to the body and help to alleviate injury.  If you work with a coach, he/she can likely give you guidelines to manage your cross training.  Anecdotally, I’ve use two minutes of cross training for each minute of running and have seen good results.  Let’s talk about shoes next. 

Shoes wear down when you run.  Honestly, shoes wear down when you wear them for any activity.  Full stop and on to the next paragraph. Oh, I should probably add a little more to this. When you run, your shoes and specifically the soles of your shoes break down. The more miles you have on your shoes, they less cushion they provide.  When there is less cushion beneath your foot, the impact is absorbed up the leg and guess where it may go? This isn’t new for anyone I’m sure, but there are a couple of things to keep in mind.  One, if you can, avoid using your running shoes as your walking around shoes. This will help you be able to accurately track how much mileage is on your shoes. Also, tracking your mileage will also help you know how much mileage on your shoes. The speed of wear varies from person to person so monitoring your shoes regularly will give you a better idea of how fast they are wearing. A brief guide is 300 to 500 miles, depending on size. For example, I weigh…a lot and am harder shoes than Elizabeth Taylor was on her ex-husbands. I typically get new shoes every 4-5 months even though I run less than 300 miles in that time span. For someone running 20-30 miles a week, the rule of thumb is roughly 15-16 weeks (3-4 months). And running in fresh kicks is important; equally as important is how you run in those fresh kicks.

Biomechanical inefficiencies can also lead to shin pain. What does that mean exactly? I am thinking about two specific things: running cadence and foot strike. Cadence and pace are not the same.  Cadence is how often your foot strikes the ground and pace are how fast you are running. A person can strike the ground a lot without going very fast and a person can go fast without striking the ground very fast. Each would look very different. Both cadence and pace are individual, yet optimal cadence to improve efficiency and minimize injury is 170-180 steps per minutes. I will tell you that after setting my cadence at 160 steps per minutes, 170 feels like sprinting.  However, I noticed that I was able to strike more under my body and run with a much more upright posture, which is more efficient. Unfortunately, I’m not fit enough to do that for very long or even at a medium pace. Having a foot strike more under the center of mass rather than in front of the center of mass, keeps the line of force in a more linear path and can thus alleviate some extra impact on the lower legs. Running on a treadmill with music makes tracking one’s cadence much easier, but I have not met too many runners who like doing that for too long.

So they like going out on the roads. Which is the preferred place for most folks…except for those who fancy running on trails and cross country.  And you know what? We still like them. Traditionally softer surfaces provide more force absorption than harder surfaces do. So doing some running on softer surfaces will lessen the impact on the lower legs, which can help to alleviate shin pain, which in turn leads to less painful running. And when that happens, everyone wins!

To quickly recap, when you increase your mileage, be sure to do so in very moderate increments (5-10% weekly). Make sure you are keeping an eye on your foot wear (I know not everyone runs in running shoes). Do what you can to improve your running cadence, if it’s not already at an optimal tempo that is. If it is, don’t go changing. You could also look to get a gait analysis (I know someone so get at me, dog).  And last, but not least, try to get some runs on softer surfaces if you can. Your shins will thank you in the long run…and so will Don Henley.

– Kunle Lawson, Track Coach Maryville College, KTC Board Member