Shin Splint Prevention: Is It Real?

Going through all the MTSS/shin splints research be like:

'There is a fifth dimension beyond that which is known to man…
between science and superstition, and it lies between the pit of man's fears and the summit of his knowledge….
It is an area which we call "The Twilight Zone". '

Am I being a tad dramatic? Maybe.

But at the same, the more research we conduct on MTSS and the more data we gather, the less we know. Which is typically the opposite result of science-ing.

Hence, the Twilight Zone. (I'm sorry in advance for all the weird dreams you might have after watching re-runs.)

But in all seriousness:

It’s interesting that the current literature (within the past 5 years) all gravitate to studying the immediate affected area: the tibia, the general musculature of the lower half of the leg, and the foot. (more blog posts about that here.)

There's been some hopeful findings that have emerged such as:

  • That a history of having MTSS increases your chance of developing it again by 17%

  • Over-pronation of your foot/feet can indicate a higher likelihood of developing MTSS

  • A need to address and strengthen the "foot core"

  • A muscle strength imbalance may be present between foot invertors and evertors

  • Possible overactive soleus muscle affecting foot and ankle kinematics

  • A potential link that poor single leg balance in individuals with a history of MTSS can be indicative of a decrease in postural stability (influenced by neuromotor control)

  • And lastly, common thought that over striding and affected running form can potential contribute to MTSS

And these are a good start, but...

Largely, these findings still leave us with a big: I DON'T KNOW.

But if we walk through this together, I'd like to ask you to look at that list of facts again

…do you see a pattern with how I've arranged them?

The more I read, the more I noticed how "zoomed-in" the research picture was with occasional moments of "zooming out".

Such as, that list of fact starts with:

  • specific about foot biomechanics

  • gradually zooms out from the foot into the lower leg

  • until it ends in a big picture moment looking at running form.

Where are we going with this?

Right Here.

Our bodies rarely keep a problem isolated to only one area. Compensations will happen when one teammate isn't pulling their weight.

Compensations happen EVEN MORE when pain is involved (duh, shin splints hurt). What we know from years and years of research, is that pain can actually re-pattern our brain AND how our muscles turn on and off (or lack thereof).

Pain also makes it reaallly hard to get an accurate picture of what you can actually do. Because typically, if an action causes pain, you DON'T do it. (duh).

Example: think back to the morning after a really hard work out. You get out of bed, go to take that first step, and start waddling around.

WHY? Because you're freaking sore and you're trying to minimize how much you have to feel the soreness, hence walking weird.

And this seems to be an over-arching theme that is gradually emerging from more and more research:

is that treating MTSS is very individualized, specific, affected by how much pain the runner is in, and may have a larger neuromotor control aspect than first believed.