One of the most common running injuries we get asked about is shin splints and how to get rid of them…

A common misconception about shin splints is that they are an actual condition of the shin bone or tibia.

Shin splints describe the pain felt along the front of your lower leg, at the shin bone. The pain concentrates in your lower leg between your knee and ankle.

The pain can be caused by inflammation of the muscles, tendons, and bone tissue. 

Let’s have a look at what shin splints are in a bit more detail, but more importantly, what is the best way to avoid getting them?

Shin Splints

As we already mentioned, a common misconception about shin splints is that they are an actual condition of the shin bone or tibia.

That is not true. 

Shin splints are normally caused by one of the muscles that are running down the tibia. Typically it is the medial or inside of the shin that normally hurts.

The connective tissues between the muscle and the shin become inflamed and it starts to pull away from the shin, causing shin pain. 

That is really the pain that you are feeling. 

(Side note: extreme levels of pressure and tightness may actually indicate compartment syndrome)

There is, therefore, pressure running through the tibia…

If we don’t treat it and you keep running through the pain, shin splints will ultimately turn into a pre-stress fracture (which is a little bit of bony oedema and bleeding on the actual bone).

Ultimately, if you continue running shin splints, it could turn into a stress fracture of the tibia.

Shin splints are an extremely common novice runner’s injury.

This is because as human beings we are always driven to succeed, improve, go faster, get better and run longer.

Often this is what happens as we always build up too quickly, and we then typically get shin splints.

There are a few other main causes of shin splints…

What Are Shin Splints Caused By?

The most common causes of shin splints:

• Doing too much too soon.
• Running in the incorrect running shoes.
• Not having a body that is adapted for exercise.
• Stress reactions to bone fractures.

How To Tell If You Are At Risk Of Getting Shin Splints?

There are a few risk factors to consider that give you a higher chance of getting shin splints…

• Not having a body that is adapted for exercise, such as flat foot syndrome.
• muscle weakness in your thighs or buttocks
• Lack of mobility
• Running on a slanted surface or uneven terrain
• Running on hard surfaces
• Using worn-out shoes

Let’s chat a bit about the recovery process…

How long do shin splints take to heal?

There’s no way to say exactly when you will be fully recovered from your shin splints…

It really depends on what caused them. People also heal at different rates. 

When you feel that you are recovered, you should make sure to properly warm up (LINK) and, you should do so gradually over a few weeks. 

Try to start out running on soft, level ground, and wear the correct shoes.

Don’t Ignore The Pain From Shin Splints

A major issue with shin splints is people tend to ignore the pain.

Pain is a signal from your body telling you something isn’t right…

Runners think it will get better as they get a little bit fitter but that is generally not the case. This is why people often end up with quite a serious case of shin splints.

The good news is, that even if it is serious, it shouldn’t take more than two weeks to deal with the actual pain.

How To Get Rid Of Shin Splints

To heal shin splints from the acute phase can take anywhere in the region of 48 hours to two weeks, depending on how far you pushed yourself into the pain.

• The first thing you need to do is rest.

I know, it’s the last thing a runner wants to hear…

…but continuing to run is just going to make the shin splints worse.

You can also take an anti-inflammatory if needed to help speed up recovery, but this is not a long-term solution and should be recommended by a doctor.

• The second thing you need to do is run an ice pack over the affected shins for 20 minutes three times a day.

This will also help settle the inflammation.

• Thirdly, a very simple strength training program will help strengthen your lower and upper legs, as well as your glutes and core. 

Exercises like toe raise and forward & lateral band walks, for example, are perfect.

• And then lastly, grab a foam roller and foam roll your legs. 

In summary…

What you can do right now to heal shin splints fast:

• Rest (Take an anti-inflammatory, if needed, to settle the inflammation)
• Run an ice pack over the affected area 3 times a day for 20 minutes
• Strength training twice a week
• Foam rolling daily

So avoiding shin splints altogether would be the best-case scenario, but how do you not get shin splints?

How to prevent shin splints in the first place

1. Get Proper Running Shoes

When people start running they very seldom start off in the right pair of running shoes.

They decide they want to start running to get fit and improve the quality of their life or to run a marathon. 

Whatever the reason is, they go into their closet and pull out whatever shoes they’ve got in there.

Their excitement and exuberance to get started, plus very often incorrect footwear is a lethal combination when it comes to shin splints.

How To Choose The Correct SIZE Running Shoe For YOU: 3 Simple Hacks To Get The Perfect Fit 

2. Strength & Conditioning Training To Get Rid of Shin Splints

Here are some of the things you can do from a strength and conditioning perspective to prevent and treat shin splints as a runner…

Strength and conditioning won’t directly help with your shin splints…

Essentially, shin splints are mostly caused by an overload issue and by an imbalance between your anterior and posterior compartments between your lower limbs…

The strength work that you should be looking at…

There is a muscle in the front of the shin called the tibialis anterior, this muscle is the one people tend to worry about because it gets very tight and starts to spasm. This muscle is not there for shock absorption… 

So when people ask if you can do strength training for shin splints… the answer is yes, but to strengthen that muscle, which is responsible for bringing your toes up (dorsiflexion). 

So really, if you’re strengthening that muscle, all you’re doing is improving your dorsiflexion not preventing shin splints. 

What we recommend is strengthening your pelvic stability, hip girdle, glutes, and definitely your inner thigh muscles. 

It’s important for people to know that if you are experiencing shin splints, it may not be an issue directly connected to your shins but rather in that chain like your hips, knees, or even shoes. 

You can download our free strength program: HERE

3. Build up really slowly

Follow a structured running training plan that will give your body time to adapt to the increased training…

If during your slow build-up, the pain returns, I would then suggest that you go see a physiotherapist.

Couple that with seeing a biokineticist because there is most probably a good chance then that you have an imbalance between your anterior and posterior compartments as we call it.

Effectively what that means is: The muscles on the front of your leg are stronger or weaker than the muscles on the back of your leg.

As a result… there is strain being placed on those anterior muscles causing them to get inflamed.

When To See a Doctor

If your pain has not been relieved by rest, ice, anti-inflammatory tablets, or foam rolling, then it is a good idea to make an appointment and your orthopedist or GP as they will be able to diagnose the exact source of your pain and recommend a treatment plan.

Join us for a free live online presentation of the…

The Running Through Menopause Masterclass

…and discover how you can run well (and faster) as you get older, without training more or harder than you currently are, all while avoiding injury. 

If it feels like you’re training harder than ever but not running the paces you’d like to be running or if you’re constantly tired, fatigued or running in some sort of pain, then this is specifically for you.

Wednesday 25 May 2022

11am Los Angeles | 2pm New York | 7pm London

A lot of people don’t know that the term “Runners Knee” is a broad term used to describe the pain you feel if you have one of several knee problems. 

You might have heard a doctor call it Patellofemoral pain syndrome.

Patellofemoral pain syndrome can be better understood as…

Pain around the front of the knee (patella). This is where the knee connects with the lower end of the thigh bone (femur).

Let’s have a deeper look into Patellofemoral pain or… more commonly known as runner’s knee…

What Is Runners Knee?

Most of the big five fall into the overuse category, but like shin splints, runners knee or patella-femoral knee pain, in particular, does come down to people building up too quickly.

We have got four muscles that make up our quadriceps, (quad meaning four).  

You’ve got a little guy called the Vastus Medialis oblique which is primarily responsible for stabilizing your patella. 

Then you’ve got some pretty big muscles too…

The point is when you’ve been inactive for some time your proprioception or the body’s ability to adjust itself to protect the joints is one of the things that becomes the most compromised. 

Those big quad muscles will stay quite big and they will work quite well but your Vastus Medialis oblique is probably not going to work so well. 

This results in some misalignment with your patella tracking. Particularly If you build up too quickly and you don’t give your body a chance for that Vastus Medialis oblique to start activating as it should and to start getting a little bit stronger… in a nutshell, it will lead to problems such as pain, particularly in and around your knee cap.

Similarly, if you have some biomechanical issues you may pick up Runner’s knee…

Your quadriceps run into your patella tendon and your quadriceps tendon runs over and around the patella and becomes the patella tendon that joins the leg on the tibia or below the knee. 

If you have some imbalances or problems with biomechanics in particular then you can get that pulling on the patella at an angle and that can also cause you some patella-femoral pain or some irritation of the knee cap.

It may seem obvious but if you are going to start running in squash shoes or in the shoes you had in high school, you are going to run into problems. 

Often when people who have been running for years develop Runners knee or patella-femoral knee pain it is very often in response to their shoes.

This Is How To Tell You Need New Running Shoes

The knee is one of those joints that really needs to work in one plane. 

Your knee joint opens and closes, which is pretty much what it does. Where you have other joints like your ankle or your hip and they’re a little more forgiving because they move in multiple directions…

So if imbalance creeps in or if there is another injury and you come back from that injury but it has caused some change or shift in your running gait and you finally find yourself in a position where you are landing on the ground and your knee is no longer able to move in just that straight plain thereby causing a bit of stress on the knee….That could also potentially cause patella-femoral knee pain.

Symptoms Of Runners Knee

There are 3 main symptoms of Runner’s knee.

1. Pain

• Pain in/ around your kneecap that happens when you are exercising.
• As well as pain after sitting for a long time with the knees bent. 

2. Grinding Sounds

• Rubbing, grinding, or clicking sound of the kneecap that you hear when you bend and straighten your knee.

3. Tender Kneecap

• If your Kneecap is tender to the touch.

How Is Runner’s Knee Diagnosed?

Healthcare providers can diagnose Runner’s knee by looking at your health history and by conducting a physical exam, possibly using an X-ray machine.

Let’s have a look at some of the main reasons why you could experience Runner’s knee…

Causes Of Runners Knee

1. Overtraining
2. An Imbalance
3. Not Warming Up Correctly
4. Knee Trauma

Overtraining

Long periods of overtraining can cause runner’s knee in even the most experienced athletes. This is why proper recovery is so important. 

By not recovering properly, and if you continue to follow your running program without strategically planning rest days, you are at risk of injuries like patellofemoral syndrome.

An Imbalance

Our knees sit between our ankles and hips, so if there is an imbalance or dysfunction in either our ankles or our hips… there is a higher chance that we will experience runners knee.

Not Warming Up Correctly

If you want to avoid getting injured as a runner, only running is not enough!

In the video below, we walk you through exactly what to do before every run that you do.

It only takes a few minutes but if you start doing this as part of your pre-run routine, you can save yourself a lot of time and heartache down the line because of training missed due to injuries

Knee Trauma

When an accident happens and it involves a direct impact on your kneecap… it can lead to inflammation and therefore Runner’s knee.

Now that we know the causes of Runner’s knee, the good news is that it is treatable!

How To Treat Runners Knee

Firstly and very importantly, rest. 

We then need to wake up that Vastus Medialis oblique and that is not a difficult thing to do…

It’s done in two ways:

Strength Exercises

This would involve 30-degree squats (or even less if there is a pain), a little pain-free range of motion such as single-leg squats, single-leg press-ups, and step-ups onto a very low step at first.

We’ll have a detailed look at strength training exercises for Runner’s knee in the next section.

Work On The Proprioception Simultaneously

The easiest way to do this is to stand on a thick carpet or rug, balance on one leg, and close your eyes. 

That will throw yourself completely out of kilter and all the muscles in your ankle, in your bum, and around the knee that are supposed to stabilize those joints will be forced to engage better because there will be an exaggeration of the movement.

As you repeat that over time, that loss of balance will get smaller and smaller as those proprioceptors do their job, your Vastus Medialis oblique will be doing its job better and your runner’s knee or patella-femoral knee pain shouldn’t be bothering you anymore.

As we mentioned above, our strength & conditioning expert Shona Hendricks talks about what strength training you can do to prevent Runner’s knee. 

Strength Training for Runner’s Knee

To prevent knee pain when running, download our free strength program here.

Being sidelined from a running injury is the last thing any runner wants. 

Based on this case study, more than 80% of running injuries are caused by repetitive stress and according to the same study, the knees, legs, and feet are the most common injury areas for runners. 

According to the case study, the location-specific incidence of running injuries is as follows:

• Knees: 7.2% to 50%
• Lower leg: 9.0% to 32.2%
• Upper leg: 3.4% to 38.1%
• Foot: 5.7% to 39.3%
• Ankles: 3.9% to 16.6%
• Hips, pelvis, or groin: 3.3% to 11.5%
• Lower back: 5.3% to 19.1%

Now that we know that running injuries usually happen when you push yourself too hard, let’s have a look at our first common running injury of the series…

Piriformis Syndrome

Piriformis syndrome can be a real pain in the butt for runners! Literally…

Piriformis is a muscle in your glutes and hip structure, which plays a massive role in your walking gait and running gait. 

Piriformis syndrome is when that muscle becomes so tight that it compresses the sciatic nerve and creates a lot of pain.

Two main causes of Piriformis syndrome:

1. Some people have anatomy where the sciatic nerve runs through the Piriformis and if the Piriformis gets irritated, then there will be a pain.

2. Having tight, inflexible, immobile hips. Couple with the fact that we sit at our desks for most of the day with poor posture.

Why Do Runners Get Piriformis Syndrome?

Our glutes are so important in stabilizing the pelvis and also in creating the ‘hip drive’ every time we step. 

The Piriformis muscle (which is VERY little) has to work overtime. While it’s working constantly it’s getting tighter and tighter and if it’s weak it gets even tighter because it’s not able to contract correctly.

Now that we know what it is and how runners get Piriformis pain in the first place, let’s have a look at how we can alleviate the pain…

3 Key Stretches To Help Alleviate Piriformis Pain

1. Spine Rotation

Lie down on your back and put your arms out at shoulder height on each side of you.
Keeping both shoulders flat on the floor, bring your knees into your chest.

Gently roll both knees down towards the floor on your left side and hold that stretch in the lower back and glute. Then do the same on the right side.

You can use one hand to help pull the legs down and then hold for a few seconds (20 to 30 seconds). If you feel the need to repeat this, you can for two or three times on each side. 

2. Piriformis Stretch/ Glute Stretch

This stretch can be done either seated or standing.

Cross your right leg over your left leg knee and lean the body forwards slightly. You can even use one hand to push your right knee down a little. 

And do the same on the other side. (for 20 to 30 seconds)

None of this should be a balancing act as we are just trying to alleviate tension.

3. Groin Adductor Stretch

Seat yourself on the floor and place your legs out wide in front of you, keeping your knees as straight as possible.

Next, lean your body forward, place your hands on the floor if it makes it easier. 

The goal is to keep your legs as straight as possible and just feel the groin stretching and hold for 20 to 30 seconds

So, we know that by doing those 3 stretches we can alleviate the pain from Piriformis syndrome… but how do we prevent it from coming back again?

Stopping Piriformis Syndrome From Coming Back

It’s important to have that muscle, not in a tight state but it’s even more important to STRENGTHEN that muscle.

The reason we need to strengthen that muscle is so that it doesn’t get weak and then in turn get tight again. 

You need to do specific glute strength work to strengthen the Piriformis muscle. 

Strength Exercises To Prevent Piriformis Syndrome:

1. Lying on the floor clams… progressed to Clams with a band around the knees….progressed to Clams in a standing position.

2. Band walks. Putting the band around your knees and doing a couple of lateral or forward and backward walks… progressed to putting the band around your ankles.

By strengthening our glutes we are helping our glutes hold out pelvis into a much more stable position every time you step and run. 

If you’d like to download a free strength plan that will help, you can by clicking here!

As runners, almost all of us have experienced this situation…

Last week I headed out for a lovely Sunday morning EASY 10km with my trusty pup at hand and a cheerful smile on my face… the sun was shining and I was feeling absolutely fantastic…

That is until… 4km in and all of a sudden I feel intense muscle cramps in my legs.

I stop and try to massage my calves as well as possible… but that doesn’t help, I try to walk it out and that doesn’t help either… 

On my walk home I was thinking to myself all the million-dollar questions…

Will breathing through my mouth as opposed to my nose help prevent cramps?

Should I run slower to prevent muscle cramps?

Will muscle cramp pills help me?

What about using salt to prevent muscle cramps?”

People mean well when giving advice about preventing muscle cramps but the truth is that not even experts can say with certainty what the cause of muscle cramps is.

We do not know EXACTLY what causes cramps… but let’s have a look at what we do know.

Muscle Cramps

Cramps are seldom caused by a lack of electrolytes and in cases where this is the case, it’s generally accompanied by nighttime cramping.

It’s important to note that while a shortage of electrolytes in extreme conditions can contribute to cramping, too high a concentration of electrolytes will have the same impact as too little.

There is only one mechanism for cramps: Cross Bridge fatigue.

Simply put, as we proceed with exercise, there is an association with fatigue, a gradual decay in the signaling that instructs the muscles to contract and relax.

As this process delays we get to a point where your agonist (calf) and antagonist (peroneal and/or anterior tibialis) contract at the same time, this leads to cramping.

The cause of this cross-bridge fatigue is most commonly from muscle fatigue and in less than 30% of cases from nutrition (low magnesium, calcium, and/or potassium).

Strength training is likely contributing to this fatigue in the shorter term but should assist in the longer term.

Let’s have a look at lactic acid and if it’s the reason you are cramping when you run…

Is Lactic Acid The Cause Of Muscle Cramps?

It seems like everyone has their own theories about lactic acid and how they prevent it…

Lactic acid is real, it is measured as blood lactate. Lactic acid is NOT the reason for workouts to end. In fact, blood lactate is cleared very quickly and is used by the body to produce energy.

Everyone needs to understand that lactic acid is an important part of our energy metabolism.

Let’s break down what lactic acid is exactly…

Lactic Acid

Lactic acid is a by-product of the system when your body is breaking down chemical bonds inside the muscle that provides the chemical energy for the body to do mechanical work.

Almost as soon as lactate is produced it is shuttled away by the blood very quickly to the liver where it is processed. 

A lot of people swear that cramping is caused by a build-up of lactic acid…

This is NOT necessarily true… 

It’s more likely that cramps are caused by other by-products of energy metabolism which do cause the acidity or PH of the muscles to drop and for acidosis to take place, which causes interference of muscle function.

The Role Of Lactic Acid

Lactic acid’s role in exercise is still not properly understood.

At least we’ve gotten to the point where we know that it definitely provides some of the chemical energy that we need to produce the mechanical energy of movement. 

What we do know is that massages on the side of the road do absolutely nothing to help you get to the finish line…  so how do we prevent these dreaded cramps??

How to Prevent Cramps

1. Strength Training

Running is a compounding sport, it places that eccentric strain on your muscles.

Strength training helps build the structures around the joints and helps make the joints stronger, allowing your body to sustain the load from running so much better. 

Free Strength Training Program Here!

2. Pace Yourself Correctly

If you train logging 10-minute miles and you start racing 8:45-minute miles, your muscles won’t be prepared for that effort, and you’ll place yourself at a higher risk of cramping.

3. Warming Up & Cooling Down Correctly 

Lindsey, Shona, and Devlin walk you through exactly what to do before every run that you do.

It only takes a few minutes but if you start doing this as part of your pre-run routine, you can save yourself a lot of time and heartache down the line because of training missed due to injuries.

Let’s have a look at some common theories when it comes to preventing cramps while running…

Does Salt Prevent Cramps? 

We’ve seen it at races… People taking literal handfuls of salt and shoving it into their mouths… the question is… Does it help?

As we established above, there are a few people who suffer from cramping because of an electrolyte imbalance but that is not the main cause of cramping. Having salt to prevent leg cramps does help those specific people.

If you have very low stores of sodium then it can lead to cramping, although things like magnesium and calcium shortages are probably worse than having sodium shortage.

The reason why people shouldn’t take a blanket approach and just start taking salt tablets is that TOO MUCH SODIUM CAN ALSO LEAD TO CRAMPING.

So, in very long, ultra distances and multi-day races it is important to do some sodium replacement. 

For most people cramping is caused by fatigue, there is a delay in the signaling (due to fatigue) in telling muscles when to relax and contract. 

Eg. Your quads and hamstrings. When your quads are relaxed your hamstrings should contract and vice versa.

Watch this video to see when having salt is handy during race time.

Do Potato Chips Prevent Leg Cramps While Running?

Potato chips can prevent leg cramps because they contain potassium and sodium – two important electrolytes that help your muscles to contract, relax and function smoothly.

However, these nutrients can be found in many different foods, so eating a balanced diet, in general, will also help in preventing muscle cramps.

Potato chips contain potassium and sodium (salt) which are both important electrolytes that help muscles to function properly. 

Potassium aids in electrical impulse generation, so if you’re not getting enough of it, your muscles are more susceptible to cramping.  

It’s important to note that if you suffer from leg cramps, it’s difficult to say which food group you should be eating more of or what supplements you should take if your diet does not allow for all food groups because it’s different for everyone. 

You need to analyze your diet and see which food group you may be neglecting. It’s all about trial and error so find what works for you and stick to it.

When potassium is mentioned the first thing to pop into most people’s minds is BANANAS…

Do Bananas Prevent Leg Cramps While Running?

If you are susceptible to cramping, chances are that you’ve heard the notion that bananas can help to prevent or relieve leg cramps.

Bananas do help prevent leg cramps (to a certain extent). They are rich in several important nutrients including potassium and magnesium. These nutrients play a crucial role in the way our muscles function, so getting enough of them is vital for our muscles to work normally.

That being said, there is no scientific evidence to prove that bananas alone prevent your legs from cramping when you run.

If you’re suffering from tight calves you’ve going to LOVE this guide: Get Rid Of Tight Calves FOREVER – The Ultimate Guide