Shin Splints

The strength training (i.e. tough guy) community has scorned running like a bastard child. They take pride in the fact that they can’t shuffle down the street without having a cardiac touting how “gay” it would be if they could. While I’m not recommending that a 250+ pound person needs to be running in the dead of a northern hemisphere summer, but the “running is gay” crowd forgets that some of the most badass shit happens when running.

Most general strength trainees won’t have any kind of fitness test running requirements, nor will they be required to run. However, most general strength trainees aren’t in danger of breaking anything but personal records and could use the capability of running 50 meters really fast if necessary (e.g. chasing a woman with a purse, hunting boar with a knife, or retrieving their dog). Getting winded after a sprint and NOT being on dbol just makes you an asshole. Besides, you should be able to go out and play non-sober softball or rec-league basketball any time you want without achieving crippling soreness.

Recently a reader of this site failed out of a 1.5 mile run in an application fitness test because of horrible shin splints. I want to first explain why shin splints occur, how to prevent them, and suggestions on progressions and technique.

What Causes Shin Splints
The standard technique of running is…no technique.

Just think about your own personal history in running, when did you learn to run and did anyone ever actually watch you and teach you how to run efficiently? If someone did, how do you know they taught you correctly? The assumption that one innately knows how to run simply by virtue of being human is not justified or appropriate.
–pg 84 of FIT, by Kilgore, Hartman, and Lascek

With the advent of the running hobby around the 1960s, shoe manufacturers reflected this interest by producing large, cushioned soles in their shoes to improve instance of injury — it didn’t really work, as there is a conservative report of 3 injuries per 100 hours of running (2,3). In any case, shin splints occur regularly in a trainee when they are unadapted to running — and this was the case in the reader who failed out.

When the initial heel strike occurs, the ankle is in active dorsi-flexion where the toes are pulled up; the opposite (or toes pointed down) is plantar-flexion. It seems odd that you would actively dorsi-flex your ankle, but it occurs; Brian Mackenzie shows people this all the time when viewing their slow motion replay. Consider it the byproduct of never being taught efficient technique and utilizing the available foot wear.


Image from FIT

When going through this “heel strike, forefoot flop”, the ankle is moving into plantar-flexion (toe down) while trying to maintain dorsi-flexion (toe up). The resistance of the movement causes the muscles that maintain dorsi-flexion to eccentrically act — they are stretched when still trying to contract. This is the same thing that happens to the hamstrings in an RDL: the hip goes through resisted hip flexion yet the hip extensors (the hamstrings) are resisting the action and preventing you from just falling over. Let’s substitute the terms and focus on the ankle while running: the ankle goes through resisted plantar flexion yet the dorsi-flexors (on the front of the shin) are resisting the action and preventing the foot from just falling forward.

If you paid attention to your muscle mag lore, you know that eccentric muscle action causes the most damage to muscle fibers and as a result more soreness (since the muscle fibers are being ripped apart while trying to stay contracted). The muscle on the front of the shin that cause dorsi-flexion (pulling the toes up) is primarily the tibialis anterior. When heel striking, it’s going through hundreds of repetitions of damaging eccentric action. The damage occurs along the entire attachment site of the tibialis anterior, which for this muscle is along the entire tibia (shin bone). That’s why it’s called “shin splints” since the entire shin is painful afterwards.

How To Prevent Shin Splints
Lots of people heel strike, but not everyone has shin splints because it’s relatively easy to adapt to. Had our failed reader done a few running workouts prior to the fitness test, he could have lasted the entire workout instead of hobbling off the track halfway through. Merely do a few short distance workouts and progressively increase over time; this is the same principle you would apply to beginning any new activity and something that is discussed in lots of detail in FIT.

An example of re-introducing running would be running several regular paced 50m intervals. Notice I didn’t say 15 intervals or 400m; it’s purposely low to allow adaptation. Crippling soreness with new activity is your fault and an indication of lack of care, ignorance, or stupidity. Progressively increase the total amount of work over time (perhaps up to 10 intervals), then increase the distance (100 meter intervals), and then progress into regular distances and intervals (repeats of 200m or 400m). Notice this is all at a regular pace instead of a fast pace; in this case, we’re conditioning the structures instead of the energy system capability. In this simple progression, it’s assumed that the trainee is still heel striking.

Modifying Technique
A complete discussion on efficient running mechanics would leave the scope of this post, yet it revolves around proper balance over center of mass, not heel striking, and running on the fore foot. To learn this technique, I’m partial to my friend Brian Mackenzie; I have been to his running seminar and he’s a cool dude (and has an awesome pitt bull). The biggest mistakes I see people doing with this are running on the toes (which is too far forward), pointing the toe prior to making contact with the ground (which is probably an equally injurious position to heel striking), trying to extend the hip back (instead of pulling the foot/ankle up), and bouncing up and down (instead of streamlined). Realistically, if you’re interested in proper technique you should find a coach (the easiest way would be to call a CrossFit and see if they have any people that have been to Brian’s seminar and are a decent coach). Not many people can teach themselves correct squatting technique, and if they do, a coach is usually needed to get it on track. Running is similar, and if anything more difficult because of it’s dynamic nature.

There are a lot of drills that can help you learn and improve running economy, and you should be able to find some on the CF Endurance website. The two best cuing concepts I’ve used are “lift the foot up the inseam of your opposite leg” and doing it with a “relaxed ankle” (with the latter being the hardest). By pulling up an imaginary inseam (think of wearing pants), the foot goes up instead of back, and the relaxed ankle prevents unnecessary toe off. For lifters who have heard the “mid-foot” cue, it helps to imagine landing on that point, or slightly in front of it.

When introducing new running technique, EASE INTO IT. Lots of critics will cite how this new technique is more injurious than the old technique. However, with any new activity, slow and progressive increase of that activity is how to adapt optimally without injury. You may feel like you’re capable of more, yet the soreness after will be a reminder that you were wrong. Develop the new skill over time — Mackenzie recommends a six week introductory program before attempting regular workouts.

If you’re interested in a complete analysis of running research, running mechanics, foot wear, and endurance training principles, then check out the Endurance Chapter in FIT (release day is less than a week away).

People like sources:
1. Kilgore, Hartman, and Lascek. FIT.
2. Buist, I., et al. Incidence and risk factors of running-related injuries during preparation for a
4-mile recreational running event. British Journal of Sports Medicine 44:598-604, 2010.
3. Marti, B., et al. On the epidemiology of running injuries. The 1984 Bern Grand-Prix study.
American Journal of Sports Medicine 16(3):285-94, 1988.

26 thoughts on “Shin Splints

  1. After having ran competitively for six years throughout HS and college with extensive coaching, I would suggest avoiding heel-strike altogether, as Justin mentions later in the post.

    It’s just poor form to begin with and should not be encouraged. The act of heel-strike literally involves putting the brakes on every stride.

    Heel striking. Not even once.

  2. I’m a runner on top of a strength athlete, and have been running “POSE” for nearly 2 years at this point. I went from being someone who could barely run 3 miles without wanting to pass out and be sore for days to running a 50 mile race earlier this year. I now have my eyes set on running 100 miles for the first time in the next couple months. This technique is amazing if you teach yourself properly.

    I learned barefoot, and when I taught myself I made a mistake I will only make once in my life– going too far the first time barefoot. My calves and ankles were so sore the next day that I almost had to stay home from school (I was a senior in HS at the time) because I could barely walk. I worked up to 11 miles on trails in the VFF’s. I now use trail shoes but use the same technique and prefer minimal trail shoes to allow for proper fore foot striking.

    And FWIW, in my training I’ve never actually noticed a time where I could say the run I went on the day or days before hindered my performance in the weightroom. So if you’re on the fence with learning to run I say give it a shot for sure.

    For those reasons listed here, I would recommend wearing proper foot wear when altering your running style. However, if you switch to a more minimal shoe, ease into wearing that, even if you have been using efficient running technique in your traditional running shoes.

    Compared to bare feet, minimal running shoes still provide protection for the sole as well as support. For those reasons, I’d have suggest minimal shoes as opposed to five fingers (and I think Mackenzie would say the same thing).

    Edit: Betty says this same message a few posts below.
    –Justin

  3. It’s funny to see Brian Mackenzie referenced after seeing him so frequently maligned on the Couch Thread.

    Worlds are colliding!

    I’d wager that most of them have never met the guy.

    –Justin

  4. Good explanation of anterior shin splints. The cause of posterior shin splints is similar – it’s the arch collapsing on landing (“over-pronation”), along the same lines as the forefoot flopping down on landing for anterior shin splints.

    And the muscle affected is the tibialis posterior.

    On technique, I would agree that heel striking is basically wrong and should be corrected.

  5. Excellent post. The biggest mistake, myself included, is when switching to minimalist shoes is that they do too much too soon and write off the notion that the less is more approach to footwear is actually better. When you think about the high tech running shoes that you buy from a running store where they watch your gate/run to determine which kind of shoe, they are fitting you to keep your foot from as little motion as possible. In a way, they are creating casts for your feet so they don’t have to work, which is bad for ankle dorsiflexion and this can effect ones ROM when squatting. I would like to add the idea that just like any other part of the body, we should also strengthen and stretch our feet when training them (especially when retraining the body how to run with a mid-fore foot strike). Simple things like rolling the arches of the feet with a golf or tennis ball, using your fingers to spread out the toes by lacing them to help stretch them out as well, and even trying to isolate the movement of each toe (try lifting the big toe, then pinky toe, then try lifting the three middle toes only with big and little toes down) will help develop strong feet.

    Good points on foot care, and this will also help people who are ruck marching.

    Foot maintenance can fill up a post all on its own.

    –Justin

  6. Great post. I’m a big fan of running in VFFs for this and many other reasons. I initially dismissed the minimalist movement as “hippy bullshit,” but quickly changed my tune when I could run pain-free for the first time in 10 years despite weighing 40 lbs. more than I did when running HS track.

    As betty and others have said, they key in switching is to take it easily. I started with slow 100s at the football field. I’d run 100 yards, walk to the back of the endzone and back to the goal line, do another 100 yards, etc. I’d do 8 of those, then 16, then 24. By that time, I could start with a slow mile. Granted, this took me awhile to get adapted, but I didn’t get hurt in the process.

  7. I think the consensus on Mackenzie is that he is decent with the mechanics, but full of hot air as regards programming.

    I’m sorry, I guess I forgot the online strength community was full of ultra marathoners. He can get people ready for a marathon or less with minimal training (and this allows them to stay/get strong).

    –Justin

  8. That’s fair enough. My impression was that some of the claims he made about his program were aimed not at the recreational endurance enthusiast but at truly elite athletes and olympians, some of whom I think he’s called out by name, which I don’t think is cool. This is what my comment was referring to.

    Fair enough, I haven’t followed it that closely.

    –Justin

  9. Oddly enough I had some shin splints when I switched from box squatting to deep oly-style squatting. But when I started wearing some knee socks the small amount of added warmth seemed to fix the problem.

    Will there be any advice in this book for the flat footed and, I forget what it’s called plantar fascia, the pain we flat footed people on the muscles underneath our foot from running?

    There is much more dorsi-flexion in high bar squatting compared to back squatting, so either the active dorsi-flexion (which can occur for balance in this squat), or the plantar flexion that occurs on the ascent against the dorsi-flexion (eccentrically working) could cause it too. It may be that you adapted to it (through accumulated work) instead of the socks doing anything, but it’s arbitrary.

    –Justin

  10. Shin splints is a garbage pale term. The health care professional telling the patient will call them shin splints, but in reality it could be medial tibial stress syndrome, stress fractures, minor tibialis anterior strain, tendonopathy of tibialis anterior or posterior tibialis. That part of the post made me cringe.

    I think its awesome you’re getting lifters to run (they need it desperately), but sending them to forefoot running is just complicating things…

    I have been searching and searching for studies that are legit and supporting forefoot running because I am intrigued by the better running economy idea it suggests. All of the ones I have found say you can’t get rid of energy, only redistribute it. Injury rate is just the same if not more but in different places than heel strike running.

    What have you experienced or found on this subject. I am neutral and just trying to learn

  11. Justin, so you’re saying the guys on the couch thread are wrong about Mackenzie just b/c they’ve never met him? Some of them definitely have, and either way it doesn’t matter. Just because someone is a nice guy doesn’t mean he isn’t full of shit. His reputation for DNFing at least seems legit and ruins some of his credibility. Also, the fact that he calls out accomplished athletes on their training, claiming it would take 3 years to correct their problems, reeks of arrogance.

    I’m not saying I agree wholeheartedly with the guys on the couch thread, and Mackenzie definitely has good stuff to offer, but he might not be the true expert when it comes to this stuff.

    First off, a portion of IGX are trolls (although I like them). Secondly, like I fucking said, he can get people prepped for marathons or less with minimal training time and while getting/staying strong. I don’t know much about ultra marathons (aside from multiple books I’ve read), and I’m not saying he’s right about calling proven athletes out. LIKE I FUCKING SAID in the response to “dave h” regarding that topic: “Fair enough, I haven’t followed it that closely.” So that’s what I’m saying. Again.

    –Justin

  12. But seriously, how hard is it to get people prepped for marathons staying decently strong? once he gets people actually winning marathons i’ll be impressed.

    Fair enough, I haven’t followed your comments on comments that closely.

    Anyway, he’s a friend of mine yet objective criticism is allowed (in the sake of fairness), but that doesn’t mean it isn’t in bad taste. It’s not like he’s just poo poos other training methods, he’s also an experimenter and keeps moving forward (which Glassman used to do once upon a time). I would look to his personal performance as something that doesn’t prove or disprove his programming method. For example, I bombed out of one of my meets when I competed, but it was because of a random shoulder injury that occurred on the day. We don’t discount Peyton Manning’s offensive coordinator because he can’t throw a football. If you guys are looking at the number of people he has prepped for ultras and have the same opinion, then that’s fair. However, in this post his ability to teach running technique is what should be on trial.

    –Justin

  13. I guess one of the virtues of hill sprints is that they don’t allow you to heel strike. Imma go to the HS track this Sunday and see if I can change to a midfoot/forefoot style for some short 100s or something. It’ll be interesting.

  14. “I’d wager that most of them have never met the guy.”

    True story – I was supposed to meet BMac a little over a year ago, but he didn’t show up. No call, no show, no joke. Because of that I find the IGX posts about him DNF’ing even more funny.

    I would agree that a person doesn’t have to excel at a sport to be a viable coach as Justin points out. I would also say that the true measure of a coach is in the successes of their clients. When someone claims to be a subject matter expert and at the level of elite coaches but doesn’t produce elite athletes, his or her credibility should be questioned.

  15. Justin, what have you experienced or what evidence have you found on the forefoot/midfoot running subject?

    I don’t understand what you’re trying to find out. My experience with it?

    I’ve ran 3 miles in 19 minutes weighing 195 in 2008. Earlier that year I ran a 22 minute 5k weighing the same in Key West in July (mega humid/hot). The same Key West trip I ran 1.5 miles in 10 minutes (at mid-day, terrible). These aren’t even good times, but it’s difficult to run fast when you’re heavier and don’t really focus on running. I’ve done Tabata treadmill sprints at a 5:30 pace on an 8% incline. There’s a significant difference in running efficiently and stomping your way down the street regarding stress on the structures, economy of effort, and overall capability. I’ve taught quite a few people the basic principles, although it wasn’t the focus in their program. The primary consensus is that the economy of effort is lower (less energy expended).

    Are you asking me for a literature review? Or are you just in the camp of skeptics against this running technique?

    –Justin

  16. I was honestly curious with your experience, and what you have told me displays you have ran with that technique mid-distance with awesome results!

    Yes, I am a skeptic, because of the lack of literature, and I am with every new idea. I am not trying to troll or dismiss an idea without evaluating it and trying it out for myself.

    Thanks for your input and answering my question. How long did it take you to learn and adopt? And how drastic of a time difference did you see compared to your previous heel strike times?

    I’ve read websites before of serious skeptics, so that’s okay. Skepticism in healthy amounts is good. There are some opponents to the ‘POSE/Chi style of running’ who discuss the injury potential of being more forward on the foot. I submit that the people who do get injured ignore the largely visible warning that emphasize practicing the new movement and easily progressing into it. To me it’s pretty clear how much more efficient it is mechanically. I also failed to mention that I’ve read various books on the topic (with my favorite being a physics book about track and field).

    In any case, I’ve never made an emphasis on running prior to teaching this technique to myself (and later getting coaching at Mackenzie’s CF seminar). In high school I could run a mile in about 6 minutes (I played linebacker for football, yet we ran a mile occasionally in weight training) and I ran a de-conditioned 5:31 mile before I started CrossFit (this was an absolutely horrible idea). Depending on the weather I could probably run a sub 14 minute 2 mile right now (and the next day go 130/155 in an Oly meet) without running a whole lot lately. I also haven’t done any “sprint a mile” endeavors because of how horrible my reaction was the first time, but I could probably run it in a similar time or even faster (although I will absolutely never try it again).

    So I don’t have any run times to compare it to because I’ve never really enjoyed running (if it happened at a longer distance in football, it’s because we got scored on). It will take some time to adapt to, and I think for most people (especially when they haven’t done any running whatsoever) they should take longer than 6 weeks to progress into it. A calcaneal tendon injury is difficult to come back from, so learn it right and learn it slow (and don’t land on the ball of your foot, that’s wrong).

    –Justin

  17. It’s cool being skeptical and not just taking someone’s word for something, but Justin has great knowledge of biomechanics and kinesiology and shit. A coach or trainer doesn’t necessarily need to have experience in the sport to know how the body moves or how musculature reacts to a stress.

  18. Justin,

    Thanks for the thorough response! I have gotten in the forefoot/midfoot vs. Heelstrike debate with my dean of health sciences, Jay Scifers (Who is a genius, and been running since he was fairly young). After all of the biomechanical, physics, and other arguements we had one day he goes on to say give me the evidence and research. The most recent research says for long distance runners it has a higher liklihood of injury. We did agree that for mid-distance it is more efficient to do forefoot/midfoot. As we get into marathon/ultra-marathon distances, it’s hard to maintain that perfect technique for such a long period of time. There is anecdotal evidence by Kstar and others that forefoot running can be maintained for ultras.

    I am currently training for a 25 mile run, while trying to maintain my hard-earned squat (the most I have ever run before this last month was 3 miles in high school for lacrosse conditioning). After I get this out of the way I am going to go back to a solid strength program and focus on my mile. Which is why forefoot/midfoot running interests me since it is definately faster and possibly more efficient.

    What physics book on track and field were you reffering to? It sounds pretty cool to me since I loved physics last year.

    I’m unfamiliar with the research on running, but I do know the “programming” realm in Exercise Science is shoddy at best — anyone asking for the research here would do better to shit on a piece of paper. There’s a running website I found that did a pretty stellar lit review on running stuff; maybe I can find that for you. My forte isn’t in distance running, but if I ever tried it I wouldn’t be heel striking (I’m giant relative to runners and it would be stressful, indeed).

    –Justin

  19. What is the website? Also, what was that physics book cause I am interested haha

    Thanks again!

    I have a friend who was a decathlete and it was his book. I can’t remember the name, but I will ask him.

    –Justin

  20. Mike Boyle commented on Stregth Coach, shin splints are a 100% overuse injury. How much did the guy who failed his PT test run prior to the test? Switching to Pose/Chi would have probably have resulted in an overuse injury in the posterior aspect of the leg. Regardless, if you are in the military, you need to run to pass your PT test and if you do not run, and are a big dude that lifts, you will probably fail.

    Yes, this particular guy who failed out of the run was a stupid person and didn’t do any training before hand. I pointed this out and then made the point that all running of any type should be progressed easily and slowly. “Of any type” means heel striking and POSE/Chi, so I already addressed this obvious point. He’s not in the military, so your comment seemingly directed at him is irrelevant, especially since any big guy that lifts in the military knows he has PT standards since he ran his entire time in basic training. Lastly, I’m pretty sure I thoroughly explained how shin splints are an overuse injury.

    BMack is full of crap. Sorry he is. Trolling aside, there is nothing impressive about taking a bunch a mediocre yuppies and having them run 3.5-4hour marathons.

    I totalled 220 last year, training 30min only 2-3 times a week on a very simple weightlifting plan (snatch day 2, clean and jerk day 2). My 220 is probably more of an achievement in weightlifting, then BMack 3:50 marathon he did to justify that CrossFit can prepare one for marathons.

    However, I think he is full of crap because his dismal of the role of LSD training. In his original article in the CrossFit Journal he wrote LSD training trains muscular endurance of the postural muscles. Strength training and circuits do a better job, in a faster time. Therefore, switching to strength training, circuits (CrossFit) and improving running mechanics will all produce better results then LSD. Isn’t the ideal behind CFE to train less and get your life back?

    The problem with BMacks statements aagainst LSD is that the primary phsyiologic adaption to LSD training is improvement in the ability to generate ATP from fat. This occuring by going for a prolong period in the aerobic/oxidative pathway, aka Long Slow Distance. This is why cyclist spend half the year in the small chainring. I do not think it is a coincidence that he has DNF everything lately, I think the longer he goes away from LSD training (which he did before starting CF) the more the adaptation to use fat as fuel is lost and he can not finish the race.

    BMack has never addressed this, though Mark Twight, who is experience in both circuits and long slow distance writes about it. His essay There Is No Such Thing As A Free Lunch (TINSTAAFL) tells his side.

    If anyone wants to discuss this, I would love to. If I am wrong, please tell me.

    These criticism are the only ones I’ve seen with an explanation behind them, and they are fair. In “FIT” we talk about how sustained effort endurance (same as LSD) is necessary to build the structural capacity and glycogen stores to ready for the longer event (we admittedly spend more time discussing demands of soldiers than marathoners). I don’t know much about longer endurance efforts (and I should know this, but I’m unsure right now), but if the body is undergoing a “lower metabolic stress” like LSD, then it’s not going to avoid using fat as fuel. Perhaps the fact that his body composition is different, and he has less body fat would have more of an effect? Although Dean Karnazes used to have lower body fat when he started, so that might be a point against that argument. In any case, the lack of stellar productivity might be due to a lack longer bouts of training during the preparation. I’m not sure because I don’t know what his personal program is or what goes on in the race day. I also don’t know how he coaches a regular marathoner, but I do know he can take people who never thought they could do a marathon and prep them for it in minimal time. But, there’s too much stuff I don’t know to give any kind of argument either way, but based on what you’re saying your criticisms are fair, aside from saying that he’s full of crap.

    There are plenty of people who have improved their training, their running, or their PT tests on the account of learning from Brian. And, again, he was brought up for his ability to teach running technique.

    –Justin

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