Case Studies: Shin Splints – How To Prevent Them

RYC Updated

Shin splints have been causing problems for runners of all abilities for many years now. Here, physiotherapist Paul Noble talks us through how he successfully got one runner back to full fitness.

Case Study: Oli

“Oli came to see me for a full body running gait analysis to see if anything could be done for his chronic shin splints. He was planning to join the RAF and desperately needed to increase his running speed and volume in order to train and fulfil the fitness test requirements. He had suffered for over three years with debilitating pains on the inside of both shins every time he ran.

The pain would affect him so much that he would have to rest for up a week before he could venture out again.

Shin splints or medial tibial stress syndrome, (MTSS) to give it its correct term, accounts for over 25% of all running injuries. It is thought to be a tissue overload condition primarily affecting the tibialis posterior muscle and a related bone stress reaction along its attachment.

Oli had tried everything from experimenting with different trainers, resting for weeks on end, stretching and icing. Every time the pain subsided it would return with a vengeance each time he set out for a run.

Depressed and frustrated, Oli came to see me for a Runfit assessment in the hope that something could help him achieve his RAF goal.

In addition to my usual Physiotherapy assessment I like to put runners through a full body, slow motion, running gait analysis. By videoing at different angles and slowing the footage down to 240 frames per second, I can see biomechanical anomalies and running technique issues which may play a part in overloading certain injury prone hotspots.

Oli’s shin pain was being exacerbated by a heavy footed running style, a tendency to overstride and and a low running cadence. Overstriding tends to be thought of as a less economical way of running, increasing the braking forces and slowing down the body. Slamming down the leading foot, often on the heel is also known to increase the vertical loading forces felt in the shin.

By increasing Oli’s step rate (cadence) from 155 to 170 and by cueing him to land with a softer footfall we were able to encourage a more efficient and less loading, midfoot running pattern.

Oli practised these changes in a gait retraining session by gradually increasing the time spent running in the new style. Within a week Oli had successfully incorporated this new style into his outdoor runs and was delighted to be pain free.

Oli has now exceeded his initial goal of ‘just passing’ the RAF fitness tests.”

About the author: Paul Noble is a Musculoskeletal Specialist in all conditions with a particular interest in running injuries, gait analysis and gait retraining. For more information visit

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