A record number of runners signed up for the London Marathon last month, in the hottest temperatures ever experienced in the history of the race.
That marathon is over, but the season is still in full swing, and physio clinics are as busy as ever with runners suffering from medial tibia stress syndrome, or ‘shin splints’. The pain is located in the middle to lower third on the inside of the tibia.
What causes it? The soleus muscle (one of the two calf muscles) connects to the periosteum (outer covering of the bone) of the tibia. With repetitive stress, the impact forces fatigue on the soleus muscle which then leads to shin pain. The pain is trying to alert you to a specific underlying problem.
Symptoms can get so bad that people have to stop running. Some runners experience swelling in the area of pain. A few days of rest and a return to physical activity may see pain coming back with a vengeance.

What is the solution?

1: Weak and inflexible calf muscles – strengthening exercises should be performed, focusing on the lower leg and hip muscles

2: Excessive pronation (flat feet) – orthotics and insoles help to offset biomechanical irregularities

With advice from a physio, runners can gradually return to activity, beginning with a short bursts at low level intensity. Over several weeks, they can slowly work up to their normal activity level.
Follow this advice, and the symptoms should go away for the long term.

Happy running!

Mark Alderton
Senior Clinician at Bury Physio