Shinsplints, front of shin pain and side of shin pain are terms used to describe periostitis of the tibia.  Tamworth and Solihull sports physiotherapist John Williams is now treating many runners for this complaint who are training for the Virgin London Marathon in April 2010. The Atlas Sports Injury Clinics provide sports physiotherapy for many injured runners who are training for the London Marathon.

 The most common is posterior shinsplints or posterior periostitis which is diagnosed as being painful on the lower third of the inside shin.  Pressing into this area with your thumb along the inner ridge of the shin will ultimately be painful.  Running when the shin is painful will only irritate the condition more and hinder recovery time.

 Shinsplints can have many causes but the symptoms are always inflammation and soreness.  In many cases the pain is acute and can’t bear to be touched, when this is the case, ice should be used to reduce inflammation levels and ease the pain.  A simple succession of icecubes massaged along the inner ridge of the affected shin should help cool it down.

 Why do I get shinsplints when I run?

 Well this is the million dollar question. It may be tight lower limb musculature which creates an inbalance and unwanted stress when running extended distances.  It can be poor biomechanics such as overpronation, or just the simple fact of a lack of suitable conditioning resulting in an overuse running injury.

 How about a creating heated debate by suggesting it could be your running trainers?

 Well let’s look at this in more detail.  Stability running shoes and corrected footwear are well established by all major running footwear manufacturers. Lots of research of where to put cushioning and support goes into the design and manufacture of the modern running shoe or trainers.  The final product is an attractive comfortable shoe that should help us manage the stress on our lower limbs and feet during high mileage running activities.

 The journey begins when as a runner you visit your local running footwear retailer.  These are the experts who are going to advise you on the best footwear for your particular needs.  In some retail outlets they will have a treadmill and softwear such as Silicon Coach or Dartfish which will allow the operator to analyse your running gait and decide if you pronate excessively are a neutral runner or rarely, supinate.

 A selection of footwear is generally suggested for you to try on and test out by running on the treadmill.  You make your selection based on advice, price, comfort and attractiveness of the shoes.

 The problems arise if you have purchased shoes with correction or stability.  Why you might ask? The salesperson told you these shoes were suited to your overpronation and it appeared to correct the fault when filmed on the treadmill.

 Now let’s examine what the stability or corrected shoe does for the overpronator.  It supports the arch of the foot and generally provides a facility for the heel to invert slightly.  This has the effect of raising and supporting the medial arch and limiting the effects of pronation.  As overpronation is the problem this will attempt to correct the rolling in of the ankle which tends to flatten the arch.  In effect it is a form of orthotic device.

 Great, what a wonderful idea, the running footwear industry literally picked up this concept and ran with it, so to speak.  An orthotic built into the running shoe has to be a winner surely.  Many have been sold and allegedly helped many runners avoid injuries from running.  This is all positive stuff so now let’s look at the problems these shoes create.

 Firstly what springs to mind is the limitations these shoes bring for correcting biomechanical faults.  Many people when assessed during a biomechanical assessment will have a different prescription between left foot and right foot. You may be neutral on the left and need 6 degrees correction on the right, the shoes will generally be sold to you to correct the 6 degrees if the salesman wants a sale.  The salesperson in some cases has little training in biomechanics and wouldn’t recognise an overpronator if they fell over one.

 Secondly if a runner needs correction they will need to alter their relationship with the ground.  This will alter the angles of the pull on bones from muscles.  This alteration will take some time to be established as the body copes with the changes that have been introduced.

 This is where the problems appear, how can the body expect to get used to the alterations when they are contained in footwear that you only wear when you go for a run? After the run you take off your corrected footwear and put on your neutral footwear and continue about your day.  Your body will be in a continual state of flux and will be vulnerable to injuries when you step up your running mileage.

 It’s like training to do wide arm pressups in preparation for an event where you will be asked to perform pressups with your hands close together.  Just try it and see the effect that altering the angles make.

 We hopefully have established that I have an argument for suggesting stability shoes and corrected shoes, if worn without fitting correction into your daily living shoes, can possibly cause running injuries when ramping up the mileage.

 The Atlas suggestion and ideal scenario is to get a full biomechanical assessment done before purchasing running shoes.  If you do overpronate then purchase a neutral shoe and have a prescription pair of orthotic foot inserts made, which you can wear in your running shoes and also, more importantly, you can transfer the orthotics into you daily footwear so you have consistency.  This will ensure the correction will be effective and that the risks of developing running shinsplints will be reduced.

 If you need expert advice and help please contact Atlas Sports Injury Clinic on 01827 59943 or visit their website www.runninginjuryclinic.co.uk