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I get shin splints when running on concrete/asphalt, anything hard. Rubber track I am fine, grass I am fine, treamills fine. So what can I do to limit shin splints on hard surfaces? I have tried stretching and different shoes.

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what stretches have you tried? how do you know you have shin splints? where exactly does it hurt? –  Kate Jul 27 '13 at 20:20
    
I have seen two drs and they had the same prognoses. For example I can run on concrete and feel great, day 2 shins are a bit sore, day 3 I am in deep pain... If I just run once every couple weeks on concrete it is just mild discomfort and soreness for a day. If I start doing it every day or two it can last weeks. Stretching only helps lessen the recovery time. I still have to stop running on roads. None of the road running I am doing is "hard" comparable to a normal workout of mine. I do wear orthodics too. –  Tom Jul 27 '13 at 20:32
    
Have you had any kind of form/gait analysis done? Who prescribed you orthotics, and what kind of shoe do you run in? –  JohnP Jul 29 '13 at 14:56
    
Why were you prescribed orthotics? Flat feet? What kind of foot strike do you have? Any other overuse our repetitive stress injuries? I'm also interested in the answer to JohnP's question. –  matt Aug 1 '13 at 22:03

6 Answers 6

Having an ongoing problem is a real challenge. It sounds as if you are an experienced runner who has been dealing with this condition for a long while so I'm assuming you've researched or tried the following, but you may want some professional help, other than a doctor. And when choosing a doctor for a runner, choose a Sports Medicine doctor who runs.

  • Rest and Gradual Return to Activity

  • Shoes - What should I look for in a running shoe?

  • Good Warm Up/Cool Down - Best warm up for running, / Cool Down

  • Running Form - "Overall, runners who reported utilizing a more anterior footstrike pattern reported fewer injuries than rearfoot striking runners." according to a dissertation study on different running styles.

  • Intrinsic Factors and Balanced Alignments - @Ivo gives a nice discussion of intrinsic and extrinsic factors that contribute to running and overuse injuries. Although you say that you have seen doctors, you do not mention seeing a sports or orthopedic physical therapy specialist. A specialized physical therapist can be helpful in identifying any intrinsic factors contributing to muscle and alignment imbalances.

    Your orthotics should be specific for correcting any alignment problems in your feet, but the rest of the leg/hip/pelvis also needs to be considered. According to this clinical review hip weakness may be more linked to faulty lower extremity mechanincs and running injuries than foot mechanics.

    Stretching/Strengthening - Stretching alone is not enough to address muscle imbalances. In addition to strengthening the ankle dorsi-flexors, strengthening or stabilizing exercises, esp. at the hip as noted in the above reference, can help with the alignment and shock absorption.

    Myofascial Release - As you have said, you have done stretches and foam rollling. A physical or manual therapist can take a look at your alignments, assess where you have restrictions: plantar fascia, front, back, inside and outside of the foot, leg, thigh, and hip muscles; and correct myofascial restrictions.

So the best suggestion I have is to call around to find the right physical therapist to help you find any alignment, form and/or muscular imbalances, treat and correct them and give you an exercise and myofascial program specific to you. By balancing out your lower extremity you may reduce the stresses causing your shin splints. Otherwise, you just keep going in an endless cycle of aggravation, avoidance, aggravation, avoidance etc. Hope that gives you some ideas for help.

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I disagree that an 'anterior footstrike pattern' reduces injuries. I naturally have an anterior footstrike (ie supinated) running pattern and as a result have suffered greatly from shin splints in the past. If the OP has a similar gait, the best option would be to try 'forefoot running' instead. runblogger.com/2012/03/… –  Evan Plaice Aug 5 '13 at 19:14
    
@Evan, Anterior = front and therefore forefoot. Anterior does not mean supinated (supinated = adduction and inversion which is altogether different). The article you link to reported advantages with forefoot running rather than heel strike (or "rearfoot"): [a training program to instruct them to forefoot strike with an increased cadence] (runblogger.com/2012/03/…) An anterior footstrike pattern is another way of saying a forefoot running pattern and is in agreement with the article you link to. –  BackInShapeBuddy Aug 6 '13 at 7:09

Oddly, I've experienced the same thing. I suffered through shin splints for years. Even a 5% increase in mileage made my legs ache. I sought advice from a number of doctors (including sports physicians), physical therapists, physical trainers, long distance/ultra runners, etc... and finally found a solution that helped me.

A fellow runner suggested that it was a muscle imbalance causing my shin splints. He suggested that I strengthen my shin muscles with toe lifts (4x50-daily) and then lifting light weights (5lbs) with my toes. He suggested that I put light weights into a small bucket (think: sand bucket kids play with at the beach) and sit on a table and use my toes to lift the bucket towards my shins. Yes--you're wearing shoes during this process. Again, 4x50-daily.

I laid off the running for a few weeks while I strengthened my shins and then eased my way back into my daily routine. I haven't had a problem since. I still do the occasional toe lift (2x/week) as I'm fearful they will return, but to date I haven't experienced a problem.

I suppose it can (and will be) argued that the two week rest was the trick and that the weights wasn't a factor. However, my problem with shin splints was an ongoing problem for three years. During that time span I tried the following: rest, ice, rolling, stretching, air casts, orthotics (prescribed and OTC), new shoes, old shoes, minimalist shoes (Vibrams), minimal shoes (4mm drop), cushioning/control/neutral shoes, different shoe lace patterns, ankle wraps, shin wraps, compression stockings, compression sleeves, KT tape, myofascial massage (stripping), sports & Swedish massage and yoga. I have a whole box of products (and experiences) to last me a lifetime. I found that the weights worked for me.

Good luck & good running.

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One of my teams mates tried something different some years back in a very similar situation:

He simply spent 5-7 weeks where he didn't run on roads at all, but instead went for long walks - 10-15 km - in his running shoes. As I recollect, he walked for 2 x 1 hour the first week and ended with 3 x 3 hours the last week. He did experience some mild shin pains in the beginning, but that went away after a few weeks. After this he moved to walk-run and followed a regular beginners 10 week program until he got to 5 km. He is running fine now with very few problems.

Whether this will work for anybody else, I have no ideas. But I'm very, very sure you have to be very disciplined to not start running too soon if you feel everything is fine.

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After a showboarding accident I've had problems with shin splints in my right ankle for years. I've tried a couple of things and between the two I've seen a huge improvement in under a week.

Toe lifts

If you just to go straight to the instructions they're some good ones on gizmodo.

This seems to be the only way to solve the problem for good. If your calf muscles are strong enough you're probably not going to have a problem with shin splints. Unfortunately, running places such huge stress on the shins (particularly if you're a bit overweight) that you're more likely to injure them before they get strong. Toe lifts allow you to build up the strength progressively by doing a little every day.

Orthotics

I'm using vasyli blue insoles to correct for fallen arches in both feet. If you have fallen arches I can't recommend these enough. Besides improving my shin splints they've also completely eliminated pain in my left knee which I've been suffering from for years (on first use!).

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This is the best review article I know about medial tibial stress syndrome (MTSS): http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848339/?report=classic

You should look at the differential diagnoses and consider if you have a different injury which gives similar symptoms, like stress fracture, compartment syndrome, muscle tears, or vascular injuries, among other things.

If you do have MTSS, treatment generally involves

  • Controlling inflammation during and post activity (icing, and NSAIDs)
  • Drastically reducing intensity of training and gradually ramp back up
  • Calf stretching and foam rolling (like 30+ minutes, spread throughout the day, every day) and eccentric calf exercises
  • Gait analysis to determine if orthotics could help
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I don't find this useful - sorry. I do not have a condition that is ongoing. It only springs up when I start road running. My doctors have given me these suggestions and they do not work. They tell me to not run on roads. Which why would I go see them if that was their answer? I want to do road running without shin splints or having considerably less effects - and I want to be able to run hard. –  Tom Jul 27 '13 at 20:43
    
If it springs up whenever you road run, the underlying causes are probably ongoing. You have tried 30 minutes of stretching and rolling every day? –  Kate Jul 27 '13 at 20:57
    
@Tom Nevermind. If you don't want to do this don't do it. –  Kate Jul 27 '13 at 20:58
    
Yes I have tried this. I have dealt with this for 15 years. I have followed my doctors advice. I have stretched for 30 mins a day. Maybe it reduces the pain a little but after day 4 it is still killing me and I have to go back to treadmill. No offense but really looking for real world advice. I can google medical treatments for shin splints. Also most doctors are clueless when it comes to athletes. I had one when I was younger suggest me wearing a bubble cast on my leg... –  Tom Jul 27 '13 at 21:01
    
Stretched and rolled? Why don't you think this is real world advice? It worked for me, and for many of my teammates. –  Kate Jul 27 '13 at 21:08

Here's my advice. It has already been said, but I'd like to say it in a different way.

Have you really tried rolling? Like actually doing it correctly? Here's how to do it. You need to roll BEFORE and AFTER the workout. Rolling before is even more important than after. Also, try getting in the habit of rolling for several weeks before trying to run on concrete again. Rolling can do quite a few things for you. The obvious is it can roll your muscles and such to make them more flexible and smooth so they don't cramp and kink...tear or pull. If you actually do it on the bone though, it can strengthen the bone (well sorta, but think of it that way, really you can calm down the nerves around the bone)! How do you think UFC fighters take such harsh blows to their shins constantly? These kind of kicks can sometimes break an average person's shin. They strength train their bone so it doesn't break as easily. Of course, there are a plethora of exercises to do this which I don't think you need to get involved in, but rolling across your shin can calm down the nerves and strengthen areas that cause soreness in your shins.

So if you haven't tried dedicating yourself to rolling for several weeks, do that. That's the only fix I can think of.

Also, it's a well known fact that running on concrete is the absolute worst thing for your knees and shins. Coaches don't even let their runners run on concrete it's so awful. I mean I know you want to road run, but I'm pretty sure you can avoid concrete. Asphalt is still not great, but it's better than concrete and should help significantly.

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To a runner, there is no difference in the hardness between concrete and asphalt. –  JohnP Jul 29 '13 at 0:27
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Well I meant coaches don't let their athletes run on either of them, asphalt or concrete. The difference is pretty minute. Concrete is actually harder though, up to 10x harder. Obviously the deformation isn't significant, but asphalt also can be gravelly which can decreases that hardness even further. Also, aslphalt tends to be easier to run on because concrete is more slanted and has cracks...etc. If you actually are a runner, I feel like you would know these subtle differences. Better safe than sorry –  Spaderdabomb Jul 29 '13 at 8:09
    
I am a runner. It paid for most of my college. There is a hardness difference, but to a runner, the difference can't be felt between asphalt and concrete. Any perception of this is in your own mind. And your statement that coaches don't let their runners run on concrete/asphalt is erroneous as well. There are countless runners around the world (Teams and recreational) that train on concrete/asphalt regularly with no problems at all. The primary contributors to shin splints are overuse, bad form, poor equipment or ramping mileage up too quickly. –  JohnP Jul 29 '13 at 14:48
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Not the same experience I had –  Spaderdabomb Jul 29 '13 at 14:52
    
I also can definitely tell a difference between running on an asphalt track locally and the sidewalk right outside. How can you generalize "runner" like that @JohnP. and what about shin splints being caused by another sport? like Soccer or in Spader's case UFC...? –  Hituptony Oct 8 '13 at 19:15

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