Anyone keep running through medial tibial stress syndrome (shin splints) pain and have the pain go away?

I did but it didn't go away and I did several weeks of probably lower mileage than you're anticipating (6mpw) and it didn't go away. Then again you can still get pain even when bone damage has improved, and I didn't get a second scan. I did ask take off 3 weeks with only about 2 runs in that time and pain improved but then came back when mileage increased. Your situation may be different as it really depends on what your bone damage looks like now.

ShinOw wrote:

I did but it didn't go away and I did several weeks of probably lower mileage than you're anticipating (6mpw) and it didn't go away. Then again you can still get pain even when bone damage has improved, and I didn't get a second scan. I did ask take off 3 weeks with only about 2 runs in that time and pain improved but then came back when mileage increased. Your situation may be different as it really depends on what your bone damage looks like now.

But isn't it almost impossible to know how much actual bone damage has already occurred, even with a scan? Still, it sounds like total break from running is the only way to deal with it?

No. I ran with it for years, eventually found a fracture, then continued getting re-fractured for a number of years. I had to quit running in college. It took about 5 years to finally heal. In other words, take of of it now!

Yes. Believe it or not, I have the cure.

More than 40 years ago, when I began running, I quickly developed shin spints. After struggling briefly with exercises, which did nothing for me, I stumbled across a cure. After every run, I would take a two trays of ice cubes--one for each shin. I'd pull up a high cotton sock. And I'd stuff parallel rows of ice cubes into each sock, so that ice was directly against the shin/muscle line--i.e., the painful line.

Within a few days, I noticed an immediate diminishing of the pain. Within one week, it was basically gone.

I've done some version of that ritual after every run for the past forty years. One difference, though, is that the pain went away for good on the left side. So I only do it on the right side. If I don't do it for even one day, I'll probably notice a return. Two or three days and the problem would blossom all over again.

Since the medial tibial tendon continues down to the "bump" on the inside of your foot, I now shove crushed ice (rather than cubes) down in there as well.

Ice is a miracle cure for shin splints. I'm living testimony to that. I can't imagine my running life without this daily ritual.

15 minutes. That's all you need. 20 at most.

There's an extremely important corollary to my post above: shin splits are one thing; a medial tibial stress fracture is a whole different thing.

You can roll back the first with the help of ice, and you can continue running as you do so.

You can NOT roll back a stress fracture. I had one of those. It required a full 10 weeks off. Ice helped a little, but not much, right after I injured it. But no healing AT ALL was possible while I continued to run, no matter how much I iced.

I thought the conventional wisdom now is that icing is good for pain relief (or to cool you down) but not good for healing an injury. I understood the inflammation is now seen to be beneficial and is all part of the healing process. So by icing you are essentially slowing the healing process.

If someone knows better, please explain why icing would speed healing, I can only guess it would be if inflammation was seen as a negative thing.

I had this problem for all of high school. It did not mostly go away until maybe my sophomore or junior year of college and even then still was sometimes an issue during track season. Some things that helps diminish the pain...

*run on grass instead of pavement whenever possible

*use ice cups to massage your shins after running. If shin splits hurt outside of practice do this 3x a day.

*Ibuprofin for a few days may help calm it down

*calf sleeves or compression socks help some

*make sure you have the right type of shoes for your foot. You might need custom orthotics

*graston treatment on your shins can help a ton, but is very painful

*stretch your calves so they are not tight

Are you having the pain right now at 37.5 mpw?

When I had severe shin splints in high school (very possible I had an undiagnosed stress reaction...severe pain just walking at one point in 9th grade after track season) I ended up having to take a few weeks of very low mileage running followed by two weeks off (only reason for the 2 low mileage weeks first were b/c I was training for JO nats) completely which helped a lot. I then lowered my mileage and tried to run on grass as much as possible which helped make the problem more manageable. I finally realized my coach was increasing my mileage too dramatically b/w summer and xc, so I just refused to run the longer runs and kept my mileage at 35-40 mpw depending on how my shins were. After years of keeping it lower and building up strength from weight lifting the problem mostly went away. Cross training easy days helps too. That is probably what made them eventually go away in college.

Yes, I had shin splints really bad when I first started running but after increasing my mileage to about 25mpw they went away.

I've had this issue on and off. If you haven't tried it yet do some strengthening excercises for the inside of your shins. Use a theraband or just sit on a chair and do isometretic strengthing -- rotate your foot inward with the inside of your big toe pushing up against an immobile object and hold it for 5 secs. Do 10 reps of this. Build up to doing it longer and more reps. It might get more sore at first but over time it will help strengthen.

I found that shin splints are something you get within 18 months of doing distance training for the first time. I found it was caused by 4 things:

1) too much running on pavement/road/concrete. So run on grass or dirt tracks.

2) too much foot slap in too heavy shoes. But I know Dick Quax & Walker had this problem and it wasn't the shoe weight (they later got compartment syndrome).

3) every now & then you need to run in hills (but make sure your healed first). Your calf isn't timing to take the stress load.

4) weak hips.

Good luck

Try some arnica cream it really helps

- One son too much TRACK sprint training too soon after injury - too many training days during a week - 7 days no training - cured.

- Other son - too much high intensive intervals on TRACK - cheesing national record - lasted few months, missed record for blink of an eye, then cured when cut on training. Never more than 25km weekly - only on TRACK.

If you have that pain then your body telling you "it is too much, back off" and come back latter - stronger and faster.

Or be a macho and withstand the pain - no pain no gain - but this strategy is not smart one.

What pace are you running on most of your runs and what kind of shape are you currently in (recent 5K/10K times)? Most people with shin splints are running way too fast for their current fitness level.

Not to state the obvious are you sure you are getting proper nutrition? Have you had your overall bone density checked? If you aren't consuming and absorbing enough calcium and other vitamins, you put your bones at risk for stress fractures.

Also, 10% per week is a nonsense rule. I have no idea why it's gotten the traction it has. If you started at 10mpw and followed that rule, you'd be running 1400 miles per week in a year. Follow common sense. Don't build up too quickly. What's too quickly? Well, if your shins are hurting, that's a sign. I'm not saying don't run 35mpw ever. Just don't do it until you can handle 30 without any pain. Then test the waters at 35 and see how it goes. If your shins adapt, hold it for 6 weeks and experiment with 40 for a couple weeks, then drop back to 30 for a week to recuperate, then work you way back up to 40. Next year do the same thing but start with 40 and try to work up to 50. You shouldn't rush this.

Thank you everyone for the varied responses, a lot of information.

I cut out all speed work to build mileage because I worry about my shin problems. I do 6 runs a week - every day during the week, 4-6 miles, and then one longer run on the weekend. My runs during the week are all on pavement, and trails for my long run. My shins only started hurting last week a little bit, and then this week after my third 10k (m/t/w) the pain was getting worse and starting to worry me. I admit that my pace has also been dropping during my weekday runs which maybe has added to the problem, started with easy 7:15/mile and now probably closer to (under) 7:00 for a lot of them, but nothing fast. I do focus on staying easy. (My last 5k was 16:23 so 7:15 should be fine I think for easy pace)

I've decided based on what everyone has said that I will take a couple days off now, then start again but back off the mileage. I'm going to see if I can go easy and stick to 32 miles per week (was pain free at 32) until the pain goes completely. If the pain doesn't go after a week I'll rethink it, and stop if it gets worse.

Most people do their easy runs somewhere around 70% of 5k speed, which would be about 7:30 for you. The difference between 7:15 and 7:30 becomes quite significant.

Also: strengthen lower legs and hips (calf raises with straight and bent knees, walking on heels, barefoot drills on grass, single leg bridges, donkey kicks, clamshells, monster walk with band etc). Make sure you get enough calcium and vitamin D (maybe take a supplement). Make sure you get enough calories overall. Stick at a given mileage for 6 weeks before increasing (bone remodelling takes that long). Increase in small, even steps (eg. 3-4 mpw every 6 weeks) - forget about 10%. Massage the lower leg muscles when they get tight. Focus on good posture and quick, light steps. Stick to hard surfaces. Or soft surfaces. Or rough surfaces… whatever works for you. Complete rest probably won't work but neither will carrying on doing the same thing. If you think you might have a stress fracture (e.g. Hurts to hop, localised pain/sensitivity), stop and get an MRI (not x-Ray).

How come animals and Kenyans don't have these problems?

I ran with shin splints for years and hated it. Then I started adding trail running to my training and they went away completely in a few months. It could have just been coincidence all I know is they are gone and have been gone for 3 years now.

So note, that all this advice is coming anecdotally, but hedged by some good science, I believe. I'm by no means an expert(nor do I claim to be offering that level of advice), but my undergraduate degree is in Biophysics, and I'm a high school coach. Also, all of my advice is going to be built on the assumption that your symptoms of shin pain are low in the spectrum of bone pain, that is, you haven't overloaded your bone long enough to put your bone stress injury into the realm of what would be in the stress fracture territory.

As someone who has battled "shin splints" for years, I've come upon various ways to troubleshoot them, especially when they pop up. To develop any plan of action of dealing with shin splints, first understanding what is going on is of deep importance. Without a precise understanding of what the problem even is, any attempt to solve the problem can't be systematic, repeatable, or approached in a knowledgeable way. With that in mind, it is important to understand that what shin splints are. They are a bone overloading problem, and the pain/symptoms felt are a result of the body's response to that, which includes inflammation (from my best understanding).

I firmly believe that that inflammation response is not always in the body's best interest. I think biology is erratic and the body does not always help itself out by functioning in the most optimal way, so sometimes that inflammation can be treated and help in a meaningful way to relieve symptoms (see "Stopping the Spread of Misinflammation" By Dr. Jonathon Sullivan). I have found success with compression sleeves, ice baths(which provide cold and graded compression), and even taking an NSAID when there are large flare ups. None of those things are "cures" but they can make the symptoms manageable.

From a biomechanics perspective, I have found that one of the things contributing deeply to my own shin pain is what I'll call a "lagging leg". Active forces on the tibia are the primary forces on the bone (bending forces) and if the talocrual joint (ankle) moves through a greater range of motion, the forces will be higher. One of the form cues I use is "snapping" my feet up earlier in the stride. This makes the leg come up with the foot in less dorsiflexion, and also has the added effects of increasing stride rate, which lower the forces during each foot strike (if the same speed is maintained, by lowering ground reaction time) and from my experience triggering something called the "stretch reflex" as well, which makes the calf more activated and could support the hard structures of the leg.

I would be careful in implementing this, and as with any form change, don't force your body to do anything. I would play around with how it feels, and search out to see if something like a "lagging leg" could be contributing to undue bone stress.

But ultimately I think you should keep in mind how slow bone actually adapts, and how increasing mileage is not a project to be dealt with in a few weeks, but rather months and years. I would also recommend to take a look over at John Davis's "running writings.com" which have a lot of useful information he has conglomerated on shin splints/medial tibial stress syndrome.

~Best of luck, hope some of this may have helped~