Shin Splint Treatment: How Improving Calf Strength Can Fix Your Shin Splints

Shin pain, or “shin splints,” is a common and frustrating problem for a lot of beginning (and experienced) runners. It’s one of the most common ailments in runners, from sprinters all the way up to marathoners.

While there are a variety of remedies out there for shin splints—more properly referred to as “medial tibial stress syndrome”—the purpose of today’s article is to highlight some recent scientific studies that point to an easy method of preventing and treating shin pain: calf strength.

How calf strength influences shin splints

Impact forces bend the tibia

The shinbone, or tibia, absorbs a lot of shock from impact during running.1 As a result, it’s particularly prone to injuries, both mundane and serious.

A recent scientific review by Maarten Moen and colleagues at a medical center in the Netherlands concluded that shin splints, viewed as an irritating but ordinary problem, and tibial stress fractures, a serious bone injury, are actually caused by the same phenomenon: bending of the tibia during running.2

Now, the tibia doesn’t bend like a wet noodle; it’s more like a bridge under strain. After your foot hits the ground during running, the force traveling up your legs puts stress on your shin, causing it to bend slightly backwards. The degree to which your shinbone bends with a given impact depends on two factors: how thick the bone is, and how well it’s supported by the muscles around it. Fortunately, having strong calf muscles helps on both of these fronts.

Running helps you develop stronger muscles and bones

With all the talk about the evils of impact and the dangers of running injury, you might be under the impression that runners are risking their bodily integrity in pursuit of their goals.

But it’s quite the opposite.

Runners, and anyone else who participates in a high-impact activity, have stronger and denser bones than sedentary people. That’s because bones adapt to the stresses they encounter during your daily activities. And stronger muscles means thicker bones, as shown by a 2009 study by Kristen Popp and coworkers at the University of Minnesota.3

In this study, Popp et al. used CT scans to examine the bone thickness and muscular cross-sectional area (a more quantifiable measurement of muscle size) in female runners with a history of stress fractures, mostly to the tibia, then compared these runners to ones who had never suffered a stress fracture.

The results showed that the previously-injured women had smaller bones, but more importantly, smaller muscles than the never-injured runners. In fact, when the researchers looked at bone size relative to muscle size, there was no difference between the two groups! So, the tibia “grows” in response to the size of the muscles around it, and the calves are by far the largest muscle group surrounding the tibia.

Calf muscles support the tibia

The calf muscles also make the shinbone more resistant to bending by resisting and redirecting some of the forces on it.

Getting back to our bridge analogy, the calf muscles are like the strong cables on a suspension bridge. When the muscles tense up, as they so during impact with the ground, they counter the bending forces that are attempting to deform and strain the tibia. So, in theory, runners with stronger calf muscles will be more resistant to shin injury.

This hypothesis was put to the test in a 2007 study by Luke Madeley, Shannon Munteanu, and Daniel Bonanno at la Trobe University in Australia.4 Like Popp’s study, Madeley and his two fellow researchers compared two groups of runners: one with shin splints, and one without. Both groups were asked to complete as many consecutive single-leg calf raises as possible, with the researchers ensuring they didn’t “cheat” by going too low or leaning forward.

As predicted, the injured runners averaged only 23 calf raises, with the healthy runners averaging 33—a difference of 30%!

Calf strengthening as a treatment for shin splints

So, calf strength should be considered as a serious treatment and prevention option if you are prone to shin pain. Even if you’re healthy now, it’s an easy and simple way to ward off future injury.

Unfortunately, there’s no standard protocol as of yet. But doing single-leg calf raises to failure, like the runners in Madeley et al.’s study, once or perhaps twice a day is a good place to start.

Stronger calves looks as though they will will “straighten up” your shinbone in the short term, preventing the kind of bending that causes excessive strain on the tibia, and strengthen your lower leg bones in the long run, making them more resistant to injury.

Finally, if you’ve had severe shin pain for a week or more, you ought to see a doctor to ensure it hasn’t developed into a stress fracture (especially if the pain is localized to an area only an inch or two in size). It usually takes high-tech imaging to diagnose a stress fracture, and they are definitely not something you want to try to run on.

Cross Training While Injured and During Recovery

Cross training is recommended while you're injured and as you slowly return to running.

The best form of cross training for this injury is Aqua Jogging. Studies have shown that aqua jogging can enable a well-trained runner to maintain running fitness for up to 4-6 weeks.

Aqua jogging is a form of deep water running that closely mimics the actual running movement.  Your feet don’t actually touch the bottom of the pool, so it is zero impact and safe for almost any type of injury. In my experience, the only time to avoid aqua jogging is when you have a hip flexor injury, which can be aggravated by the increased resistance of the water as you bring your leg up. Because aqua jogging closely mimics natural running form, it provides a neuromuscular workout that, in addition to aerobic benefits, helps keep the running specific muscles active. The same can’t be said for biking and swimming. The only downside to aqua jogging is that you need a pool that is deep enough to run in without touching the bottom. If you’re lucky enough to have access to a pool of this size, aqua jogging should be your first cross training choice.

In one study, a group of ten runners trained exclusively with deep water running for four weeks and compared 5km race times pre deep water running and post deep water running.

The researchers found no statistical difference in 5k time or other markers for performance, such as submaximal oxygen consumption or lactate threshold.

In a second study, researchers measured the effects of aqua jogging over a six week period.

This time, 16 runners were separated into two groups – one who did aqua jogging workouts and the other who did over land running.

Using the same training intensities and durations, the researchers found no difference between the groups in maximal blood glucose, blood lactate, and body composition.

It get’s better:

Research has also demonstrated that aqua jogging can be used as a recovery tool to facilitate the repair of damaged muscles after hard workouts.

These findings make aqua jogging an important recovery tool in addition to being the best cross training method for injuries.

Need one more reason?

The calories burned aqua jogging are even higher than running on land, so if you want to avoid weight gain while you take time off from running, this is definitely the exercise for you!

Aqua Jogging Workouts For Runners

If you're interested in aqua jogging to rehab your injury, then the absolute best way is to use one of my favorite programs, Fluid Running.

First, it comes with an aqua jogging belt and waterpoof bluetooth headphones so you have everything you need to aqua jog effectively.

Second, they have an app that pairs with the headphones so you can get workouts, guided instructions on how to aqua jog properly, and motivation while you're actually pool running.

This has been an absolute game changer for me when I am injured.

I used to dread aqua jogging workouts because they were so boring and it took all my mental energy to stay consistent.

But, with workouts directly in my ear, it's changed the whole experience and I actually look forward to the workouts. So much so that I now use aqua jogging as a cross training activity in the summer, even when I am not injured.

Fluid running is an awesome deal when you consider it comes with the belt (highly recommended for better form), the waterproof headphones (game changer for making pool workouts fun), a tether (to add variety to the workouts you can do) and the guided workout app (to make your cross training structure and a whole lot more interesting).

That's why we've partnered with them to give you 2 additional running-specific workouts you can load into the app when you use the code RTTT .

Check out the product here and then on the checkout page, add the code RTTT in the coupon field and the workouts will be added to your order for free.

If you'd rather do the aqua jogging workouts on your own, here are some great ideas to get you started!

Medium Effort Workouts

The Pyramid

10 minutes easy warm up - 1:00 hard, 30 seconds easy - 1:30 hard, 30 seconds easy - 2:00 hard, 30 seconds easy - 2:30 hard, 30 seconds easy, go to 5:00 in 30 second intervals and then come back down the pyramid (4:30 hard, 30 easy, 4:00 hard, 30 easy etc). Finish with 10 minutes easy cool down.

Wave your hands in the air like you just don’t care

10 minutes easy warm up, 1 minute medium (87-92% of maximum heart rate or what feels like tempo effort), 1 minute sprint (95-100% of maximum heart rate or all out sprint), 30 seconds hands in air (keep moving your legs in the running motion, but put your hand above your head), 1 minute rest, Repeat 10-15 times. 10 minutes easy cool down.

Hard Workouts

One of the difficulties of cross training is replicating those truly lung-busting, difficult workouts.

So, if you’re going to be pool running quite a bit due to injury or limited training volume, invest in a bungee cord designed for sprinters.

Tie one end of the resistance band to a sturdy object (pole, lifeguard stand, pool ladder) and bring the other into the water with you.

Put the strap around your waist and begin aqua jog away from your starting point.

You’ll begin to notice the bungee tighten and resist against you (depending on the length of your pool, you may need to wrap the bungee around the supporting object or tie it in knots to make it shorter to feel resistance).

Spend a few moments testing yourself to see how far you can pull the bungee.

This is a great challenge and a fun way to compete with yourself during an otherwise boring cross training activity.

Now for the hard part:

Pick a point on the pool wall or side of the pool that you feel stretches the bungee to a very hard sprint that you could maintain for 60-90 seconds.

This will be your “sprint” marker that you’ll use on sprint intervals (95-100% of maximum heart rate or all out sprint).

Now:

Find a point that feels like the end of a hard tempo run.

Mark this spot as your “medium” interval distance.

When you complete the hard workouts, you can use these reference points to ensure that you maintain a very hard effort.

The springboard

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minute medium, 1 minute sprint, 1 min rest (let the bungee pull you back – this is kind of fun). Repeat 10 times. 10 minutes easy cool down.

The race simulation

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 5 minutes medium (focus and concentrate, just like during the hard part of a race), 30 seconds sprint, 2 minutes rest. Repeat 4 times. 10 minutes easy col down

The lactic acid

10 minutes easy warm up, 90 seconds easy (slowly moving out and stretching the bungee), 2 minutes sprint, 90 seconds rest. Repeat 12 times, 10 minutes easy cool down.

I guarantee that with the bungee, you’ll get your heart rate through the roof.

You can challenge yourself and make aqua jogging more fun by seeing how long you can stay at your maximum stretched distance or seeing how far you can push it.

Likewise, if you have a friend who is injured (or someone willing to be a good sport) you can try pulling each other across the pool for some competitive fun.

Cross training can be tough, especially when you’re injured or want to be increasing your volume faster.

However, I hope that providing a variety of workouts, either through the Fluid Running app (which also makes it easier to keep track of the workout while in the water) or on your own can add a fun challenge in the pool and you can emerge from your injury with minimal fitness loss.