Shin Splints - Unsure what to try next

Corona

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Hi all, I've had shin splints for about 3 years now and I thought I was making progress but unfortunately, the pain keeps coming back and was wondering if anyone had any ideas of what to do. I've tried using custom insoles, changing trainers, gait analysis and lots of physio (strengthening glutes, soleus, calves, stretching a lot, etc) . I am currently trying to alter my gait so that I don't lean forward so much and my foot strikes the ground in a more vertical motion, beneath me if that makes sense, reducing my stride length. If anyone has any ideas as to what I could try I'd be much obliged
Thanks
 

Mattys

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Hi all, I've had shin splints for about 3 years now and I thought I was making progress but unfortunately, the pain keeps coming back and was wondering if anyone had any ideas of what to do. I've tried using custom insoles, changing trainers, gait analysis and lots of physio (strengthening glutes, soleus, calves, stretching a lot, etc) . I am currently trying to alter my gait so that I don't lean forward so much and my foot strikes the ground in a more vertical motion, beneath me if that makes sense, reducing my stride length. If anyone has any ideas as to what I could try I'd be much obliged
Thanks

Hey mate

You need to do what I said a while back to you and get scans on your legs , It could be anything small that’s coming back from not resting or it can be an underlining condition that requires scans to find it.

If your having these issues now without doing much physical training then your just shooting yourself in the foot for the future when it comes to doing the harder stuff might set you back even more , go private and pay for scans to rule out anything serious and go from there if you can afford this.
 

mace

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Have you ever tried strengthening your tibialis anterior? If not look up Ben Patrick (kneesovertoesguy on Youtube) and he has videos on how to tibialis raises that said to help. What gait analysis have you had done? Was it a 3D one using a MotionMetrix kit? If you have a chance to travel to the RunLab in St Austell, Cornwall, I highly recommend it, they helped me a lot.
Their analysis will tell you exactly how much you are leaning forward, what’s your stride length, cadence and forces you produce etc. Lou, the lady who runs it gives you corrective exercises that you do on the spot and have a re-test (only takes a minute / selected speed) to see if it’s something that instantly helps or not.

Also, are you flat footed? If so, what trainers do you run in? They can actually make a lot of difference if you are flat footed (which increases the likelihood of shin splints).
 

mace

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You see much more data than this plus a video of you and an animated skeleton showing the path your foot takes. The light blue indicates your current run, the dark blue shows the data points pulled from your different run so you can compare progression but also different speeds to give you an idea which speed you are the most economical at the moment (the goal obviously is to increase the speed at which you run the most economically).
 

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Corona

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Hey mate

You need to do what I said a while back to you and get scans on your legs , It could be anything small that’s coming back from not resting or it can be an underlining condition that requires scans to find it.

If your having these issues now without doing much physical training then your just shooting yourself in the foot for the future when it comes to doing the harder stuff might set you back even more , go private and pay for scans to rule out anything serious and go from there if you can afford this.
With the scans, do you think something like this would work: https://www.thechirocentre.co.uk/pricing/ go here, get the initial consultation and then a scan like this? Or would I need a different kind of scan?1611402613617.png
 

Corona

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Have you ever tried strengthening your tibialis anterior? If not look up Ben Patrick (kneesovertoesguy on Youtube) and he has videos on how to tibialis raises that said to help. What gait analysis have you had done? Was it a 3D one using a MotionMetrix kit? If you have a chance to travel to the RunLab in St Austell, Cornwall, I highly recommend it, they helped me a lot.
Their analysis will tell you exactly how much you are leaning forward, what’s your stride length, cadence and forces you produce etc. Lou, the lady who runs it gives you corrective exercises that you do on the spot and have a re-test (only takes a minute / selected speed) to see if it’s something that instantly helps or not.

Also, are you flat footed? If so, what trainers do you run in? They can actually make a lot of difference if you are flat footed (which increases the likelihood of shin splints).
I do a lot of tib ant exercises, and am quite strong there from them (although I have a bad habit of overdoing the exercises and it getting quite painful/achey for a while)

The gait analysis was done by a podiatrist, just using an iPad and slowing it down and then figuring out what custom insoles to make using that and the other checks she did. I haven't had a 3D one, is it worth getting? Unfortunately, I'm too far away from Cornwall to go there, are there any others you could recommend?

Not flat-footed but I believe I was told I have a very slightly sunken arch (but I will need to double-check what she said as I can't quite remember). Trainer wise, I was advised by the physio to get some trainers that have an equal amount of padding under both forefoot and heel (although her reasoning was off according to the specialist who fitted the shoes and checked my gait -banghead-) The trainers name is: Brooks Hyperion Tempo

Thanks for the help
 

Mattys

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With the scans, do you think something like this would work: https://www.thechirocentre.co.uk/pricing/ go here, get the initial consultation and then a scan like this? Or would I need a different kind of scan?1611402613617.png

You definately need to have scans although not at that place as that’s a chirocentre which is all to do with the back unless they do leg scans which is very unlikely?

Its all good having insoles and £150 very comfy cushioned trainers to do anything to help with your legs but the problem is when you don’t have these luxuries that’s the downside , Physios can only do so much that’s why scans are required what the eye can’t see and can rule out anything or find out something.

https://www.nuffieldhealth.com/tests-scans/x-ray

These do X-rays and other medical treatment you can enquire about.
 

mace

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I do a lot of tib ant exercises, and am quite strong there from them (although I have a bad habit of overdoing the exercises and it getting quite painful/achey for a while)

The gait analysis was done by a podiatrist, just using an iPad and slowing it down and then figuring out what custom insoles to make using that and the other checks she did. I haven't had a 3D one, is it worth getting? Unfortunately, I'm too far away from Cornwall to go there, are there any others you could recommend?

Not flat-footed but I believe I was told I have a very slightly sunken arch (but I will need to double-check what she said as I can't quite remember). Trainer wise, I was advised by the physio to get some trainers that have an equal amount of padding under both forefoot and heel (although her reasoning was off according to the specialist who fitted the shoes and checked my gait -banghead-) The trainers name is: Brooks Hyperion Tempo

Thanks for the help
I higly recommend getting a Motion Metrix markerless 3D analysis done. I am sure there are many in the UK just google it with your location.
I also recommend trying out this shoe: Altra Escalante 2.0
The problem with a very cushioned shoe is that you are more likely to heel strike unless you have had really good run coaching. The above shoe has a nice wide toe box allowing the toes to spread as you land and will engage the elasticity of your sole more as it’s without an arch support and also with a 0 mm heel to toe drop. These are not barefoot shoes as they have a really nice responsive midsole to provide just enough cushioning.
But the number one thing would be getting a 3D analysis done in my opinion.
An X-Ray will only show any damage done to your bones, although stress fractures can obviously cause shin pain. CT/MRI’s are more useful, however, the result should be considered with caution.
As the saying goes in the sports rehab community: “you are not your MRI”.
Just because you have the pain manifested in your shin you need to find out the root cause of the problem.
 

Chelonian

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CT/MRI’s are more useful, however, the result should be considered with caution.
Agreed. Arguably the scan is worthless unless it is correctly interpreted by a specialist and is assessed holistically rather than as an individual item of evidence.

@Corona have you been professionally assessed by a physio who has a reputation for specialising in shin splints?
 

Corona

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You definately need to have scans although not at that place as that’s a chirocentre which is all to do with the back unless they do leg scans which is very unlikely?

Its all good having insoles and £150 very comfy cushioned trainers to do anything to help with your legs but the problem is when you don’t have these luxuries that’s the downside , Physios can only do so much that’s why scans are required what the eye can’t see and can rule out anything or find out something.

https://www.nuffieldhealth.com/tests-scans/x-ray

These do X-rays and other medical treatment you can enquire about.
Yeah I'm very much guilty of thinking more cushioning = best, but the guy who fitted these ones explained its more often the opposite so luckily these ones don't have toooo much. I've contacted nuffield about getting an MRI done on my legs, hopefully they can do both at the same time and not separately although I don't really know what an mri machine looks like so maybe they cant. Had a look at some ct scan quotes and unfortunately its just too much money. Was hoping the £50 x-ray would suffice but as chelonian said it needs to be interpreted by a specialist.

I higly recommend getting a Motion Metrix markerless 3D analysis done. I am sure there are many in the UK just google it with your location.
I also recommend trying out this shoe: Altra Escalante 2.0
The problem with a very cushioned shoe is that you are more likely to heel strike unless you have had really good run coaching. The above shoe has a nice wide toe box allowing the toes to spread as you land and will engage the elasticity of your sole more as it’s without an arch support and also with a 0 mm heel to toe drop. These are not barefoot shoes as they have a really nice responsive midsole to provide just enough cushioning.
But the number one thing would be getting a 3D analysis done in my opinion.
An X-Ray will only show any damage done to your bones, although stress fractures can obviously cause shin pain. CT/MRI’s are more useful, however, the result should be considered with caution.
As the saying goes in the sports rehab community: “you are not your MRI”.
Just because you have the pain manifested in your shin you need to find out the root cause of the problem.
Thanks, I'll have a look for some 3d gait analysis people near me and see what the costing is like.
 

Corona

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Agreed. Arguably the scan is worthless unless it is correctly interpreted by a specialist and is assessed holistically rather than as an individual item of evidence.

@Corona have you been professionally assessed by a physio who has a reputation for specialising in shin splints?
I've been assessed by one who has a very good reputation for training injuries, although its unfortunately being done via zoom so the tests conducted are not as thorough.

I hadn't actually thought of searching google for a physio with an emphasis on shin splints -banghead- will take a look now.

Thanks all for the advise, much appreciated.
 

Mattys

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Yeah I'm very much guilty of thinking more cushioning = best, but the guy who fitted these ones explained its more often the opposite so luckily these ones don't have toooo much. I've contacted nuffield about getting an MRI done on my legs, hopefully they can do both at the same time and not separately although I don't really know what an mri machine looks like so maybe they cant. Had a look at some ct scan quotes and unfortunately its just too much money. Was hoping the £50 x-ray would suffice but as chelonian said it needs to be interpreted by a specialist.


Thanks, I'll have a look for some 3d gait analysis people near me and see what the costing is like.

How much do the ct scans cost? MRI would be the much better option if it was financially possible as it would show more than just your bones could be anything ligament/tendon issues muscle problem you just never know!
 

Corona

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How much do the ct scans cost? MRI would be the much better option if it was financially possible as it would show more than just your bones could be anything ligament/tendon issues muscle problem you just never know!
Ct was around 400 I think, Nuffield quoted MRI as £335 for 1 area although the price could change. Unfortunately they said in the email I need to be referred there by a GP or a health care professional unfortunately so I'm not too sure what to do and how to do it in such a way my medical records stay clean
 

mace

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Ct was around 400 I think, Nuffield quoted MRI as £335 for 1 area although the price could change. Unfortunately they said in the email I need to be referred there by a GP or a health care professional unfortunately so I'm not too sure what to do and how to do it in such a way my medical records stay clean
It would be much cheaper to do a 3D running gait analysis with a physio who actually knows about running type injuries.
 

Mattys

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Ct was around 400 I think, Nuffield quoted MRI as £335 for 1 area although the price could change. Unfortunately they said in the email I need to be referred there by a GP or a health care professional unfortunately so I'm not too sure what to do and how to do it in such a way my medical records stay clean

Thats not to bad then in all honest I thought it would be more expensive. There must be private facilities in the UK you can go to without being referred by your GP and in all honest you should get your legs looked at even if it goes on your medical records as you’ve been trying to get them better for 3 years and your lucky you have age on your side!
 

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Have you considered seeing a biokineticist? My son battled with a particular injury when he was playing rugby, had all the physio, scans etc. They referred him to a bio and it was sorted in the first session by him picking up a weakness elsewhere which was causing the recurring injury. He hasn't looked back since! Well, in respect of that particular issue. When he injured himself in training and had to return home, he saw a physio twice a week for 6 weeks and she then referred him to a bio the measure muscles, ligaments etc. That bio gave him particular exercises to correct the imbalances in his quads and hamstrings. He has been given the all clear now. Not sure about the costs over there but Bios are way more friendly on the pocket here.

It may be worth giving it a bash as they work on how the body works and what causes the injury as opposed to treating the injury. You have nothing to lose and everything to gain.
 

mace

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Have you considered seeing a biokineticist? My son battled with a particular injury when he was playing rugby, had all the physio, scans etc. They referred him to a bio and it was sorted in the first session by him picking up a weakness elsewhere which was causing the recurring injury. He hasn't looked back since! Well, in respect of that particular issue. When he injured himself in training and had to return home, he saw a physio twice a week for 6 weeks and she then referred him to a bio the measure muscles, ligaments etc. That bio gave him particular exercises to correct the imbalances in his quads and hamstrings. He has been given the all clear now. Not sure about the costs over there but Bios are way more friendly on the pocket here.

It may be worth giving it a bash as they work on how the body works and what causes the injury as opposed to treating the injury. You have nothing to lose and everything to gain.
In the UK look it up as a biomechanist / sports therapist (make sure they actually studied biomechanics...). Most courses are named Sports Biomechanics over here.
 

Claddagh

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In the UK look it up as a biomechanist / sports therapist (make sure they actually studied biomechanics...). Most courses are named Sports Biomechanics over here.
Interesting-didn't realise they are called something different over there-here being SA. @Corona try your luck at a centre/practice who specialise in Sports Injuries and Rehab
 

Corona

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How are your shins now @Corona ?
Still not doing so good unfortunately, I'm paying for an mri to be done to see if that sheds any light. Unfortunately I didn't realise it would need to be 1 mri per leg which makes it quite expensive. I'm still doing the physio everyday but have stopped the running drills for at least 2 weeks. Trying to keep at least putting a good amount of stress on my shins through lots of walking although hopefully I can start the running again soon
 
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