#245 Is it risky to keep running with shin splints? - DOC

#245 Is it risky to keep running with shin splints?

Today on the Doc On The Run podcast, we’re talking about whether or not it’s risky to keep running when you have shin splints. 

Shin splints are one of the most common causes of pain in runners and typically shin splints happen as a consequence of ramping up your mileage really quickly or when you start adding a lot of hill work or you add some other increase in mileage or stress to your running routine. The problem is most people think that shinsplints or just pain in your shins and it’s true. You can get shin splints that are just really a source of pain and are not really a source of risk, but that’s not always the case. 

I started running when I was a kid and I had shin splints literally for years. Anytime I would rapidly ramp up my mileage or when I would do lots of hill work and that went on practically for decades, I would get plagued by shin splints. So trust me, I understand how uncomfortable they are.

And in fact, one time when I was doing the Salt Lake City Marathon, I’d been training a lot and I was determined to set a new PR and I had shin splints that started right before the marathon and then I did something really stupid. 

I actually took one of those blue ice packs, I put it on the front of my shin the night before the race. I decided I was going to ice it like crazy and I basically wound up with frostbite. So I had a actual blisters on the front of my leg from frostbite when I was doing my marathon. 

Now that is a stupid thing to do. You should not do that. I shouldn’t have done it. I should’ve known better. But that’s what I did and it did not really help me accomplish my goal.

The only reason I’m telling you that is not because I’m trying to give you a ridiculous suggestion, but I just want to let you know that I do understand. I know how frustrating it is and we kind of go to some extreme links sometimes just to try to get rid of the pain from shin splints, but you have to understand not all shin splints are created equal. 

There are lots of different things that can cause shin splints. 

You can get anterior shins splints where you have pain in the muscle belly that actually pulls your foot upward.

You can get that because you’re pulling your foot up when you’re trying to clear the ground running uphill. 

You can get medial tibial stress syndrome where you have a irritation of the covering of the bone where the muscles attach on the inside of the middle part of your leg. 

And you can also get tibial stress fractures.

Some doctors say that if you get medial tibial stress syndrome to keep running, whether you get chronic irritation in the bone, you get chronic inflammation around the bone. You have an increase in blood flow that happens locally and then you wind up with a tibial stress fracture. 

I don’t really know if that’s true. I understand the theory, but I don’t know if it happens that way, but I do know that I see lots of runners who actually call me and say they have shin splints, but it turns out they actually have a tibial stress fracture. 

So the thing I can tell you is that if you really have true shin splints, if you really have medial tibial stress syndrome, you really have anterior shin splints and it really is just one of those benign conditions that is annoying, then you probably don’t have much risk of making things a lot worse if you keep running on it.

The problem comes in where people are confused and they want to believe it’s one of those two less risky conditions, but they actually have a tibial stress fracture. And if you have an anterior tibial stress fracture, that’s very high risk. 

If you have a distal tibial stress fracture, that’s also very high risk, that can turn into an ankle fracture. If you have a posterior tibial stress fracture, that it really seems like it’s shin splints, that’s the least risky of all the three kinds of stress fractures you can get in the tibia. But it’s still more risky than shin splints. 

The key is to really talk to an expert and figure out whether or not you might actually have a true tibial stress fracture and not just shin splints. 

Make sure you talk to an expert and make sure you can figure out whether or not you have one of those other riskier conditions. And then you can decide whether or not you should just keep running.


If you have a question that you would like answered as a future addition of the Doc On The Run Podcast, send it to me PodcastQuestion@docontherun.com. And then make sure you join me for the next edition of the Doc On The Run Podcast!