Physical Therapists Using Clinical Analysis To Discuss The Art And Science Behind Running and The Stuff We Put On Our Feet

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DOR Podcast #113: The Truth about Shin Splints

Shin splints is one of the most common running injuries, but also one of the most commonly misunderstood. When people report having shin splints, the cause of the pain could be any number of things. Today on the podcast, Nate, Matt, and David discuss the truth behind shin splints. That lower leg pain could possibly be a stress fracture, medial tibial stress syndrome (MTSS), or something else entirely. They discuss ways to understand symptoms & causes of shin pain, as well as tips for rehab and strengthening.

Listen to This Week's Podcast Here!

Direct Links: Apple | Spotify | Anchor


The Subjective:
What running-related injury are you most interested in learning more about? 

0:00 - Intro
4:18 - Breaking down the anatomy of the shin
6:35 - The structure of our bones
16:27 - Diagnosing shin pain
24:59 - Stress fracture vs. MTSS
34:29 - Causes of MTSS
45:04 - What do we do when we feel signs of MTSS?
54:11 - Rehabbing & strength training for MTSS
1:01:02 - How shoes can effect MTSS
1:08:06 - Wrap-up

Science Feature: Finding the Perfect Fit
By Chief Editor Matt Klein

How do you find the perfect fit? Since each person is different, you are going to have to find what works best for you. Some people like snug shoes while others don't like any pressure on their feet. Some people like having a wide toebox for their forefoot while others like a wide heel. Fortunately with the huge variety of running shoes out there, there is something for everyone. I do have some general suggestions for everyone however. 

1.  Except for shorter races, shoes should not be too tight. There are a large number of sensitive nerves in the foot and ankle. Nerves do not typically do well with compression. Compression of the toes, metatarsals or any one of common nerve entrapment sites is asking for trouble. YOUR FEET SHOULD NOT GO NUMB WHEN YOU PUT ON A SHOE OR WHEN YOU RUN. That is not normal. So make sure you have adequate room through the shoe, but not so much that you slide around. 

2. Make sure your toes have enough room! Shoes that are too narrow not only may cause excessive compression, they may alter the mechanics of the foot. More research is coming out suggesting that shoe shape may predispose people to certain pathologies, like narrow toeboxes and bunions (Ferrari et al., 2004). The foot works best when everything is lined up. The tendons and muscles have optimal length tension relationships, so changing that (ie smashing the toes together) may alter your mechanics, speed, strength and more. I will have a post in the future to dive into the research on this topic.

3. Again except for some people racing very short distances, make sure you have a little room between your toes and the end of the shoe. Feet do swell over runs and over the course of the day. That is why it is usually better to try on shoes in the evening compared to the morning. Shoes that are too short may predispose individuals to pathologies like hammer toes or shortened toe flexor muscles/tendons. 

4. Find what works for you. Each person has a unique foot. It doesn't matter what your neighbor or best running friend says. You need to try these things and learn what works for your feet.

Recent Episodes

#107: Finding the Right Shoe for You
#108: Mailbag Episode!
#109: What do Heel Counters Actually Do
#110: Tips, Tricks, and Treats to Shopping Run Retail
#111: Mastering the Art of Running Over the Age of 40
#112: Best in New Balance, 2022

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