I Started Running and Immediately Got Shin Splints – Now What?

A newbie struggles with shin pain two weeks into a beginner’s running plan. Here’s what the doctor recommends.

J Merrilees asks: I’m really new to running: I’m currently trying to work my way through the couch to 5K plan with the aim of taking part in some runs later this year. 

I’m only about two weeks in to the plan but three times now I have started to get shin splints. I rest, recover, start again, and end up with the same shin pain. I have good running shoes that were properly fitted at a running shop. I’ve tried varying my stride length, speed, and the number of runs I do in a week. It feels like I’ve tried almost everything. So I’m just looking for a bit of advice: any tips or tricks to aid and speed up recovery, and to prevent shin splints in the future.

Congratulations on choosing to get active! Your timing is good: many people make plans over the New Year to get fit. The Couch to 5K plan can be effective for many new runners, but like anything in life it isn’t necessarily a perfect fit for everyone. It may be too slow from some and too aggressive for others.

You appear to be in the latter group. That is not a bad thing, but it may mean that your progress to a 5K will not be as rapid. Part of a new exercise program involves “toughening” the tissues to tolerate the exercise load. If you are truly coming off the couch, your leg tissues may need more time to tolerate the increased physical exercise, especially if you are carrying more weight than is ideal. Since you have already tried several of the usual training modifications, you may need to ramp up your activity more gradually.

The brisk warmup that the couch to 5K program recommends, for intance, may be a full workout for some people, at least initially. If you are having trouble with shin pain, you may not be ready for the demands of running until you have the core strength and you have toughened your leg tissues with repeated exercise. In my practice, I have many patients who have not been doing any exercise and really need activity for health. My “starting exercise” prescription is very slow comparatively.

In addition to toughening tissue, building core muscle strength and cardiovascular endurance are an important part of any exercise program. Tissue toughening comes with repeated gradual and progressive loading of the tissues over a period of months to years. Strength to hold the body in position for running and walking is also critical for injury (and pain) free running. Core strength is often overlooked in beginning running programs. The applicable saying is “you can’t fire a cannon from a canoe”. Without adequate strength in the core and glutes, it is hard to maintain the neuromuscular control that keeps the legs properly aligned while running.

For core strengthening, I have patients start with partial squats holding on to a counter or the kitchen sink. To strengthen the glute muscles, keep your knees bent, and lower legs vertical, while squatting down as if you are about to sit in a chair. Initially you may drop as little as a 15cm, but with many repetitions you will be able evolve this into a full squat. Eventually most people can move away from the solid support of the sink and restart partial squats without support.

If you’ve never run before, I suggest starting with a 5 minute out-and-back walk (two and a half minutes out from home and back) then add a minute every day or two until you can walk easily for 30 minutes. Once you’ve crossed the 30 minute threshold, start adding in some running. After five minutes of warm-up walking, jog (or run slowly) one block, then walk one block, then walk until you’ve completed 30 minutes. Every day or two add another block to the running portion until you’re able to alternate walk-runs for the full 30 minutes. Once this goal is achieved, increase the running portion to two blocks of running and one block walking, then three blocks, etc. until you can run for the full 30 minutes.

If you have pain or excess fatigue, go back to your previously tolerated level for a day or two. New exercisers should start with an every-other-day routine to improve success, but may eventually move to six days a week on a “hard-easy” rotation. The off or easy days can be used for strengthening activities.

For fitness, the routine should be on an every other day basis. For weight loss, the volume will often need to be increased to six or seven days per week and an hour each day, but this should be at walking intensity, not the higher intensity of running.


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