Have you ever tried to start running regularly, only to be stopped by sharp stabbing pain in your shins? Every step can feel like shards of glass breaking into your soft tissue, or maybe you feel like your bones are about to break. If you’ve experienced what I’m talking about then you know how frustratingly painful shin splints are.
You don’t have to suffer through shin splints in order to become (or stay) a runner.
A lot of you know about the knee pain that stopped me from running for 8 years and hiking for 6, but it actually started with shin splints.
I was 16, had stopped doing gymnastics and took up running. I loved the freedom and strength I felt during and after a nice long run. Pretty soon after I started running regularly I experienced that stabbing pain in my shins. Being stubborn and someone with a high pain tolerance, I just kept running. Eventually the shin splints went away; but I ended up with horrific knee pain a year later. This new pain was something I couldn’t ignore. Sharp stabbing pain literally brought me to my knees, and there was no way to run through that.
I now know these two things were connected, and had I taken care of the shin splints like I’m about to show you how – I never would have experienced such debilitating knee pain and I could have kept running and hiking all those years.
What are shin splints?
Medically speaking, shin splints (or medial tibial stress syndrome) is considered an overuse issue specifically from running and often from running on hard surfaces like pavement.
They tell us you’re at risk if:
you’re a runner or just beginning a running program
you change the duration, length or frequency of your running
you’re in the military
have high or flat arches
Then there’s a laundry list of ways to “manage” the pain, such as:
have your running gait analyzed
buy shoes with more support/cushion
try inserts with shock absorption
lessen the impact of your activities by adding things like swimming and biking and
do more strength training…
But NONE of the above address the actual CAUSE of shin splints.
Besides, if you love running and you just wanna be out there pounding pavement or miles of dirt…you don’t want to hear things like “try swimming instead.” Right?
I’m here to tell you, you can run to your heart’s content SO LONG AS you address the CAUSE of your shin splints. And – it’s fairly EASY once you “get” it.
Most of us have experienced, or will experience, pain or injury multiple times in our lives. Getting the right help to bring our bodies back into health can feel hard enough, and if we’re lucky enough to reach a point where we’re ready to get back to our favorite sport or activity, it can feel like an impossible mountain to climb.
We ask ourselves questions like:
“What if it happens again?”
“If there’s pain, do I stop or push through?”
“What if I do this thing and get re-inured so badly I can’t even walk?! Maybe I’m just not meant to be a ______ (runner, cyclist, mountaineer, swimmer, CrossFiter).”
I learned to run again after 8 years of believing I never would:
As most of you know, I had knee pain that prevented me from running for 8 years.
Now, I can run anything – short, long, pavement, trail, uphill, down steep mountains…and most of the time I’m completely pain-free.
I say most of the time because I’ve promised to never bullshit you, and the truth is on rare occasions I do have twinges of knee pain. However, it no longer scares me or stops me from doing what I love, and – by experiencing knee pain sometimes, I’ve discovered a few amazing facts about recovery after long standing injuries that will help me help you get back out there too.
I just went running the other day for the first time in a month or so. The first few steps were creaky and stiff, and I noticed a familiar tightening around my left knee – the kind that years ago would have meant sharp stabbing knee pain if I ran even one more minute.
Instead of contracting in fear or cutting my run short, I was able to use a trick I’ve learned well over the past 5 years and nothing came of those creaky joints except more movement, fluidity and I had a pain-free run.
I want to let you in on this trick so you can apply it to your own body and sport. I believe we can do whatever we want, if we can just find a way to support our bodies.
Mind games can work FOR or against us! Our choice.
Let’s say you just recovered from an acute or long standing injury. You’ve been “cleared” to get back out there.
Those first few moments as we return to an activity that either produced a sudden and scary injury, or perhaps gave us pain for years or stopped us from doing something for a long time? They can be terrifying and produce all kinds of mind games.
The overwhelming nervous system response seems to be one of FEAR:
Fear of pain.
Fear of re-injury.
Fear that we’ll set ourselves back another month or year or decade.
Fear that we won’t get this right and we’ll have to give up the activity we love for good.
Your mind might even be re-creating the pain or accident like a movie it’s watching on re-play, in slow-mo. You watch yourself get injuried over and over and over.
If you’ve ever tried to return to an activity after injury then you probably know what I’m talking about.
Your mind might even be clever enough to convince you you’re not afraid, but YOUR BODY KNOWS THE TRUTH.
Our bodies simply manifest what we are telling them with our subconscious or nervous system.
The subconscious doesn’t recognize negatives! Use this to your advantage:
First of all – I am NOT a running coach and this is NOT meant to be advice for how to be faster or a “better” runner; this is my opinion (based on personal experience with knee pain as well as my work with countless knee pain clients) on how to run without knee pain. That’s it.
If you love running and your goal is simply to enjoy running again without knee pain…this post is for YOU.
Running this way might make you slower (or faster), it might feel awkward or fantastic…I leave it entirely up to you to try this as an experiment – and then run this way or not.
Changing how I run (and taking care of my fascia in general) helped me run again after 8 YEARS of not being able to. Personally, I don’t care how fast I run as long as I’m out there bouncing on a trail again without knee pain!
One more quick disclaimer: this post is NOT meant to address knee pain in general. I’m specifically addressing knee pain that only seems to show up while you are running. If you get knee pain while running and it stops as soon as you stop running, then this post applies to you. If you have knee pain 24/7, there are likely other things going on and this post may not apply to you.
What causes knee pain while running?
While there are certainly many causes and types of knee pain, the vast majority of the time knee pain while running has a basic pattern.
Most of the time knee pain while running shows up on the lateral (out)side of the joint, and feels like a knife stabbing you under the kneecap. That sharp excruciating pain can bring you to the ground as the knee gives out.
A lot of people like to blame the IT Band. Understandable, given the IT Band’s size and the fact that it attaches laterally at the distal (far) end of the kneecap.
However, it has been my experience that the IT Band is 3rd in line as the cause, behind two other major players that contribute far more to both the cause and the reversal of this pattern.
Meaning…addressing these two other things often makes the IT Band issue obsolete. Not always, but very often.
The first major cause is fascial restriction (often in the form of huge knots the size of golf balls) in the lateral upper calf or gastrocnemius muscle.
The second major cause (both of these should be considered together), is the fascial restriction within the hamstrings, particularly the biceps femoris where the long and short head meet and where the long head meets the IT Band.
Often there are GRAPEFRUIT sized lumps of inflamed irritated fascia stuck between the IT Band and the hamstring. Please note that these adhesions are NOT within the IT Band OR hamstring muscles themselves, but rather…it is the fascia that wraps both muscle groups that is stuck BETWEEN these muscles (essentially the ITB and hamstring muscles are adhesed together via giant knots of dehydrated or inflamed fascia and all of that tissue is no longer able to GLIDE through movement).
(DO NOT ATTEMPT TO ROLL YOUR ITB TO SOLVE THIS ISSUE!)
It’s also a distinct possibility that your hamstrings are weak, if you sit at a desk all day and don’t intentionally work on strengthening that posterior chain.
All of this creates a powerful force that pulls the ITB and lateral knee ligaments even more laterally, which can cause the patella to slip off the bursa and create a bone on bone feeling (which I believe is that sharp knife-like pain in the knee).
What does this have to do with running?
Many runners use a short quick gait that emphasizes extensive use of the quads and quad hip flexors as well as the calves to create forward movement. This is especially true of trail runners, even more so distance trail runners. The other common stride I see (mostly in marathoners or road runners who run for time on mostly flat surfaces) is to have a long thrusting forward stride that uses extreme hip flexion followed by knee extension that happens in FRONT of them, causing a hard heel strike that forces the knee joints to stabilize their body through the entire run.
The first scenario I described above is certainly the most common, and if you are a barefoot runner or toe striker and your heel barely or doesn’t even touch the ground while running then you are especially likely to create fascial restrictions in your calves.
What all this does while running is put your hip and knee joints into a near-constant state of flexion, and all that overuse of the already restricted fascia within the upper lateral gastrocs combined with fascially restricted WEAK hamstrings (which probably aren’t tight from overuse but actually under-use, especially if you sit at a desk all day with bent knees and contracted/weak hamstrings and run with your quads and calves) means near constant tension on the lateral fascia of the knee joint, including all the tendons, ligaments and bursa.
The IT Band is supposed to stabilize us through sports like running, but its job becomes increasingly difficult with these fascial restrictions constantly pulling it off track (laterally and posterior), combined (possibly, if your foot strikes in front of you) with a gait that doesn’t allow for hip stabilization and instead relies on the knees for that, and to top it all off…so many people are now foam rolling the bejeezus out of their IT Bands in an attempt to change all of this, but the IT Band actually NEEDS to be extremely tight from hip to knee since it is made up mostly of dense fascia (it’s basically a giant tendon) whose job it is TO STAY TIGHT AND KEEP US STABLE. While the fascial adhesions between the ITB and hamstring DO need releasing (strategically), I’m not a fan WHATSOEVER of rolling out the IT Band from knee to hip.
Take a closer look at the knee joint and surrounding muscles.
Now imagine someone tugging on the lateral upper calf tissue while also tugging at the hamstring and ITB tendons that attach to the knee and patellar tendon (the “balls” or knots of fascia are doing the “tugging”); these two things pull everything laterally and posterior, possibly taking the patella with it, creating a nice set-up for bone on bone action unless released from this pattern.
What reverses all of the above as far as running is concerned is reversing the muscle patterns that lead to these restrictions while running, and changing where our foot strikes the ground.
Are you one of the many people who thinks that the “pounding” during running or the “impact” of downhill hiking is bad for your joints?
I used to think this too! It was drilled into my brain on a very visceral level when I had to hike 7 miles downhill on a “bad” knee and by the time I got to the bottom I had TWO bad knees (click here for that story). I believed the terrain was the problem and I didn’t hike again for 6 YEARS! Now I know better.
With SO many people experiencing pain on the downhill, or pain through impact sports like running, it’s logical to conclude that the sport or the terrain are “bad” for your joints.
I’m here to tell you it is NOT the pounding, impact or downhill that is bad!
I never would have believed this myself had I not experienced first hand being unable to run or hike for 8 and 6 years respectively, only to find out I can hike ridiculously steep 14ers here in Colorado (mountains above 14,000 feet), even run down them, without any pain at all – if I take care of my body before going out there.
The downhill and running are NOT the problem; they simply highlight what is already dysfunctional or unhealthy in our bodies.
If you are someone who normally does NOT have pain unless you try to run or hike downhill, and only during these activities you experience foot or ankle pain, shin splints, knee pain or hip pain, then chances are…
Your fascial system has lost its SPRING!
Our body is made up mostly of fascia, and that fascial system’s make-up is like a giant web that is meant to be elastic and flexible, able to absorb impact for us while helping us ‘spring’ out of sports such as running.
Is yours working for or against you when it comes to pain and pain relief?
Mine used to work obsessively to my own detriment. Now my mind is one of my most powerful allies, not just for me but all of my clients as well.
What we think about pain and how we REACT when it shows up, I believe, can and often does determine whether the pain stays, gets worse, or leaves as quickly as it came.
This is not to say that often (or always) there isn’t something physical going on too. Of course there is!
What controls the physical body? The brain and nervous system!
And what controls the brain? We do.
Who we are – our beliefs, stress triggers, past traumas (physical or otherwise), fight or flight response, nervous system habits and muscle memory – all of this and far more is entangled and, when pain shows up, can become a mess of reactivity that has almost nothing to do with our current circumstance.
Before you go dismissing this as a bunch of new age hooey, let me ask you…
Have you ever had something happen in your life that was mildly upsetting, and instead of being calm and assessing the reality of your situation you started obsessing with your mind and before you knew it…the situation went from mildly upsetting to a blazing inferno of “this is so f*cked up!”?
I’m pretty sure we’ve all done this, whether in relationships, traffic scenarios or any time we’re confronted by something undesirable. It’s no different when pain shows up.
Pain is upsetting, right? So it’s logical that we would feel alarmed, concerned and start thinking about it. HOW we think about it and WHAT we think about it determines what happens next. (And…what if pain didn’t have to be upsetting? What if we welcomed it as an intelligent message from our body? More on that later).
I let fear control me for 8 years!
I imagine there’s not a single person on this planet that decides consciously “I’m going to let this here fear control me.” We don’t do this on purpose. I certainly wasn’t aware of what was happening to me until I clawed my way out and looked back at myself with a new awareness. And now…
I believe most of what stopped me from running for 8 years and hiking for 6 was a mental construct. Did I have knee pain? Abso-freakin-lutely!
This wasn’t an overnight mental construct and pain helped create it.