Hi guys! This video is about medial tibial stress syndrome, or shin splints, and how you can change
your running style, or little adaptations you can make to it that may help to offload that
painful area. So, what I'm going to cover in this session is: The main causes of medial shin pain to
develop, because that will help you to understand why you need to change your running style if
you're running with certain things, and then we're going to discuss practical cues that you can use
to change if you feel you've got those elements in your running style. My name is Maryke. I'm
one of the physios from sports-injury-physio.com, where you can get online physiotherapy assessment
as well as treatment for your injuries. So, have a look at the description of this video
if you want the link to the website. Good! So, medial tibial stress syndrome is a mouthful,
but it's an overuse injury, and it's basically if you either increase your training massively,
don't get enough recovery time, or if there's something in your running style or in your muscle
balances that causes this area to over-strain. It can be caused through weak glutes combined with
pronation and things like that as well, so it's not the only thing ... your running style is not
necessary that only cause of it. So, you have to sort out muscle strength and things as well, but
I've made a whole video about all the causes and the treatment options you've got available. So,
you may want to watch that as well; I'll put a link at the end of this video to that one. Okay,
so for running style specifically, things that can strain that inside and make it overwork is
if your leg turns in excessively when you run, because that will put a large torsion force
through this area. Also, if your legs cross over as your run, so, a narrow line of progression,
because that will put extra force onto this part of the bone. One of the most important ones, which
can cause a wide variety of injuries as well, is if you over-stride, so you're landing quite hard
on your heel in front of your body, and there's a lot of force coming into your leg through that,
and that can cause all of that to be even worse. So, those are the three main things that we want
to adapt or try to reduce if you find that in your running style. Now, how do we do it? First of all,
increasing your step rate or your cadence by a tiny bit can actually address all three of … or
at least the internal rotation and the over-stride already. So, step rate is how many steps you give
in a minute. So, people with a slower or lower step rate tend to have more force coming through
their legs, and they tend to have a slightly worse running style usually. So, if you increase your
step rate, you tend to shorten your stride, so over-striding is reduced. You also tend to not
make contact with the floor that hard or for that long, so you get less reaction forces going up the
leg, and it tends to reduce how much your leg turns in. Now, for the turning in of the leg,
you can also just think about, if you run and you feel that that's what's happening in your legs,
you can just think about trying to point your kneecaps forwards as you run, not allowing them
to move quite so far in. It is normal for the knees to turn in a little bit when you run,
but it shouldn't be excessive. So, don't try and run with your knees pointing out,
that's not normal either; a little bit of a turn in is fine, but not a massive movement. Then,
another good one for over-striding is just thinking about trying to land with your foot
more underneath your centre of gravity, so, more underneath your body rather than far out. So,
to demonstrate that: So, instead of landing with it there, think about just trying to land
with it more underneath you, and you'll find that that naturally turns you into more of a mid-foot
strike runner. We don't really want you running on your forefoot when you've got medial shin pain,
because that can overwork the calf muscles, especially soleus, quite often, and that's
often already inflamed and sore or overworked in this condition. So, mid-foot strike is better than
forefoot strike for this. Then, if you find you've got a narrow line of progression – and a good tip
that you … or hint that you may have that is if you kick yourself when you run – just think about
widening your steps a little bit – your gait – so that you don't quite run as if you're running on
a tightrope. That can already make a difference. And with all of these changes – it doesn't have to
be perfect, just a little reduction in any of them can already start to offload the tissue and make a
slight difference. So, don't go for big changes, work on little changes and see what the effect
is. It's often also best to practice this with a run-walk programme, because it's a new movement
and your muscles and everything are not strong enough in that movement pattern yet. You will
not be able to do it for a full 5k, for instance, or you'll overwork other things because you're not
strong enough in that position to train for that long. So, rather do like: one minute running with
good form, one minute walking, one minute running with good form, one minute walking. And if you're
coming back from an injury, that's the perfect time to practice that, because you shouldn't
be running continuously, necessarily, when you come back from an injury; run-walks is usually
a better way to get back to running again. If you're already running continuously and you
just want to do it to prevent future injury, then have days where you just work on technique. So,
maybe for the first five minutes of your easy run or something like that, work on technique
and try to incorporate it into that. Excellent! If you've got any questions, let me know in the
comments or send me a message. But if you need more help with your injury, always welcome to
consult me via video call – link to the website is in the description of this video. Take care!