I was recently listening to a running coach discussing his approach to medial tibial stress syndrome, or shin splints to use its more common name.
I watched with interest as he took a client through an elaborate stretch aimed at their posterior tibialis muscle.
What is shin splints?
Although the name suggests that the shin is splintering or breaking apart, in the case of medial tibial stress syndrome, no such thing is happening.
There is no consensus as to what is actually taking place, although theories include small tears in the posterior tibialis muscle, an inflammation of the periosteum [a thin sheath of tissue that wraps around the tibia, or shin bone], or some combination of these.
Proposed causes include over pronation, a lack of stretching, worn shoes, training errors, or repeatedly running on a cambered surface in the same direction.
Why stretching won’t work.
The coach’s approach to stretch the area that the pain is coming from is in keeping with most rehabilitation approaches to this situation and intuitively what you want do to provide relief. It may also be entirely counterproductive.
Think about what stretching aims to do. It relaxes muscles, or put another way, reduces their ability to contract.
Every study that I’m aware of concludes that muscles which have been passively stretched lose their ability to produce force.
Now relate that back to the problem of medial tibial stress syndrome. If the cause is considered to be ‘over pronation’ then reducing the ability of posterior tibialis to contract doesn’t seem like a good idea.
This muscle, when contracting effectively, actually controls pronation at the foot by holding up the medial arch.
This would be like trying to improve your 10k time by removing a limb. It really is that wrong.
If you are suffering from shin splints and you don’t seem to be improving, assess your current treatment strategy and start asking some questions.