Case Study – Shin Pain

Scenario
Alan is 36 years of age and liked to keep fit by doing some running and gym work. However, for over a decade he has had back issues and suffered from pain in his left shin, he would also experience low energy levels and tire very quickly. Understandably, this severely curtailed his ability to run and do certain exercises.

When he jogged, he would feel a tightness in his calf which spread to the front of his shin, reaching a point where he would have to stop running. The symptoms would clear within 24 hours. Interestingly, when he sprinted, he never experienced the shin pain.

Analysis
Understanding the different biomechanics of sprinting and jogging gave me an idea as to why the sprint work didn’t affect him. I recorded Alan running at his normal pace on a treadmill and then looked at how he sprinted. Using a slow-motion camera I could see that Alan was over-striding, had a low leg turnover, was landing with a straight knee, had both feet on the ground and had an excessive heel strike. It was this last trait that informed me why jogging and sprinting were different experiences for him. When he jogged he had a very pronounced heel strike. This created a lot of activity in the muscles on the front of the shin. In contrast, when he was sprinting, he landed on the ball of his foot. In this position there is less activity in the muscle of the front of the shin. Therefore, the objective was to retrain Alan to run with less of a heel strike.

We began with form drills which ingrained a forefoot landing pattern. In tangent with this Alan ran for a number of time intervals using a metronome set at 5-7% quicker than his normal leg turnover. We also used some form cues like “land softly” and “pick up your heels”. Alan would replicate these sessions twice to three times per week.

Results

During his first week Alan ran three times for 10 minutes each, pain-free. As the weeks progressed so did the pain-free interval periods he ran for. Adding in some strength work, Alan allowed his body to absorb the demands of running.

Alan has since ran a number of 10ks and is training for a half marathon. He currently runs 3-4 times per week while also carrying out strength and conditioning work. He is delighted with his progress and believes it has had a hugely positive change on his quality of life.