Conditioning: Phase 3

The following is the third of four phases that will guide you from shin splints toward healthy running. Progress from each phase as instructed.

Duration: 2 Weeks (at least)
Goal: Progressive Loading and Strengthening
Frequency of Exercises: 3 x per week (day off in between)
Warm Up: For at least 5 minutes before activity (e.g. Pre-Run Warm up).

Mountain Climbers (With Band): (If experiencing anterior tibialis pain) 3 x 30 seconds. In a full plank position, wrap a band around your toes and anchor the other end. Keeping your core stable, bring your knees up to your chest by alternating sides. Purpose: increase load on anterior tibialis to build up resilience.
Single Leg Romanian Deadlift: 3 x 10 each side. Standing one one leg with your knee straight, lean forward while maintaining balance and a level posture. Come back up by using your hips. You should feel your hip and ankle muscles working. Purpose: increase demand on glutes and calf strength to support arch.
Tibialis Posterior Exercise (With Band): 3 x 16 reps. On a smooth surface, place a towel under your toes, keeping your heel on the ground). Wrap a band around your toes, and anchor the other side of the band on a door or other structure. Place your hands in between your knees to prevent the knees from moving. Keep your first toe down on the ground and rotate your ankle inward slowly, then back out. You should feel this on the inner part of your calf. If you feel it in the hip, you are rotating your leg too much. Purpose: strengthen posterior tibialis, which helps support the ankle and counter excessive pronation.

Side Planks: 3 x 30 seconds. On your side, bring your elbow below your shoulder and come up on your feet. Keeping your body in a level position, hold this position for at least 30 seconds or until fatigue. If it is too difficult, you can start on your knees. Purpose: increase hip strength and lateral core stability to reduce knee caving inwards and foot pronation when running.
Front Plank: 3 x 30 seconds or until fatigue. On your elbows and knees, bring your knees off the ground and hold. Try to keep your body level throughout this exercises by keeping your hips level and engaging your abdominals and glutes. Keep your elbow below your shoulders and push up to engage your scapular muscles. Purpose: strengthen core and glutes for running form stability.
Single Leg Balance (Running Man): 3 x 30 seconds (each leg). Standing on one limb with your knee slightly bent, perform a running motion by bringing your lifted leg in a backward-forward motion along with an arm swing motion. You can start off with minimal movement, and as you progress increase the range of motion and speed. Purpose: improve postural balance and stability.
Single Leg Calf Raises (On Step): 2 x 20 reps. Standing on a step with one leg, come up on your toes and then back down so your heel is below the step height. You should come up over your first/second toe. Add weight if this is too easy. Mild pain is okay as you increase the load. Purpose: increase strength in the calf for more control.

Arch Exercise (3 Parts): Think of your sole as having three key points of contact with the ground: two points on the ball of the foot and one at the heel. Stand with your feet shoulder-width apart and lift up all your toes. Hold that position for 10 seconds, maintaining the three-point anchor and a stable curved arch. Next, still maintaining the sole’s 3-point connection to the ground, lift up your big toes while keeping the little toes down for 10 seconds. Finally, bring your big toes down with little toes up, watching that your foot does not rotate inward, collapsing your ankle. Hold that for 10 seconds. If difficult, you may have to train your toes by positioning them with your hands. Purpose: improve arch posture and tissue strength to absorb the impact forces of foot strike while stabilizing the foot and shin muscles.
Arch & Shin Exercise (3 Parts): Standing with your feet and knees together, assume a crouched position balanced on your forefeet while you sit on your heels. You should primarily feel your arch and toe muscles working to stabilize your weight. Your legs should be mostly relaxed while doing so. Hold that position for 10 seconds and then slowly lower your knees to the ground. Briefly hold that position and then return to the first position. Finally, shift back to your heels while maintaining a tight crouched position. Here, you should feel your front shin muscles working the hardest. Purpose: strengthen feet and shin muscle groups.

Side Steps (With Band): 3 x 12 steps (each direction); some pain okay. Place the band around your foot/ankles, step side to side in a slight squatting position while keeping your body aligned and your feet facing forward. You should feel muscles working on the side of your hips. Purpose: increase glute strength to reduce knee caving in.
Begin Run/Walk Progression on a flat/even surface, preferably softer such as a track, dirt trail, or treadmill.
Double Leg Jump Ropes: 3 x 30 seconds. You don’t even need a jump rope; the emphasis is on the motion of jumping up and down. Purpose: strengthen the shin muscles.
Stretching: 1 minute per side.
- Gastrocnemius: Standing with one foot back, place your toes on a half roll or rolled up towel to increase stretch. Lean forward while keeping your knee straight.
- Soleus: Next, holding a split stance, bend your knee and get a lower stretch. Purpose: improve calf mobility to decrease strain on the anterior tibialis.
Foot Stretching (3 Parts): Keeping your feet and knees together, sit on your knees with an emphasis on the balls and toes of your feet, and place your weight back onto your heels. You should feel your arches stretching. Next, settle your weight on the knuckles of your toes, which should stretch the top of your feet. If painful, shift some of your upper body weight off the heel. Finally, plantar flex your foot so as to rest your weight on the front of the ankle, thereby stretching your shin muscles. Purpose: improve foot and ankle flexibility while also removing tension.

TO GRADUATE TO PHASE 4

Required: No pain with loaded anterior tibialis for at least 2 weeks
Required: No tenderness from palpation (touch) along the front of your shin
Required: Able to walk/jog and perform exercises without pain

Principles of Shin Splints: A Review

CAUSE – overloading the muscle attachment to the bone of the shin (tibia), generally rooted in muscle weakness from either the soleus, tibialis anterior, and/or foot arch
NEED – manage pain, such as by self-massage and/or icing, and strengthen mechanics
PLAN – once pain is reduced, progressively load and strengthen the tissue

Still Need Help?

You are welcome to meet virtually with our PT for additional feedback and assessment. Otherwise, continue to the next step to learn how best to manage the pain from your injury.