Like many runners who have pain, Sam’s first angle of attack was to look at his running form. In fact, almost every runner who comes to see me starts by asking for a gait analysis as they believe it must be their ‘poor’ running form that’s resulting in their pain or lack of performance. While on the surface it may look like their running form is the cause of it all, but believe it or not, it’s rarely the case – and Sam’s case highlights this perfectly.

Your running form is simply an output – it’s a set of movements produced by your ability to control and coordinate your muscles, joints and other tissue. You can think of it a bit like the final product of a cake-baking process. If your ingredients, method or process are substandard in any way, the resulting cake will not be what you want. The best way to get a good cake is to ensure that the ingredients, method and process are exactly what’s needed to produce the cake you want.

This is exactly the same with your running form. In the case of human movement, the ingredients are the sensory input signals from all over your body; the method and processes are what your brain does with that sensory input and how it integrates it; your running form is the eventual output.

Given that Sam’s shin and calf pain only came on beyond 10k tells us that something about the quality of his inputs or processing and integration wasn’t quite right. And yes, this probably was being displayed somewhere in his running form and I could have gone down the route of measuring angles, looking for muscle weakness and all the traditional stuff – but I chose a much more direct route first.

I started by testing what he could feel from his right calf and shin. Sam had his eyes closed and was to tell me what he experienced. I applied hot and cold touch. I followed this with pressing a sharp point or a dull point at various points. I tested light tough, heavy tough and vibration. In all areas we tested, except one, Sam could feel all these sensations so I knew that his brain was getting a pretty clear map of where his calf and shin were: but not a totally complete map. There was a very small area, no bigger than 2cm round, where Sam couldn’t feel any sensation at all. It was a tiny paler area of skin from a very old scar that Sam didn’t even know was there. Could that be the issue? 

I then did some skin stretch testing on that specific area and found there were some barriers, indicating further that this tiny area was messing with Sam’s braid-body map. I did a bit of work to release the barriers and we retested Sam’s movement quality: in this case we were testing ankle range of movement and calf tightness. We immediately saw an improvement so I knew we were onto something. Then came the really weird bit!

I wanted Sam to get more in touch with the sensory information that was coming in from that area of his skin. To do this, I wanted to dull down two of his primary sensory inputs – vision and hearing. Sam then stood up tall, put on a blindfold and a pair of ear defenders. His drill was to find his way down to the ground, roll over on the outside of his calf where the target area of skin was, and then come back up to standing. He was to do this five times.

The retest after doing this exercise was outstanding! Sam’s calf tightness had all but disappeared and his right-side ankle range of movement increased dramatically.

Sam’s homework for the next few days was to repeat this exercise at home once or twice per day, and just five reps.

Within five days Sam’s shin and calf pain had gone completely! Totally vanished! When he came in for his first proper session with me a couple of weeks later, he had already increased his long run to 14km and was completely pain-free. That was a couple of months ago (June 2025) and Sam has had a couple more sessions with me, and this time we were able to go straight to improving his technique – which he did in a single session – because the stability of his right side was now not an issue and we could look at optimisation. But just from that first exercise, Sam’s pain resolved and it has never come back even though he is now a good way through his half marathon training.

Why was this area causing Sam pain? Because his brain-body map was incomplete, Sam wasn’t able to effectively stabilise his knee and ankle joints reactively (unconsciously) as he was running. When he increased his distance, the skill requirement for stability also increased, especially as fatigue creeps in. The incomplete brain-body map was stopping this from happening so his brain produced the pain experience to get him to stop – it was red-flagging him that something wasn’t right.

As soon as we completed the brain-body map, he was suddenly able to stabilise his joints again and his brain was perfectly happy and safe with him increasing his distance.

Your brain and nervous system are amazing, and by working at their level and communicating with them directly, you really can make life-altering transformations – just like Sam did.

My Runner By Design membership takes everything I do with my clients on a one to one basis, and makes it available online as a set of assessments, courses, education and live coaching calls. It’s designed to take you on your next steps of your running journey, including helping you get out of pain and enjoying your running again.

To find out more, click here. 

The post The Tiny Scar That Solved Two Years of a Runner’s Pain appeared first on RunTeach.

We’ve read a lot on the forums recently about shin splints and what we can do to sort them out. But what are shin splints?

The term shin splints is actually a bit generic. It’s a little like runner’s knee in that it covers a number of different specific types of pain, and that can initially be why it’s tricky to solve. The one thing we do know, though, is that it’s painful and can put us off running for a long time.

Right, before we go any further, I need to point out that if you’ve had painful shins for a long time and nothing seems to be helping, it’s time to go and see a medical professional. There‘s a chance that long-term pain in the shins can lead to more serious conditions that really needs to be investigated. Please be sensible and take responsibility for it, and if this sounds like you then get it looked at!

So, I’m moving on assuming that if you need to seek medical attention, you are going to do so. For the rest of us, here are some of the reasons we get shin splints:

• Lack of ankle mobility
• Shortened posterior muscles, particularly the calf muscles
• Muscular imbalance
• Lack of strength in the front of our shins (tibialis anterior)
• Poor running form
• Footwear

Shin splints are a classic overuse injury, and there can be many factors that lead to this very painful condition. At the bottom line though, it comes down to the fact that our shin muscles can’t handle the amount of repetitive force we are putting on them. This is why, even after taking a few weeks rest away from running, as soon as you start back the pain returns. If you think about it, what have you actually done to increase the resilience of the damaged muscle and connective tissue? Rest alone is not the answer.

All of the reasons listed above can be, and often are, inter-related. For example, having a severe forefoot strike combined with overstriding will put our foot into a steeply angled plantarflexion (toes pointing downwards). Over time this foot position will reset our nervous system’s range of motion and can also lead to the shortening of the muscles at the back such as the calf muscles. This, in turn, will have the effect of reducing strength in the front of the shins and making them less able to tolerate the force we are putting through them. One of the results of this lack of strength may be shin splints (not everyone suffers from shin splints so we can’t say it will happen).

Let’s now look at some of these factors in a little more detail.

I’m going to combine muscular imbalance and lack of strength together as they are so closely related. It’s very well understood in both practice and research that if there’s a difference in strength between our right and left sides, or even in the muscles on the same side but playing complementary roles, then trouble is often not far behind. Indeed, muscular imbalances are often a major cause of overuse injuries.

As we’ve just learned, multiple factors are frequently involved in shin splints, and sometimes it is difficult to pinpoint which came first. A lack of strength in our toes, feet, ankles and shin muscles (anterior compartment such as tibialis anterior, peroneus longus and extensor digitorum longus) can all contribute either directly or indirectly to shin splints. In a direct way, they simply don’t have the strength and resilience they need. Indirectly, they may force the muscles at the back to work harder, which then creates a dominance and a cycle of reducing the strength of the shin muscles. The end result being the same: they can’t tolerate the load and then they fatigue and breakdown too quickly. See this post on reducing tolerance as we get injured.

This also relates to an earlier post about ankle mobility, where we looked at why ankle mobility is important. As far as shin splints are concerned, if we don’t have the range of motion that we need at the ankle we will make compensations that could either place more force directly onto the shins, shorten those muscles at the back such as the calf muscles, and/or find other ways to get the necessary range of motion (such as turning the foot out) that then leads to improper movement and pain.

Ankle mobility is very important as it’s one of the shock absorption mechanisms we use during running.

Normally I steer clear of discussions on shoes because it often becomes murky and emotive and the truth is that research into shoe recommendations is very much lacking. However, you may be surprised to learn that certain types of shoes can contribute to painful shins. In particular, shoes with high heels. Whether these are high heeled work shoes, going out shoes, or even running shoes that have a large difference between the heel height and the toe height (heel drop or ramp).

Our feet are designed to have both the back (heel) and the front (toes) on a level plane. As soon as you lift one or the other up, we start to get problems.

Warning: Do NOT take this to mean you should rush out and buy a pair of flat minimalist running shoes – don’t! While in theory this would be a good thing, if you’ve been running in shoes with a high drop for a long time, your body has adapted to that position. Your nervous system has made alterations to the start and end range of motion. You will likely have lost some muscle length in the front of your shins. These can all be reset and rebuilt, but it takes time and it takes a sensible transition period.

So we can see that in all these cases, it all leads back to a resulting lack of strength in those muscles down the front of your shins. How this lack of strength came about can take some time to unravel, and this is where our gait analysis services are invaluable.

But there is some stuff you can be doing yourselves to fix shin splints.

The first thing to do is look at what you may be doing to put pressure on those shins or shortening your calf muscles. Here are some things to have a think about:

• Are you wearing high heeled shoes? Bear in mind, that infrequent wear may be worse than regular wear because you don’t adapt properly. That’s not to say that regular wear is good, but at least you do get a chance to adapt.
• Do your running shoes have a large difference between the heel and toe height? If so, you may want to look at transitioning progressively to a shoe with a lower heel drop. But, make sure you do this in increments. If your current shoes are 12mm drop, next go to 10mm. Then when you are ready to replace those, go to 8mm, then 6mm and then may be 4mm. You may find that at 6mm or 8mm you don’t need to go any further – everyone is different. The important thing is to transition progressively.
• What’s your posture like? Do you stand swaying backwards from your ankles? This will effectively put you in a toes down position and keep your calf muscles shortened and over time rob your shins of strength.
• How’s your ankle mobility? Can you stand with your toes 7cm from a wall, keep your heel on the ground while pushing your knee forward to touch the wall? If your heel doesn’t lift then great. If it does, you need to do some ankle work. You can use this same test as the exercise to help get more mobility. 3 sets of 12 on each foot 3 times per week for 3 or 4 weeks.
• How‘s your running form? Do you land right on your forefoot while reaching your leg out in front of you? This is commonly seen in combination with a prancing or bouncing style of walking and running.

Review all of the above and start to make the necessary corrections. Remember, these things take time. Also be aware that if you change your running style, you’ll be moving those loading forces somewhere else. So, you had better be thinking about building strength into those areas otherwise they may suffer as a result.

As you’re doing the corrective stuff above, you can also start to build up the the strength of your shin muscles (anterior compartment). This’ll be the topic of the next blog post.

The post Shin Splints – Causes of shin pain in runners appeared first on RunTeach.