The new season is just around the corner and with it a new preparation. Many players prepare themselves for it and carry out runs independently. Unfortunately very common on asphalt and without football-specific load patterns.
This results in two things:
Not an optimal load and preparation for the competition.
High loads on the ankle, knee and hip.
These heavy loads often create an injury pattern that can result in weeks of loss: shin splints.
In our blog post, you can find out which exercises you can use to protect yourself from this painful and lengthy injury.
It should be said in advance that these lines are not intended to represent or replace a medical diagnosis. The following content may not be perfectly tailored to your needs and in case of doubt, you will need expert medical help. We assume that the information below can be a good starting point to pick up as many affected players as possible.
As already mentioned, the somewhat cumbersome name Medial Tibial Pain Syndrome (MMTSS) conceals shin splints. It is also known as “tibial nerve syndrome.”
Affected people usually complain of pain on the inside of the shin bone. At first, it seems that you have severe sore muscles “on your shin”. It is particularly painful at the beginning of a load, which subsides over the course of the training/load. At a certain point, the pain symptoms are so persistent that there is no improvement during training or the pain is perceived as even more intense immediately after exercise. The longer the Shin Splint Syndrome lasts, the more there is pain at rest. In addition, the inside of the shin bone is extremely sensitive to pressure (over approx. 5 cm of its course).
MTSS is a classic overload phenomenon that can have a multifactorial origin. The shin splints are often associated with a sudden increase in training intensity, training volume, changes in footwear or a change in background.
His two example situations are described here:
Player A had few opportunities to move too specific to soccer during the summer or winter break. However, general movement should not be neglected, so the lack of movement time was replaced by extensive continuous runs. Player A had no interest in running before and did not go running except in soccer. Nevertheless, three runs of distances of between 5 and 10 km were now carried out per week. After two to three weeks, the symptoms described above occurred.
Player B used the time in summer/winter to enjoy some culinary delights. Sports activities were in absolute short supply. After the summer or winter break, it's back to full steam again - with two, three or four sessions per week. Player B now slips back into soccer shoes and goes to training. The more of player B, the soccer shoes and the abrupt change from 0 — 100 could lead to the problem mentioned above.
The examples given are fictional and don't have to apply to you personally. As already mentioned, the occurrence of the Shin Splint Snydrome is mostly multifactorial. The following things can be identified as risk factors (ATTENTION not ranked by rank):
Based on this overview, it is already clear that tibial joint syndrome can involve a wide range of risk factors and should therefore not be assessed with a general “if — then” statement.
What can make these types of injuries (similar to tendinopathy — see Achilles tendon guide) so unpleasant is the length of the rehabilitation period and the necessary adherence of those affected within the recovery period. In most studies, the realistic time frame for a “return to sport” is around three months. It should be borne in mind that the Return to Sport phase only means the phase in which players should get back into running training. This is a target of around 20 minutes of running at a moderate pace. Anyone who has been suffering from MTSS pain for more than three months should plan for nine to twelve months.
As briefly mentioned in the examples above, shin splints are particularly relevant for soccer when training intensity is suddenly increased or is subject to an abrupt change (background change, shoe change). Why such a pathological change occurs or what ultimately triggers the symptoms is a matter of scientific medicine.
Some experts say that there are fine cracks in the collagen structures that connect the medial soleus (calf muscle) fascia to the tibial periosteum. Others speculate that repetitive stress in the form of shock forces cause the soleus (calf muscle) to tire in its yielding contractility (eccentricity), which ultimately causes the tibia to be “bent” back and forth and could thus impede the regenerative reconstruction of bone structures.
In addition, microfractures could be a reason for the pain symptoms, which has not yet been confirmed in X-ray examinations. Once again, this outline shows that investigating such a problem is not so easy.
Based on the previous description, one could almost assume that it was too complex, diffuse and lengthy to implement a solution at all. That is not the case.
The only method with sufficient evidence to date, in terms of MTSS prevention, is to change or adapt training: load management.
In short, load management is the intelligent planning of training science load normatives.
The duration, frequency, intensity and volume of individual training sessions should always be in line with your own regeneration strategies. If the load permanently exceeds the ability of your own body to “buffer” these burdens (adaptation & recovery), the body reacts with a “negative adjustment” and this can lead to pain.
The prevention of MTSS is therefore combined, as it were, with a certain degree of predictive training planning in order to build up basic capacities.
In the acute phase with severe pain, it is recommended to take a break in training for the content that primarily triggers the pain. So if the pain occurs while running or playing soccer, it is a good idea to let this type of stress rest first. A study also suggests that it is better to exercise with moderate pain than not at all. Individual, subjective pain perception can take place very well through so-called “pain monitoring.”
So if you are affected, evaluate your own pain status on a scale of 1 — 10, within a period of 24 to 48 hours after exercise.
If training is still possible but moderate to acceptable pain occurs, the load should be adjusted accordingly. First, you could reduce training time. In the team training setting, you therefore stop playing intensive forms of play or running sessions. You can also change shoes by warming up in running shoes or training on artificial turf (or very hard ground) in multi-socks. High forces such as jumping, hard sprints or frequent changes of direction should be avoided during this phase.
If you suffer or have suffered from MTSS, which actually required you to take a complete break from running and soccer, during which you could only do strength sessions, then the training intensity and volume of training should be increased slowly and gradually.
For example, you start team training for one session a week, then twice a week after a few weeks. Communication is the key here: Take this time, talk to your trainers at eye level and get your ego out of the room.
Anyone who plays a game injured is neither particularly “tough” nor particularly self-sacrificing. In most cases, you will be out even longer afterwards and your team will have to continue to forego you.
Exercise tolerance seems to be the biggest factor when we talk about shin splints. Increasing tolerance in order to withstand the burdens of the game should be the goal of prevention.
During a phase of rehabilitation, the individual exercise tolerance was exceeded in advance. It is now time to be patient and to integrate useful exercises into everyday training. As already mentioned, a complete sports break with MTSS is neither necessary nor advisable. In this respect, longer training breaks should be avoided.
The following exercises are excerpts from a systematic rehabilitation program and are intended to help combat shin splints. We at B42 will soon provide you with a complete rehabilitation program with the best shin splints exercises.
However, if you would like more detailed information on rehabilitation or exercise design, you are welcome to contact our experts Lasse, Nils or Peter (info@b-42.com - Subject: Shin Splint's exercises)
In the first phase, you are still on the spectrum of severe, at best moderate pain.
However, this does not mean that subsequent exercises should no longer be carried out after completing this phase, in the form of a routine below. Athletes often make the mistake of thinking that when the pain subsides, the tissue has also healed and that 100% of the function has been restored. That is not the case.
In this phase, mainly holding (isometric) shin splints exercises are performed.
The advantage of isometric contraction is the reduced mechanical irritation of the affected structures, as “no movement” takes place in the traditional sense.
Nevertheless, these exercises are extremely suitable for maintaining or even increasing muscle strength levels. In some people, isometric contractions also resulted in acute pain reduction in the short to medium term.
How long you stay in the first phase is directly linked to your “pain monitoring.”
We recommend an approximate period of four to eight weeks. Training should take place three times a week.
This phase can start overlapping with the first phase, as long as your pain level is consistently at a low level.
As already outlined, isometric shin splint exercises are generally useful and can therefore continue to be carried out depending on preferences.
In the dynamic phase, attempts are made to restore the function of individual muscles in their various joint positions and contraction patterns in order to initiate more complex movement patterns (running, jumping, sprinting). You are also evaluating yourself with “pain monitoring” in order to adjust the load if necessary.
Here, too, we provide key figures of four to eight weeks as a time range. Training should be done three times a week.
We would also suggest that the surrounding structures be included in active training, even if “load management” is likely to have the biggest impact.
Precisely because exercise tolerance will have the last word at the end, progressive jump training should be integrated, either after the two phases or integratively (depending on individual progress). Jump training thus forms the bridge between rehabilitative exercises and sport-specific training content or running and team training.
Protect yourself from shin splints in the long term or get back on track quickly. We hope these exercises can help you do just that.
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