As soon as I switched from heel strike running to forefoot strike running I felt miserable because I struggled with chronic pain on the side of the shin bone, also known as medial tibial stress syndrome or medial shin splints. I hated this pain more than anything else because it’s so crippling-feeling, this is why I needed to step back and analyse my form and dive into the scientific literature as well.
After going back to the drawing board to analyze my forefoot running form, I discovered my foot of the leg with medial tibial stress syndrome pointed inward at touchdown and during stance as compared with my other foot which pointed straight ahead in the direction I was running. The pointing-in of my foot is called ankle inversion and research suggests that it may cause a runner to develop shin splints from running over time.
Pain On Side of Shin Bone When Forefoot Running
Running with your forefoot pointing inwards at touchdown can really add a lot of stress to the shin bone because it causes an abnormal disruption of mechanical events up the leg. Not only that, I wore traditional running shoes during my heel strike running years, which consequentially, weakened my foot ankle complex, whereby a weak foot/ankle complex is strongly linked to ankle inversion.
One of the fastest, most effective strategies to strengthen the foot/ankle complex is to walk and run barefoot as doing so is backed by hard data to help catalyze a stronger ankle that is better able to cope with stress. The foot-ankle strengthening effects of going barefoot is tied to the massive surge of sensory input stimulating the bottom of the foot when you are barefoot. This is why going barefoot more often adds great value in the treatment of running-related shin splints.
Another flaw I noticed about my forefoot running technique is that my thigh pointed inwards too! This is called internal hip rotation and is also a cause of a sore inner shin bone (Burn et al). Moreover, a study by Viitasalo and Kvist found that ankle inversion in runners was an intrinsic risk factor for medial tibial stress syndrome in runners.
As mentioned above, hip internal rotation during running increases medial tibial stress by increasing repetitive load on the medial tibia. When the hip rotates internally at touchdown and during stance, this affects foot posture, causing the foot to rotate internally as well. I noticed all elite runners who were forefoot strikers, pointed their feet straight ahead when they ran and they did not have any hip internal or external rotation.
So, in order for me to use forefoot running to my benefit and avoid further injury, I needed to consciously enforce a straighter landing strategy of my foot as the root of my medial shin splints rehab. That is all you really need to do when running, and I learned this from Chi Running. This is one of the most important thing!
Here are other variances of strengthening exercises for the medial tibia. When your inner shin starts to hurt when running, do these exercises – 3 sets of 15 , every day.
I would always recommend filming yourself running head-on, so you can see where your foot and thighs are positioned at touchdown and during stance. Getting this feedback early in your process of learning forefoot running will help you avoid injury and create a safer running environment for yourself.
Also, you probably already know that you should be running forefoot in zero drop, minimalist running shoes because the absent cushioning makes you more alert of where you are landing on the ground with your foot. Here is a list of my favorite forefoot running shoes that I think you’ll love, too!
More From Run Forefoot:
Runners knee, another frequent problem in runners, is sparked by heel striking.
Blame your cushioned running shoes for the reason you are not learning forefoot running correctly.
Reasons your minimalist running shoe needs to have absolutely no cushioning.
Barefoot running promotes more reflexive, automatic movements, saving you more energy.
Keep up the great forefoot running work! You are doing a good job!
Burne SG, Khan KM, Boudville PB, et al. Risk factors associated with exertional medial tibial pain: a 12 month prospective clinical study. Br J Sports Med 2004;38(4):
Viitasalo JT, Kvist M. Some biomechanical aspects of the foot and ankle in athletes with and without shin splints. Am J Sports Med 1983;11(3):125–30.
BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.