A shin splints stress fracture, also known as a tibial stress fracture, will cause a runner to be out of commission for at least 4-6 weeks. But, when you are ready to take on the roads again, once your tibial fracture symptoms have reduced, you may want to modify your forefoot running form in a way that ‘babies’ your healing leg to avoid re-injury.
The best way to run with a healing tibial stress fracture is to not only run with a forefoot strike rather than a heel strike, but to temporarily widen your step width while you run until your tibia fracture has completely healed.
Running with a Shin Splints Stress Fracture
A tibial fracture forms during running when the front (anterior) and back (posterior) parts of the tibia bone is exposed to high tensile stress and compressive stress (Meardon et al. 2014), whereby widening your step width by at least 5% was found to significantly reduce these impact variables.
What is a wider running step width?
A wider step width during running means that the left and right foot land farther away from the mid-line. The opposite of a wider running step width is a crossover running gait where the feet fall on the midline. The problem with running with a crossover step is it increases the side-to-side ground reaction force on the tibia during the mid-stance of running (McClay, 1995). This ground reaction force leads to greater medial tibial tension and compression, and increases stress on all areas of the tibial bone as compared with running with a wider step width.
By widening your step width while you run, you not only reduce global musculoskeletal loading, but it reduces potential tissue stress and strain on the lower leg.
For example, Meardon and Derrick (2014) found strong evidence showing that the only way to effectively protect the shins from higher loading when you are recovering from a shin bone fracture is to widen your step width. First, the researchers found that running with a wider step width greatly decreased tension on the front of the tibia and reduced compression on the back and the middle of the tibia. Even more critical, the researchers discovered that the wider the running step width, the greater the reduction of shear stress on all aspects of the tibia bone. The researchers also found that the inner aspect of the tibia bone was more protected from tension and compression when a wider running step width was used as compared with a crossover landing pattern.
So, while your stress fracture is healing, and you are a stubborn runner like most and want to chance it, you can run, just be wise about your running distance and intensity, and make sure your feet land far apart from each other. You will instantly feel that the load and pain lessens on your legs.
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References:
McClay, I.S., 1995. The use of gait analysis to enhance the understanding of running injuries. Mosby, St. Louis MO, pp. 395–411.
Meardon SA and Derrick TR. Effect of step width manipulation on tibial stress during running. J Biomech, 2014; 47: 2738-2744.
Bretta Riches
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.
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