Good news for treadmill runners dealing with stubborn and painful shin splints: New research suggests that outdoor gait training might help.

A randomized controlled trial found that four weeks of outdoor gait training, combined with commonly prescribed home exercises for shin splints, led to improved running biomechanics even on a treadmill. These improvements included reducing the time runners’ feet were in contact with the ground or treadmill, a factor recently identified as contributing to shin splints.

Based on these results, researchers, including UVA Health sports medicine expert David J. Hryvniak, DO, recommend that clinicians incorporate outdoor gait training into rehabilitation programs for patients with chronic shin splints.

“This finding is significant for clinicians, as it provides a new tool to help these runners,” said Hryvniak, a running medicine specialist at UVA Health’s Runner’s Clinic. “Adding these gait-training cues to rehab programs can help patients improve running mechanics that often underlie common running injuries.”

Soothing Shin Splints

Shin splints, affecting about 40% of all runners, typically start as tenderness in the lower leg that subsides after exercise. However, for regular runners, this pain can worsen and become persistent, sometimes even leading to stress fractures.

Previous research showed that short courses of outdoor gait training could significantly reduce shin-splint pain for outdoor runners. However, experts were uncertain if these benefits would transfer to treadmill running, prompting an interdisciplinary team of researchers from UVA, Virginia Commonwealth University, Plymouth State University, and the University of North Carolina at Chapel Hill to conduct a randomized trial.

The study involved 17 treadmill runners aged 18 to 45 who ran at least three times a week and had experienced lower leg pain during or after running for at least a month. Participants were randomly assigned to two groups: one group received four weeks of outdoor gait training along with home strengthening exercises, while the other group only did the home exercises.

During gait training, participants received “vibrotactile feedback” – a small vibration – from sensors in their shoes when their feet were in contact with the ground for too long. This feedback helped them improve their stride and gait, reducing a potential contributor to shin splints.

At the end of the study, both groups showed improved leg strength, but the gait training group also exhibited improved running techniques, or “favorable adjustments in running gait mechanics.” These improvements were observed in both outdoor and treadmill runs.

The researchers suggest that outdoor gait training could be an important tool for treadmill users to exercise pain-free.

“Shin splints are a very common running injury, especially among new runners,” Hryvniak said. “These gait cues have been shown to be an effective tool that patients can use literally ‘on the run.'”

The research was supported by grants from the Mid-Atlantic Athletic Trainers’ Association, the National Athletic Trainers’ Association, and the UVA School of Education and Human Development.

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