CASE STUDY

ATHLETE

Laura  is a 25 year old runner, she has been running for approximately 1 year to gain fitness and improve her mental health.

OTHER SPORT AND FITNESS

Laura attends the gym and partakes in some exercise classes, she doesn't do any other sports

MEDICAL and INJURY HISTORY

No medical history, long term or repetitive injuries reported

GOALS

Would like to complete a half marathon

PRESENTING  CONDITION

Shin splints which comes on after about 4 or 5 miles.

ASSESSMENT

We discussed her running history, with an in depth look at her running progression of the month prior to noticing the shin splints.   Then we carried a video analysis of her running form and technique to establish if this could be contributing to her shin splint problem.  This was done outdoors as this is where she does the majority of her running, we wanted to get a real world assessment of her running as this can be different to running on a treadmill

FINDINGS FROM ASSESSMENT

The video analysis highlighted two main areas of concern

  • Over striding (left) - With her foot strike happening ahead of her centre of mass and her knee extended there is no absorption of the impact forces.   This results in these forces travelling through her lower limbs and joints and these joints taking more stress than they need to.

  • Narrow step width (right) - This is thought to be a significant contributor towards shin splint problems in runners.  Each foot landing is occurring in line with her previous foot strike, with no gapping.

  • Step Rate - We found Laura had a step rate of 160 steps per minute

  • Arm Swing - This was not ideal, her arms swing across the body rather than in the direction she is running.

Gait Analysis.jpg

WHAT WE WORKED ON

In order to reduce the forces which are most likely contributing to her shin splints, we addressed the issue of over striding and the narrow step width.  At this time there is enough to work on to fix her shin splint issue, therefore, we are not working to correct her arm swing.  The more important areas to work on are her over striding and narrow step width

  • Over striding - We worked on increasing her step rate, which will in turn reduce her over striding and bring her foot strike closer to her centre of mass.  Initially we worked on increasing her step rate by 5%.

  • Narrow step width - She self reported that she does often feel her knees touch when running, therefore, we worked on consciously running wider.  To practice this we used a white line on the football pitch running with on foot one the line but the other foot was not allowed to touch the line.

TAKE AWAY

Laura practised a few drills that would would help to focus her foot strike, these included A'Skips, B'Skips and straight leg runs.  We also suggested doing these drills on grass with no shoes on as this helps to get better proprioceptive feedback from her foot striking the ground.

In addition to her running form work we also discussed some strength and conditioning to improve her calf strength, as well as quads and hamstrings.

FOLLOW UP - 4 WEEKS

Laura reported that she had been doing well and her shin splints were not a problem. However, as her run distances have been short while working on her form and technique we could determine that all her problems were resolved yet.  We noticed an improvement in her over striding and step width.  Laura continues to do her running drills and will start increasing her run distance.

FOLLOW UP - 8 WEEKS

The last 4 weeks has gone well, she gradually increase her run mileage by no more than 10% per week and has had no shin splint problems.

Still working on it, big changes take time

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