Treadmill runners who suffer painful shin splints can heal them quicker with gait training in the great outdoors in combination with physical therapy exercises say researchers, including a UVA Health sports medicine expert. (Contributed photo)
Good news for treadmill runners who suffer from stubborn and painful shin splints: New research suggests that outdoor gait training may help.
Researchers, including UVA Health sports medicine expert Dr. David J. Hryvniak, conducted a randomized controlled trial and found that four weeks of gait training outdoors combined with home exercises often prescribed for shin splints led to improved running biomechanics even when runners were using a treadmill.
These improvements included decreasing the time the runners' feet were in contact with the ground or treadmill, a recently identified contributor to shin splints.
Based on the trial results, the researchers are recommending that clinicians include outdoor gait training as part of rehabilitation programs for patients struggling with chronic shin splints.
"This is an important finding for clinicians, as this gives us a tool to use to help these runners," said Hryvniak, a running medicine specialist who is part of UVA Health's Runner's Clinic. "These gait-training cues can be an easy thing to add into a rehab program to help patients improve running mechanics that can underlie many common running injuries."
Soothing Shin Splints
Affecting approximately 40% of all runners, shin splints typically begin as tenderness in the lower leg that goes away after exercising. But for regular runners, this pain can worsen and become persistent. In severe cases, shin splints can even lead to stress fractures.
Prior research found that short courses of outdoor gait training can significantly reduce shin-splint pain for outdoor runners. But experts had been uncertain if these benefits would transfer to the flat, regular surface of treadmill running. That prompted an interdisciplinary team of researchers - from UVA's College of Arts & Sciences, School of Education and School of Medicine, as well as Virginia Commonwealth University, Plymouth State University and the University of North Carolina at Chapel Hill - to launch a randomized trial to find out if outdoor gait training would benefit treadmill users.
Gait exercises are effective tools that shin splint sufferers can use even as they exercise, says UVA Health's Dr. David J. Hryvniak, who was on the research team. (Contributed photo)
The researchers enrolled 17 treadmill runners between ages 18 and 45 who ran at least three times a week and suffered lower leg pain during or after running for at least a month. The volunteers were randomly divided into two groups: One group received four weeks of outdoor gait training and performed commonly prescribed home strengthening exercises, while the other group only performed the home exercises.
During the gait training, participants were provided with "vibrotactile feedback" - meaning they felt a little vibration - when special sensors in their shoes detected their feet were in contact with the ground for too long. This feedback helped them improve their stride and gait to reduce this potential contributor to shin splints.
At the end of the study period, both groups saw strength improvements in their legs. But the gait trainers also had "favorable adjustments in running gait mechanics." The improved running techniques were seen during both outdoor runs and treadmill runs.
The results suggest outdoor gait training could be an important new tool to help treadmill users work up a pain-free sweat, the researchers say.
"Shin splints are a very common running injury, especially with those who are new to the sport," Hryvniak said. "These gait cues are something that have been shown to be an effective tool that patients can use literally 'on the run.'"
Findings Published
The researchers published their findings in the Journal of Biomechanics. The research team consisted of Alexandra F. DeJong Lempke, Stephanie L. Stephens, Xavier D. Thompson, Joseph M. Hart, Hryvniak, Jordan S. Rodu and Jay Hertel. The authors have no financial interest in the work.
