Shin Splints? Ankle Pain? Achilles Aches? Learn how to prevent the most common lower leg ailments. 

You’re fresh into a trail run and start to feel a twinge in your lower leg – is it shin splints, a tight calf, or something more? Lower leg injuries are common in trail runners, as off-road pounding takes its toll. What causes our shins, ankles and calves to act up? 

Here’s how you can treat, and prevent, common lower leg injuries. 

Sprained ankles are a common running injury. According to Matt Walsh, physical therapist at Evolution Healthcare & Fitness in Portland, Oregon and Owner of Walsh PT, LLC, sprained ankles are one of the top recurring injuries he sees in trail runners – along with Achilles tendonitis. A 2019 study of over 300 SkyRun race competitors found that 87.3% of reported injuries occurred in the lower limb, with the knee, ankle and foot being the most common, with muscle or tendon injuries accounting for 44.1% of the total. 

Here’s how to prevent lower leg injuries.

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​​The real problem with an issue like a sprained ankle or shin splints is that they often seem minor, the kind of injury we might be able to train through. However, if not solved, they can lend themselves to bigger issues down the road.

Prevention

When it comes to preventing lower leg injuries, Walsh recommends starting by strengthening the soleus, also known as the deep calf muscle. Isometric calf raises are a great way to do this, holding the exercise at the top and bottom of your range of motion. Choose a heavy but manageable load (a weight you can sustain for three sets of 8-12 reps), and rest for 1-2 minutes between sets. Strengthening the soleus is an effective way to prevent injuries like Achilles tendonitis by ensuring our calves have the power to get us up hills without being overwhelmed by impact and steepness. 

When doing strength exercises, consider upping your weight as another way to prevent lower leg injuries.

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“As runners, the general trend is underwhelming the tissue – we haven’t been loading it high enough,” says Walsh. If we think of running as a dance, Walsh says road running is like waltzing, a linear pattern with predictable loading patterns. Trail running is more like a mosh pit, with explosive, dynamic, and varied movements that your joints need to be prepped for. Roads have a much higher impact and a lack of variability, while trails present a host of new obstacles for our bodies to navigate.

Another consideration when it comes to lower legs is confidence and capacity in controlling hops, jumps and landings, which translates to speed and accuracy when navigating hilly and technical terrain. From skipping over rocks to blazing through a sea of sand or mud, trail running demands a lot from muscles and tendons in our lower legs. Tight hips, a weak core or other misalignments can result in a chain of compensations throughout our running gait, which equates to increased risk for injury. 

“Start by strengthening the hips and developing powerful quads. You need good brakes and shock absorption, especially for the downhills,” says Walsh. A strength training program that includes hops, skips, jumps and single leg exercises like split squats and step ups help simulate this in a controlled environment, so that we can tackle the trails without fear.

Identify Risk Factors

If it’s been a while since you’ve taken a magnifying glass to your training log, do it – take a close look at mileage, vertical feet climbed, technical terrain, speedwork and even what shoes you’ve been wearing. Are you progressing slowly and consistently, or trying to make sharp shifts? 

Big, sudden changes in shoe type (such as going from 8mm or 4mm to zero drop) can shock joints like calf muscles and Achilles tendons. Similarly, shifting too quickly from roads to trails (or vice versa) can result in higher muscular stress and injury risk, especially on terrain we haven’t quite adapted to. 

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While we often associate shin splints with road running, trail runners can experience them too, especially when incorporating road or track workouts for speedwork or races. If you’re experiencing lower limb pain, Walsh advises reducing mileage, vert and speed by 10-20% to see if things improve. If not? It might be time to see your local physical therapist and provide your lower legs with some professional TLC.