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eval set · question 20 of 22 · graded by hand

Do more miles per week cause shin splints?

Running more than 20 miles per week is associated with increased odds (OR ~1.7-1.8) of stress fracture history, and prior shin splints themselves strongly predict stress fracture risk, in female runners. 1

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High total weekly training distance is generally associated with increased injury and/or pain risk in endurance athletes, following an inverted-U pattern where both very low and very high volumes increase risk. 2

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In runners transitioning to maximal shoes, altered loading mechanics were linked to potential risk for medial tibial stress syndrome (a type of shin splints), but this was shoe-related, not mileage-related. 3

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What we can't tell you


Sources

1

Multiple risk factors are associated with stress fractures in female runners, including osteopenia, prior shin splints, high weekly mileage, fast running pace, menstrual irregularities, and certain supplement use.

pop. Female runners age ≥18 years (mean age 40 years); 1648 respondents, 25.4% with stress fracture history · direction Positive association with osteopenia (OR 4.14), shin splints (OR 3.24), running >20 miles/week (OR 1.74-1.77), faster pace (9:00-9:59 min/mile), menstrual irregularity (≥6 months without period, OR 1.43); negative association with slower pace (11:00-11:59 min/mile, OR 0.43-0.54) · design Case-control survey · weak

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Risk Factors for Stress Fractures in Female Runners: Results of a Survey (2021) · doi 10.26603/001c.18806

2

High total training distances per week/month and extreme training durations (both low weekly <2 hours/week and high monthly) are associated with increased injury and/or pain risk in endurance sport populations

pop. Endurance sport athletes (running, triathlon, rowing) · direction positive (both high total distances and extreme durations increase risk; inverted-U relationship suggested) · design Systematic review of prospective cohort studies · strong

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The associations between training load and baseline characteristics on musculoskeletal injury and pain in endurance sport populations: A systematic review. (2018) · doi 10.1016/j.jsams.2018.03.001

3

Runners transitioning to maximal shoes display prolonged eversion and altered loading characteristics that may contribute to Achilles tendinopathy and medial tibial stress syndrome

pop. Two runners during six-week transition to maximal running shoes · direction negative; maximal shoes associated with increased injury risk · design case series · anecdotal

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Biomechanical analysis of two runners who developed leg injuries during a six-week transition to maximal running shoes: A case series (2021) · doi 10.1080/02640414.2021.1930683