Location of shin splints pain

By: Evie Tate, PT, DPT

Shin splints, more formerly known as “medial tibial stress syndrome”, is a common overuse injury seen in runners. It is characterized by pain along the inside of the shin (tibia), typically in the area closer to your ankle, that can be present in one or both legs. Here are some ways you can directly address risk factors associated with shin splints.

Improve your calf muscle endurance (specifically plantarflexors)

Studies have shown that poor plantarflexor is associated with increased risk of developing shin splints.1 The plantarflexors are the muscles that you use doing a heel raise. Try doing heel raises to strengthen your plantarflexors and help keep shin splints at bay. Goal number: 25 single leg heel raises (1).

Evie demonstrating weighted single leg calf raises

Rest days

Shin splints are considered an over-use injury (2). When you are training, make sure you are utilizing rest days and/or low-impact cross training (swimming, biking) activities. When our training exceeds what our muscles and bones can tolerate, we develop overuse injuries. The best way to combat these injuries is by giving our body the rest it needs. If you are finding that you are not sleeping as much, have increased your activity levels dramatically and/or are feeling more fatigued during your runs than what is normal, don’t be afraid to take a rest day. One day of rest will sometimes far exceed the benefits of going for a run when fatigued! 


If you have shin splints, one thing you can try is using an orthotic.  While they don’t work for everyone, orthotics may help reduce your pain if you have developed shin splints (3). The best way to see if orthotics work for you is to simply try on a pair, walk around and if they feel good, they may help you! 

If you are battling shin pain, talk to your physical therapist to develop the strategy that will best suit you and your specific needs. 


1 Madeley LT, Munteanu SE, Bonanno DR. Endurance of the ankle joint plantar flexor muscles in athletes with medial tibial stress syndrome: A case-control study. Journal of Science and Medicine in Sport. 2007;10(6):356-362. doi:10.1016/j.jsams.2006.12.115 

2 KORTEBEIN, PATRICK M.; KAUFMAN, KENTON R.; BASFORD, JEFFREY R.; STUART, MICHAEL J. Medial tibial stress syndrome, Medicine & Science in Sports & Exercise: March 2000 – Volume 32 – Issue – p S27-S33

3 Moen, M.H., Tol, J.L., Weir, A. et al. Medial Tibial Stress Syndrome. Sports Med 39, 523–546 (2009). https://doi.org/10.2165/00007256-200939070-00002

Summer is flying by and we’re just a month out from the Rut Mountain Runs. We couldn’t be more excited! The rugged courses at the Rut are notorious for how hard they are on shoes. The RE staff rounded up some of our favorites that we think will be a good fit for the rocky, steep terrain at the Rut (and your other mountain adventures). If you haven’t found the perfect Rut shoe, now’s the time!

What makes a great Rut shoe?

A runner descending loose rock at the Rut. Photo: Votography Images

If you’re signed up for the Rut, you probably already know that the course features very steep climbs and descents on rough terrain. What entails “rough terrain”? Loose rocks, talus, tree roots, boulders, and narrow mountain singletrack. Sounds like fun to us! Even more fun if you have the right shoe for the job. Here are a few things we look for in a good Rut shoe:

  • Rock plate
    • What is a rock plate? Rock plates are thin sheets of plastic laminated into a trail shoe. They are typically between the rubber tread and foam midsole material. What do they do? When you step on sharp, pointy rocks they help to deflect that impact. Yes, you still feel rocks. But instead of feeling a sharp stab on the bottom of your foot, it’s more of a dull stab. In a race like the Rut, or other mountain runs, having that added protection can make all the difference over the course of many miles.
  • Aggressive outsole
  • Durable upper
  • Enough cushion (but not too much)
  • Secure fit
  • At the end of the day, a shoe you feel comfortable and confident in on challenging terrain

    A line of runners working their way up Lone Peak. Photo: Votography Images

Some of our favorites

We have many trail shoes in stock that could be a good fit for you. Any of our team members are happy to help you find the perfect shoe for training or race day! Here are a few of out favorites:

The North Face Vectiv Enduris

The new colors of the Vectiv line are awesome!

We’ll defer to The North Face Athlete and Rut Race Director Mike Foote for a review on the Enduris: “The Vectiv Enduris would be my shoe of choice for the demands of the Rut Mountain Runs.  The outsole is grippy, but not overly aggressive.  The upper is comfortable and holds your foot snug for the technical sections.  And when it’s time to turn the legs over a bit faster, the shoe responds well to speed. Overall, the shoe offers good protection and comfort without sacrificing performance.” Sounds good to us!

Saucony Peregrine 11

The Peregrine has always been a favorite Rut shoe. It has one of the most aggressive outsoles on a trail shoe we carry. There’s lots of rubber under your foot with a rock plate and moderate amount of cushioning. With a 4mm drop, it offers a close to the ground feel, but plenty of protection.

Altra Lone Peak 5

The Altra Lone Peak 5

The Lone Peak is Altra’s classic trail shoe. While it’s named after the Lone Peak in Utah’s Wasatch Range, it will be right at home on the trails on Big Sky’s Lone Peak. It offers a close to the ground feel thanks to it’s “zero-drop,” foot-shaped midsole. It has not too much, not too little cushioning and a rock plate to protect you from the plethora of rocks you will step on at the Rut.

Brooks Cascadia 16

The grippy bottom and deep lugs of the Brooks Cascadia 16.

The Cascadia is a fan-favorite trail shoe. It just got a fresh update, and it’s phenomenal! According to Brooks, this new version is “a smoother, lighter version of our iconic trail shoe.” We agree! And for a race like the Rut, we’re excited about the bigger lugs on the outsole and the forefoot rock plate (or as Brooks calls it, their “Ballistic Rock Shield.” Now THAT sounds rugged!).


If you have ever trained for a sport or participated in a regular exercise routine, you have likely heard of plyometrics. Plyometric training is a useful tool not only for athletes but also is an important component in physical therapy as way to help patients return to sport and activity. Though plyometrics are typically thought of as an exercise for more explosive sports, runners should be adding in this to their normal routine as well. 

What Are Plyometrics?

Plyometrics are a form of training that utilizes our body’s stretch-shortening cycle to produce powerful, explosive movements. Both speed(time) and strength(force) are functions of power and can be manipulated to achieve varying outcomes.  This stretch-shortening cycle in our muscles can be thought of as a spring being compressed and released (1).

Benefits of plyometrics

The primary goal when performing plyometric training is to increase our body’s power output to improve our performance during athletic maneuvers. For runners, this means increasing our running economy or improve the efficiency at which we run. Plyometrics have been shown to improve running economy as well as increase tendon stiffness and bone density (1, 2). This is especially important considering how prevalent tendon and bone injuries are in the sport of distance running.  

How to perform plyometrics

Plyometrics require an ‘explosive’ movement. Near maximal effort should be used when doing plyometrics to maximize the potential benefits, which is part of what makes plyometric training so great. Because of the level of demand placed on the body, individuals do not need to perform countless repetitions to achieve their goal. Depending on the amount of running you are doing, it is best to start with one set of ten repetitions for each type of jump, two to three times a week and then add additional sets from there.  

While plyometrics can be beneficial, we suggest consulting with your local physical therapist regarding any questions or concerns about your ability to implement plyometric training. 

Examples of Plyometrics for Runners:

  1. Double leg hop for distance
  2. Single leg hop for distance
  3. Counter movement jump (step off box and quickly follow with jump)

For more information on plyometrics, visit the Sapphire PT blog here: https://www.sapphirephysicaltherapy.com/blog/plyometric-training

By: Andrew Traver, Student of Physical Therapy/Sapphire Physical Therapy Clinical Intern


1 Voight, Michael L., and Steven R. Tippett. “Plyometric Exercise in Rehabilitation.” Musculoskeletal Interventions: Techniques for Therapeutic Exercise, Third Edition Eds. Barbara J. Hoogenboom, et al. McGraw Hill, 2013, https://accessphysiotherapy.mhmedical.com/content.aspx?bookid=960&sectionid=53549678.

2 Davies, George et al. “CURRENT CONCEPTS OF PLYOMETRIC EXERCISE.” International journal of sports physical therapy vol. 10,6 (2015): 760-86.

It looks like smoke season is upon us! This time of year, we get a lot of questions and comments about exercising outside. We hear everything from “is it safe to run?” to “are there masks I can wear?” and “I’m going outside no matter what!”. There is a seemingly endless supply of resources online to help you make a decision about whether or not you should exercise when the air is filled with smoke. Unfortunately, there is not a clear scientific consensus on the exact effects that exercising during smoky weather has on our bodies. And, there are maybe too many worm holes you can go down finding out about where smoke is coming from and trying to predict if it will get worse. Here, we’ll try to give you the resources you need in order to make an informed decision for yourself about exercising during wildfire season and our favorite tools for tracking the smoke!

First off, what pollutants are we concerned about?

With smoke comes fine particulate matter. The particulate matter we’re mostly concerned with as runners and walkers is PM2.5. The Air Quality Index (AQI) is made up of several pollutants, but it does a good job of capturing the PM2.5 value, as it is our primary pollutant during smoke season. The more PM2.5, the worse the air quality!

A light layer of smoke over the Missoula Valley. Still good enough air for a run!


How do you track the AQI?

You can find a measure of the AQI on your phone’s weather app or with a quick google search. A heads up, the AQI listed on the iPhone weather app is often slow to update (I have seen it read “unhealthy for sensitive groups” when in-town sensors have read “good”). A great resource for tracking AQI is the Wildfire Smoke Outlook from MT DEQ. They also show daily trends in specific towns, with updates every hour.

Where is the smoke coming from and what’s it going to be like tomorrow?

If you’re looking to understand where the smoke is coming from, why it’s in Missoula (or your area), and when it might go away, you need to do a bit more investigating. Thankfully, the Missoula County Public Health Department maintains a daily discussion on air quality. Here, not only can you find the AQI and health recommendations, but you can also find a discussion about the air quality, fires, smoke, winds, and more. Written by a real live human, this discussion is an indispensable resource for understanding the current smoke situation. A lot of us at the store are huge fans of the air quality blog. I mean, HUGE fans. These discussions are written by Health Department Air Quality Specialist Sarah Coefield. Thank you Sarah for diligently providing our community with the best information available!

Want more? Here’s that wormhole I was talking about…

Finally, should you run when it’s smoky out?

Heavy smoke obscuring the sun – don’t run in this!

Ahhh, we had a feeling this question would come up. We get this a LOT. Unfortunately, there is no straightforward answer. In the words of Missoula County Air Quality Specialist Sara Coefield, “the answer is a very unsatisfying ‘it depends.’ Human health is a spectrum, yo.” 

Run Wild Missoula’s Air Quality Protocols are a great place to start. If the air is Good, Moderate, or Unhealthy for Sensitive Groups, events will continue. However, depending on your medical background, running or walking may not be a good idea. If the air quality is Unhealthy, Very Unhealthy, or Hazardous, events will be cancelled. We agree! If the air is Unhealthy or worse, the risk of exercising outdoors outweighs the benefits.

Missoula County has a great chart that lays out different activity types and what duration might be ok at various air quality levels. It is definitely worth checking out!

What if I REALLY want to run or walk outside when the air is terrible?

Short answer, you would likely be better off staying indoors in clean air. BUT, there may be ways to get outside and stave off that pesky particulate matter and the nasty effects it has on your lungs. If you have an N-95 mask laying around from the pandemic, now is the time to whip it out again. These aren’t just masks, but are “particulate respirators.” Your cloth mask won’t do the job against wildfire smoke. Only a PROPERLY FITTING N-95 offers enough protection to run during terrible air quality. This means you need to be clean shaven and ensure a perfect fit. More on that here. Remember, you have an N-95 on. So it’s also very hot and muggy in there. If your mask gets wet, crumpled, or compromised in any way, it will stop filtering out particulate matter. Be sure to replace them frequently! Again, you are most likely best off avoiding the outdoors when the AQI is Unhealthy or worse. But if you insist on going outside, wear a properly fitting N-95.

A slight smoke haze obscuring the distant mountains in southwest MT

So if I run inside on a treadmill I’m fine?

Maybe! Be sure that the air where your treadmill is has been properly filtered. Find a high quality HEPA air filter and keep it running while you’re on the treadmill. Or, try a less-expensive do-it-yourself version that uses just a box fan and simple air filter. Climate Smart Missoula has directions for this easy DIY project here.

Stay safe this smoke season! Hopefully we’ll be breathing cleaner air soon 🙂