Shin Splints – “Medial Tibial Stress Syndrome”

Shin splints is a generic term used to describe pain experienced over the front or inside of the lower leg. The most common presentation of pain in this area is an irritation of the muscles and their attachments to the inside of the shin bone or tibia.
Although commonly called shin splints, the medical professional now describe this condition as “Medial tibial stress syndrome (MTSS)”, which better describes the stress and overload of the tibia bone which causes pain, inflammation and limits our ability to run or be active.


The pain in MTSS can be caused from numerous structures, basically starting with tightness and pain in the muscles of the lower leg, namely the tibialis posterior, flexor digitorum longus and soleus muscles, before starting to affect the attachment of the tendon attachments onto the periosteal or outer layer of the bone (tibia), before finally starting to affect the bone, possibly causing bony stress or fracture. As this is a condition that can progress and deteriorate, the earlier the condition is assessed will give the patient a better understanding of where they sit on the injury timeline, and an appropriate management can be implemented.


MTSS can be cause by numerous factors, and our physiotherapists will take all of these factors into account in their assessment: Common causative factors are: - Changes to training volume or type, with extra sessions, extra kms or more intense sessions - changes to terrain and surface, - old or inappropriate footwear - calf muscle tightness or weakness - Weak, unstable foot types like over-pronation - Reduced hip, gluteal and core strength - Poor running, landing or jumping technique eg. Heavy foot strike An accurate diagnosis and assessment of the severity of the problem should be made by a physiotherapist to ensure appropriate action is taken to manage the problem, such as the necessity for resting or cross training, further investigations such as medical imaging like MRI, and possible treatment options considered. Initially ice, rest or moderation from the aggravating activity is required but it is important that the underlying weaknesses are addressed to ensure the resumption of exercise is smooth and there is no chance of recurring problems. Please contact your closest Physiohealth clinic to have any concerns in your shins assessed by an expert physiotherapist.
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