Medial Tibial Stress Syndrome (‘Shin Splints’)

Written By Rebecca Doumergue

What are they?

Medial Tibial Stress Syndrome (MTSS), or more commonly known as ‘Shin Splints’, is a chronic over-use injury that generally affects active individuals. The condition is characterised by diffuse pain along the inside of the shin bone (Tibia) and is generally located over an area of approximately 5-10cm. Through its early stages, patients often mention that the pain improves after warming up. However, once the condition progresses, pain levels can become quite debilitating resulting in cessation of exercise. Despite previous thoughts, the pain is because of small micro-tears in the musculature attaching to the bone, rather than directly over the bone itself.  MTSS can be caused by many factors and is generally seen in active/sporty individuals of all ages. Most people with the condition often present with many of the following risk factors:

  • Poor footwear

  • Biomechanical foot issues (poor alignment)

  • Sudden increase in exercise levels

  • Sudden change in exercise program

  • Tight lower limb musculature

  • Poor running style

Symptoms:

  • Pain

  • Tenderness

  • Swelling of the lower legs

  • Continuous pain that may lead to fracture

  • In severe cases, redness may be seen on the inside of the lower leg

How is it diagnosed?

A thorough clinical examination will generally be sufficient for the diagnosis of MTSS. Depending on the severity of symptoms, you may be referred for a diagnosis scan to rule out further pathology e.g. Stress fracture.

Possible treatments:

  • Strapping

  • Rest, Ice, compression

  • Footwear advice

  • Custom orthotics devices

  • Soft tissue massage

  • Neuromuscular needling

  • Anti-inflammatories

  • Moderated rest

  • Rehabilitation program

  • Surgery (rarely required)

Prognosis:

Providing absolute compliance to the above conservative treatment options, individuals with MTSS are generally back to full activity after 4-6 weeks. Surgery is very rarely recommended however is an option for non-responsive, chronic cases.

Rebecca Doumergue
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