Medial Tibial Stress Syndrome (Shin Splints)

Medial Tibial Stress Syndrome (Shin Splints)

What is Medial Tibial Stress Syndrome (Shin Splints)?

Medial tibial stress syndrome (MTSS), commonly known as shin splints, is a condition that causes pain along the inner side of the tibia (shinbone), particularly nearer to the ankle. This condition commonly affects runners and patient often reports throbbing pain or ache during runs.

Risk factors of MTSS

Risk factors of medial tibial stress syndrome include:

  • Runners or athletes
  • Military personnel with long periods of marching and training
  • Sudden increase in physical activity
  • Incorrect footwear or improper training surface
  • Obesity or high BMI
  • Flat feet (pes planus) or high arch feet (pes cavus)
  • Calf tightness or weakness

Causes of MTSS

Medial tibial stress syndrome is caused by consistent damage to the cortical bone of the tibia (shinbone), resulting in inflammation and pain. However, the exact mechanism of injury is not adequately understood and there are 2 proposed theories at present:

  1. Constant muscle traction or pulling by the deep calf muscles (tibialis posterior and soleus) resulted in inflammation of the lining of the shinbone (periosteum).
  2. Forces from the ground create a bending moment acting on the shinbone and resulting in an accumulation of microdamage to the bone.

Signs and Symptoms of MTSS

Signs and symptoms include:

  • Pain during activity, and is often worse with increased intensity of activity
  • Pain may ease after “warm up” in the early stages
  • Pain may last for a few days after the activity
  • Throbbing or aching pain

MTSS Treatment

The treatment for medial tibial stress syndrome requires a combination of treating the injury and its underlying cause. This holistic approach will ensure a better outcome and a lower risk of recurrence.

When left untreated, this condition may eventually lead to a medial tibial stress fracture.

Treatment options for medial tibial stress syndrome include:

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