Shin Splints (Medial Tibial Stress Syndrome)

Did You Know?

Shin splints isn’t splinting of the shin bone, it is often a combination of muscular overuse leading stress on the bone.

What Are Shin Splints?

Shin splints is usually a generic term that is used for a number of conditions that can lead to pain in the tibia. The most common area of pain referred to with shin splints is the lower third of the inside of the shin bone (tibia). This condition is also referred to as medial tibial stress syndrome and is usually a form of overuse injury. This condition is most commonly experienced by runners, however it can also effect anyone partaking in repetitive high impact activity.

Anatomy

Medial tibial stress affects the inside, lower third of the tibia (shin bone) and is more commonly associated with inflammation of the periosteum (top layer of tissue within your bones). This is thought to be stressed by overuse of the tibialis posterior and soleus muscles.

Symptoms

The most common presentation for symptoms for this condition include:

• Pain in the medial lower third of the tibia when exercise/activity is increased

• Pain can decrease within a few minutes of running

• Discomfort on palpation of the inside of the tibia

• Pain after exercise in the middle/lower shin area

What Causes Medial Tibial Stress Syndrome?

As with most conditions there are a number of factors that can contribute to pain in the lower third of the tibia. Here is a list of the most common contributory factors:

• Activity levels – Increasing the amount of running in a small period of time without recovering adequately.

• Reduced recovery time – Not allowing adequate recovery after running/activity will lead to increased risk of this injury

• Foot and ankle mechanics – Certain foot types can lead to increased load on the tibialis posterior and soleus which can leave you more prone to this condition.

• Biomechanical factors – Running style can contribute, evidence suggests that a very narrow running style can increase the risk of this condition.

• Footwear – Unsupportive footwear can lead to increased load on certain muscle groups – make sure you are stable and comfortable. Running shoes should be replaced every 350-500 miles.

How To Treat Shin Splints

Like many of the conditions that we treat there are many factors to consider when treating this condition. My immediate advice would be to book in with one of our MSK podiatrists so that they can individually assess your condition and build a tailored treatment plan for you. Here are a few of the things we are likely to consider when treating this condition:

Manage Training Loads
It is important to make sure that we are allowing for adequate recovery between runs, this can mean introducing exercises that are lower impact such as cycling or swimming.

Footwear
It is important that footwear is not contributing to increased loads on the lower limb. Make sure that your shoes are not increasing movement at the ankle and that they are changed regularly.

Foot Mechanics
Assessment of you foot posture and dynamic function will give us indicators of whether you are more prone to tibialis posterior overuse.

Running Technique
If running is leading to pain, it is important to assess your foot during the activity that is aggravating. During assessment we will be looking at a number of factors including stride length and width.

Orthoses (insoles)
Insoles can be used to reduce load on muscles and tendons that might be contributing to the pain you are experiencing.

Shockwave Therapy
If you are performing regular strength exercises, have the right footwear/orthoses and are still experiencing discomfort then shockwave is certainly an option. This treatment is very effective in the treatment of chronic pain (over 4 months).