What Are ‘Shin Splints’ and How Do I Treat Them?


Em Batger

What are ‘shin splints’ and how do I treat them?

Shin Splints is the colloquial term given to pain felt along the inside of the tibia (shin bone).

Clinically we prefer the term medial tibial stress syndrome (MTSS).

Typically this condition develops when the muscles in the medial compartment of the shin (namely the tibialis posterior) become overworked by repetitive activity. It’s most commonly seen in runners but I have seen it in rugby players, dancers and basketballers presenting with MTSS. Patients often report changes in the frequency or intensity of their training load whether it be increasing their weekly km’s, running more hills, or starting (or resuming) a new training program.

What are the symptoms?

Shin splints is aggravated by activity. There is often a pattern with MTSS in that pain will be worse at the onset of exercise but may well disappear or be reduced during training only to return with greater severity following exercise. In more severe cases pain may be present at rest and worsen with activity to the point where it is not possible to continue.

There is usually tenderness along the inside border of the tibia, with the bottom half down towards the ankle usually being more sensitive. Swelling and redness can also be present.

How is Medial Tibial Stress Syndrome treated?

Management of MTSS depends on the underlying cause of the condition.

In almost all cases a period of rest from the aggravating activity will be necessary. During this time using ice can assist in relieving pain. Cross training may be permitted if symptoms can be controlled.

A physio may incorporate some of the following techniques as part of treatment:

  • Taping the foot and arch. This can serve as a short term strategy to unload the affected muscles that are inflamed.
  • Self massage of tight surrounding muscles such as the calf using a trigger ball combined with gentle appropriate stretching.
  • Targeted strengthening. A full biomechanical assessment should performed because often  MTSS is the result of underlying factors. For example I would look at pelvic stability, single leg control, calf strength and ankle range of motion as deficiencies in any of the above will need to be addressed for long term injury management.
  • There should also be discussion around footwear, training surface and program design. I have a no thongs policy when it comes to MTSS (not even to walk down to the shops for coffee) and I like to stress the importance of having up to date high quality running shoes. It’s one of the easiest things that a client can control themselves and you would be surprised at how many people train in old, worn out shoes. With regards to program design surface does matter with grass being a much more forgiving surface than concrete or road. There should be a graded return to activity plan and depending on the severity it could up to 6 weeks to build back up to pre injury loads.

Medial Tibial Stress Syndrome can be a painful and debilitating injury. I would never advise someone to continue to train through pain as there is the potential for this condition to worsen into stress fractures. If you are experiencing shin pain I would encourage you to seek a professionals opinion to guide you through a recovery and rehabilitation program.

Em Batger

Please note: Em's blog is general advice only. For further information on this topic, please consult your healthcare professional.

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