Shin Splints is a common term for shin pain which usually occurs during or after activity. It can be a misleading term and most sports medicine professionals try to avoid using it. This is because shin pain and ‘Shin Splints’ can be due to several different conditions. One of the most common shin conditions that is frequently labeled ‘Shin Splints’ is Medial Tibial Stress Syndrome. (MTSS)
Medial Tibial Stress Syndrome occurs frequently in distance runners, dancers, football, soccer, hockey, basketball players and gymnasts. Medial Tibial Stress Syndrome has been classified into two distinct types, which affect specific tissues on the inside of the tibia.
This is characterised by a stress reaction on the medial border of the tibia bone. This stress reaction is a preceding stage to a stress fracture.
This is characterised by irritation of the periosteum of the medial tibial border at the insertion point where the Soleus and Tibialis Posterior muscles attach.
Regardless of the type, Medial Tibial Stress Syndrome is largely caused by over-use, with those who run regularly on hard or uneven surfaces being particularly affected. However, there are a number of factors, such as altered foot, knee and hip biomechanics, which can make a person susceptible to the syndrome. The accurate assessment of these is critical in appropriate management of the condition. The most common contributing factor to developing MTSS is over pronation of the feet and increased training load.
Most patients respond well to non-operative treatment. The physiotherapy approach involves active rest, biomechanical analysis to determine those structures which need to be stretched and/or strengthened, appropriate soft tissue work and specific exercises and education. Then a graduated return to sport or activity can be started.