Shin Splints – Medial Tibial Stress Syndrome Treatment

What are Shin Splints? 

Medial tibial stress syndrome (MTSS) is an overuse repetitive type injury of the shin area. Although it can occur on the front or anterior leg musculature, it’s most commonly located on the inside of the shin bone (tibia), hence the medial side. 

When medial tibial stress syndrome (MTSS) occurs along the inside portion of the shin bone, commonly called “shin splints”, it’s related to the posterior tibial tendon.  This common sports injury is especially prevalent  in runners, but can occur with any running athlete. Long-standing or involved cases can be related to exertional leg pain, chronic compartment syndrome and even stress fractures which are more complex to diagnose and treat. 

Traditional MTSS/shin splints, although often not serious, can be quite disabling and can progress causing loss of competition or playing time if not treated properly and quickly.

man on a track tending to a shin injury

What Causes Shin Splints? 

Often, the cause of MTSS is multi-factorial and involves training errors, muscular weakness, inflexibilities,  various biomechanical abnormalities, and even shoe and running surface. Medial Tibial Stress Syndrome if often the result of:

  • Inflammation of the muscles running the length of the shin (the posterior tibial muscle) 
  • Inflammation of the fascia (the tissue covering of the posterior tibial muscle)
  • Injury to the periosteum (vascular tissue that surrounds the bone) from overloading and abnormal pull of the leg muscles .

Dysfunction, tightness and/or weakness of the tibialis posterior,  long flexor tendons, tibialis anterior, and soleus muscles are commonly involved as they are very important in running athletes. 

Abnormal foot alignment often can predispose running athletes to shin pain. As the foot abnormally pronates (rolls inward) the strain placed on the posterior tibial muscle increases, and becomes abnormally lengthened which causes pain. 

Runners ramping up too quickly, running in less supportive or worn shoe gear, runners with poor form ie: excessive heel striking or hip and core weakness allowing the collapse of the knee inwardly, will also predispose this athlete to shin pain. 

Treating Medial Tibial Stress Syndrome 

Getting treatment quickly is important when symptoms of shin splints arise. Evaluating foot alignment, shoe gear, hip, core and lower extremity strength is paramount. All of these need to be corrected. Evaluation of running form, and training logs will also be important to make a well rounded treatment plan. 

Other treatments include:

  • Ice packs
  • Shin massages
  • Buyings new shoes that alleviate stress on the shins
  • Orthotics
  • Stretching
  • Strengthening exercises