Medial Tibial Stress Syndrome
Medial tibial stress syndrome (MTSS), also known as “shin splints” refers to exercise induced pain along the inside of the lower leg. It is one of the most common injuries seen in runners, being responsible for up to 25% of injuries. Around 80% of runners will experience shin pain during their career. A wide range of tibial stress injuries is likely to be involved in MTSS, such as tendinopathy, periostitis, periosteal remodelling, bone marrow oedema or stress reaction of the tibia.
If not addressed properly shin splints can become increasingly debilitating and frustrating for athletes, and will likely lead to a longer recovery time frame. Management is often long and tedious.
MTSS can often be diagnosed clinically by assessing the location of pain, whether pain worsens with exercise and if there wasn’t a specific inciting event.
Causes and Risk Factors
The cause of shin splints is often that the cumulative load in the tissue exceeds the load that the tissue can take. Risk factors for developing MTSS include:
- Training load issues
- Training on hard or uneven surfaces
- Improper footwear
- Having a pronated foot posture
- Poor motor control at the hip
- Tibial bending
- Having a narrow angle of gait leading to increased load on the tibia
- Tissue vulnerability due to poor nutrition and rest
How to Manage Shin Splints
Once we have correctly diagnosed and ruled out any other potential injuries, such as a stress fracture or overuse injuries to the area, the Podiatrists at TFC Podiatry are able to customise a management plan based on your lifestyle to minimise the effects of shin splints.
Management of shin splints often revolves around four key steps:
- Reducing initial symptoms, often through NSAIDs, ice, stretching and massage
- Reducing load
- Increasing the ability of tissues surrounding the area to take load
- Facilitate healing
Treatment of MTSS is often varied depending on the case. Some modalities of treatment include:
- Orthotic therapy if there is excessive pronation of the foot
- Addressing any potential issues with running gait and making adjustments accordingly
- Training modifications: at first to reduce load on the tibia then gradually build up load tolerance. Modifications may include modifying running intensity, volume and frequency or adjusting training surface to a softer surface.
- Shockwave therapy/dry needling/prolotherapy to assist in scar tissue destruction, increased healing and pain/muscle spasm reduction
At TFC Podiatry we offer assessments that includes muscle and joint testing, gait analysis and subjective note taking to in order identify MTSS and the causes/risk factors that may be present with you. We are then able to create a management plan specific to your case, aiming to get you back to 100% as soon as possible.