Shin Splints

Shin splints, also known as medial tibial stress syndrome (MTSS) is a common overuse injury of the lower extremity that affects the inner, lower 2/3rds of the medial (inner) tibia (shin bone). It is a common condition seen in athletes such as runners or jumpers where there is a sudden increase in loading, volume and high impact activities while some other risk factors include being female, high BMI and muscle weakness leading to altered biomechanics. 

It is believed that symptoms develop secondary to the periosteum (a thin layer of tissue that covers all bones) due to excessive traction from the surrounding musculature. While in the acute phases symptoms are usually exacerbated by the aggravating activity development into the latter stages some people will report symptoms with daily activities.

During the subjective history taking people may report:

• Increasing pain during exercise that is experienced on the middle to lower third of the anterior inner part of the shin

• Pain usually persists for a day or two after stopping activity

• Pain which may initially settle once activity starts, however in the later stages the pain develops earlier within the aggravating activity and in severe cases can be felt on walking.

After hearing the history of the persons problem, a thorough physical examination would commonly identify:

• Tenderness over the anterior inner aspect of the tibia (shin bone) where people report their pain to be

• Potential tightness in the calf musculature

• Pain when there is resistance provided to someone pointing their toes towards the floor.

• Pain when performing landing and jumping based tasks.

Shin splints can be assisted via conservative management, which usually includes:

• Advice and education

• Activity modification

• Therapeutic ultrasound

• Sort tissue massage

• Shockwave therapy

• Acupuncture

• Home exercise programme focussing on stretching and strengthening

• Gait analysis and re-education 

• Graded return to sport