Shin Splints: Understanding, Preventing, and Treating Medial Tibial Stress Syndrome

 

Shin splints, medically known as medial tibial stress syndrome (MTSS), refers to both anterior and posterior shin splints. It is an umbrella term for a number of conditions. These include tibialis anterior/ posterior tendinopathy, stress fracture, compartment syndrome and medial tibial periostitis (inflammation of the periosteum or the fascia that surrounds the bone). It is characterised by pain along the shinbone (tibia).

 

shin splints

 

 

For the sake of this blog post, I am going to use the term shin splints, but please keep in mind that this is an umbrella term.

 

What are Some of the Possible Causes of Shin Splints

Shin splints result from overuse and repetitive stress on the tibia and the connective tissues (muscles and tendons). Factors contributing to this condition include:

  • Sudden Increase in Activity: Rapidly intensifying or changing your training routine can overwork the muscles, tendons, and bone tissue.
  • Improper Footwear: Worn-out or inappropriate shoes fail to provide adequate support and cushioning, increasing stress on the lower legs.
  • Flat Feet or High Arches: These structural abnormalities can lead to different weight distribution during activities, potentially placing additional strain on the shinbone.

 

What are Some of the Symptoms of Shin Splints

Individuals with shin splints often experience:

  • Tenderness, soreness, or pain along the shinbone or the inner and outer edges of it.
  • Mild swelling in the lower leg.

What are Some Possible Prevention Strategies

To minimise the risk of developing shin splints:

  1. Gradual Progression: Increase your exercise intensity and duration gradually. Avoid sudden spikes in activity levels to prevent overloading your muscles and bones.
  2. Proper Footwear: Select shoes that provide appropriate support for your foot type and the specific activity. Replace running shoes approximately every 350 to 500 miles to maintain optimal support and cushioning.
  3. Strength Training: Incorporate exercises that strengthen and stabilise your legs, ankles, hips, and core. This preparation helps your legs handle high-impact sports more effectively.
  4. Surface Selection: Whenever possible, opt for softer running surfaces to reduce impact stress on your legs. Avoid prolonged training on hard or uneven terrain.

 

 

What are some Common Physiotherapy Interventions

If you develop shin splints, consider the following treatment approaches:

  • Rest: Temporarily halt activities that cause pain, swelling, or discomfort. Engage in low-impact exercises like swimming or cycling during the recovery period.
  • Pain Relief: Over-the-counter pain relievers can help manage discomfort.
  • Stretching and Strengthening exercises: We can develop a tailored rehabilitation program, including strengthening and stretching exercises, to address the underlying causes of shin splints. For example, calf stretches or tibialis anterior strengthening exercises.
  • Kinesiology taping: Some people find K-tape beneficial, although the current body of evidence is inconclusive.
  • Manual Therapy: Manual therapy, such as deep tissue massage, may relieve tension in the calf muscles and improve circulation to facilitate recovery.
  • Gradual Return to Activity: Once pain subsides, it is key to gradually return to your normal activities over a few weeks. You are at high risk of recurrence if you return to normal activities without gradual progression.

 

 

Shin splints are a common overuse injury resulting from repetitive stress on the shinbone and surrounding tissues. By understanding the causes, recognising the symptoms and implementing effective prevention and treatment strategies, individuals can reduce the risk of developing shin splints and maintain an active, healthy lifestyle.

 

If you or anyone you know, would like to have a Physiotherapy assessment and treatment, with one of our team at Dorking , Leatherhead or Crawley book online here or contact us here.

Blog post guest written by Evie Spreadbury, Physiotherapist.

Evie Spreadbury

 

 

References

Lippincott Williams & Wilkins. (2017). Comparison of effectiveness of kinesio taping with non-elastic taping in athletes with acute shin splints. Available at: https://journals.lww.com/iaph/fulltext/2017/11010/comparison_of_effectiveness_of_kinesio_taping_with.6.aspx [Accessed 20 Jan. 2025].

Mayo Clinic. (2021). Shin splints – Diagnosis & treatment. Retrieved from

Mayo Clinic. (2021). Shin splints – Symptoms & causes. Retrieved from

Moen, M.H., Tol, J.L., Weir, A., Steunebrink, M. and De Winter, T.C., 2014. Medial tibial stress syndrome: a critical review. Sports Medicine, 44(5), pp.697-709.

Morrissey, D., Roskilly, A., Twycross-Lewis, R., Perry, M. and Crisp, T., 2016. Medial tibial stress syndrome—a systematic review of current treatment modalities. Sports Medicine – Open, 2(1), pp.1-11.

Neal, B.S., Griffiths, I.B. and Dowling, G.J., 2019. Foot posture as a risk factor for lower limb overuse injury: A systematic review and meta-analysis. Journal of Foot and Ankle Research, 12(1), pp.1-14.

NHS. (2023). Shin splints. Retrieved from

PubMed. (2013). Kinesiology taping for musculoskeletal injuries: Systematic review and meta-analysis. Available at: https://pubmed.ncbi.nlm.nih.gov/23306413/ [Accessed 20 Jan. 2025].

PubMed. (2021). The effectiveness of kinesiology taping in managing medial tibial stress syndrome: A systematic review. Available at: https://pubmed.ncbi.nlm.nih.gov/34176444/ [Accessed 20 Jan. 2025].