Shin Splints: Understanding, Preventing, and Treating the Ache
Medial Tibial Stress Syndrome (MTSS), often referred to as “Shin Splints”, commonly presents as an overuse injury of the lower leg. MTSS is reported as pain on the inside edge of the tibial (shin) bone about a quarter of the way up the tibia from the ankle, with the painful area between 5-12 centimetres in length. It can also present higher on the tibia but is less common. It is not uncommon to see a high incidence of MTSS in preseason sports, including football, netball, soccer, and with high volume training increases in middle and distance runners. It is considered as an early warning sign of a potential stress fracture if the person continues along the current training/exercise path.
Symptoms often include pain on the inside edge of the shin, and swelling can be present but not always. Pain description ranges from a dull ache and throbbing to sharp knife-like pain when the person is running, briskly walking, or during repetitive foot impact activities. It can also continue to be painful at completion of exercise.
Diagnosis typically made by an allied or complementary health practitioner include taking a thorough medical history and physical examination of the client with assessments, including posture, legs, feet and even movement patterns. An X-ray or MRI may also be requested to rule out stress fractures as part of the definitive diagnosis.
Treatment for MTSS to reduce recurrent occurrence includes:
- Training Load Modification: Swapping high impact activities such as running, to complete rest, or lower impact activities e.g. swimming, or cycling.
- Manual Therapy: Greatly assists in the treatment and recovery of MTSS targeting the affected inflamed injury site and surrounding tissues.
- Strength and Conditioning Training: Designed to target the locally affected injury site and general strength fitness to reduce the risk of recurrence.
What can you do to reduce the likelihood of developing MTSS presentations?
- Wear supportive exercise appropriate shoes when exercising.
- Starting new exercise with slow progressive increases activity over time. A good guide is to not increase activity levels by greater than 10% on the previous week.
- Running on soft surfaces can assist with impact reduction too.
- Cross-training can be a great way to continue exercising while reducing the impact load.
- If you start to feel shin pain, reduce training load, if it does not start to improve within a few days, seek assistance from a healthcare professional.