What are Shin Splints?
MTSS stands for Medial Tibial Stress Syndrome and is the preferred acronym for shin splints in the medical world however shin splints is widely recognised so will be our preferred terminology.
Shin splints is when a patient feels localised pain on the inner and lower 1/3 portion of the tibia or the shin and the soft tissues surrounding it. With MTSS, pain usually disappears once the activity that causes the pain is reduced or stopped.
Imaging can hep to confirm the diagnosis and X ray can show up shin splints in really high level cases where there is thickening of the soft tissues surrounding the shin.
It is also important to consider other investigations like a bone scan and pressure testing to exclude conditions such as stress fractures and compartment syndrome if the symptoms are persistent.
- If your feet roll and your arch collapses (pronation) in whilst running then that shock will be transmitted into pain in the shin and can cause shin splints. Good supportive shoes and/or orthotics are important considerations if this is part of your biomechanics.
- Excessive calf tightness can pull at the periosteum (the skin that lines the tibia/shin) and contribute to shin splints.
- The surfaces that you run on. If you run on roads and concrete there is little shock absorption. Equally if you are a pronator then sandy, boggy or unstable surfaces can also contribute to shin splints.
- Your running style. If you are a heavy front foot / toe striker then your biomechanics can be contributing.
- Poor gluteal, core and pelvis stabilising muscles can contribute.
- Not gradually increasing running loads including speed and distance.
How Does It Feel
- Pain on the front of the shin is the most common. It is usually bad to start, better once warmed up and worse upon finishing.
- Inner, front lower calf pain.
- Gradually worsening over a period of time. Generally it’s not a sudden onset.
- Visible oedema and swelling along the inner lower third of the shin.
- Pain to touch the inner lower shin and calf. There can even be lumpy adhesions which are a tell tale sign.
What Can PhysioPro offer?
Initially the best advice is rest, ice and anti inflammatory medication. Manual therapy from your therapist will include deep tissue massage, myofascial releases, frictions and ultrasound. There will be also careful analysis of your running pattern, calf flexibility, shoes, orthotics and loading of your exercise program which will have to be modified.