Medial tibia stress syndrome (MTSS), exercise related lower limb pain or shin splints are all umbrella terms which relate to pain you can get along the inside of the shin bone (tibia). The cause is repetitive loading that commonly occurs in activities like running, jumping and landing.
Incidence:
MTSS is a very common overuse injury, affecting between 4% and 19% in the athletic population. The injury and onset of symptoms can be related to sudden changes in training distance, load and intensity. Changes to the ground you exercise on and your footwear can also be linked to the condition. Intrinsically we will always consider your strength and conditioning capacity, flexibility, biomechanics and overall fitness.
Signs and Symptoms:
You will experience dull pain on the inside of the shin bone (tibia), usually the distal 1/3 so closer to the ankle. The pain usually spreads over about 5cm. Initially the pain might only be present at the start of an activity and then settle. As the condition worsens pain can be present at rest as well as when exercising. The pain will be worse when weight bearing, especially running and jumping.
Treatment:
A thorough assessment of your lower limb and overall conditioning is vital. We also need to rule out things like stress fractures. Once we are happy that it is MTSS we will remove the aggravating factors (running/jumping) and work on your strength and conditioning, gait, biomechanics and flexibility. As the symptoms settle we can then work through a return to running programme, making sure we control distance, speed and intensity so that the symptoms don’t return.
Shin splints can be a very restricting condition, especially if you are training for a specific event so making sure you address if early is very important. If you are struggling with any of the symptoms described please do get in touch so that we can help get you back pain free.
Paul O’Connell
Owner and Physiotherapist
Bridge Health & Wellbeing