Medial Tibial Stress Syndrome (MTSS or “Shin Splints”), is another condition we regularly encounter at Functional Health. Simply put, Shin Splints is basically pain caused by overuse along the shinbone (the large front bone in the lower leg). Common among runners and any athlete who’ve recently intensified or changed their training routines.
As we have discussed before here Suffering with Shin Splints? We’ve all heard of shin splints, most of us probably even know someone who has suﬀered with them. But what are they exactly? When most people say shin splints, what they are referring to is a condition known medically as Medial Tibial Stress Syndrome (MTSS). This is the most common form of shin pain and is thought to be both accumulation of boney stress as well as inﬂammation of the area where the muscles attach on to the inside edge of the bone, and is most commonly felt one third of the way up the inside edge of the shin bone.
While there can be a combination of issues that contribute to Shin Splints, Overuse (Excessive Training Load or Intensified Training) is one of the most common causes of Shin Splints. Excessive Exercise or Training beyond your normal level of fitness/ability are common among most athletes.
Other Risk Factors include:
Biomechanical (especially distance runners)
Running Mechanics is often the underlying cause of shin splints. Heel striking, Over-striding, Excessive over-pronation (inward rolling of the feet), Excessive knee valgus posture (knocking knees), Poor Hip & Pelvis Control and even Tight Calves
Personal Foot Mechanics
Flat Foot, High Arch
Excessive Body Weight/Obesity
Added stress is only increased when your weight increases.
Our Physiotherapists will diagnose your condition based on your medical history and physical examination. We will assess areas of soreness/tenderness/pain across both your feet and lower legs and discuss further with you to help us determine the cause of the issue.
In some cases, you may need an x-ray, bone scan, MRI or CT scan to rule out other conditions, depending largely upon your individual circumstances.
It is important to differentiate MTSS from:
– Stress Fracture
– Chronic Exertional Compartmental Syndrome
– Deep Vein Thrombosis (DVT)
– Popliteal Artery Entrapment
– Muscle Strain
– Arterial Endofibrosis
– Nerve entrapment (common/superficial peroneus and saphenous)
To correctly diagnose MTSS, or any physical health condition, you should contact your Physiotherapist or GP.
Rest is essential! Your body needs time to heal. Recovery will vary depending on the individual and your lifestyle. Most people recover within a couple of weeks when conservatively treatment, rest, icing and stretching.
Ice your shin to ease pain and swelling for approx. 20 minutes every 3 to 4 hours, to reduce inflammation, for 2 to 3 days, or until the pain is gone.
Wear supportive shoes and consider insoles/orthotics for your shoes. These can be custom-made or bought off the shelf.
Physiotherapy and Sports Massage can speed up the treatment process.
Some individuals will use pain relieving and anti-inflammatory medications to aid recovery. Functional Health ALWAYS recommend you discuss medication with your GP!
Manage your Overuse Training Effectively
Too much running or other high impact physical activity (performed for too long at too high an intensity) is likely to overload the Shins and you’ll need to repeat the treatment again. Management/Prevention is best. Learn to listen to your body and minimise the risk of future occurrence.
Lessen the Impact
Consider Cross Training with activities sport that place less impact on your shins. Swimming, Walking or even Cycling. Always begin new physical activities gradually and increase time and intensity as your body and ability develop.
Add Strength Training to your workout. Exercises to strengthen and stabilise your legs, ankles, hips and core can considerably help you to prepare your lower limbs to deal with higher impact sports/training regimens.
Maintain a Healthy Body Weight
Extra weight means extra stress and greater impact. Lose weight if needed, to lessen stress and decrease the risk of Shin Splints (MTSS).
Choose footwear suitable to your feet. Ensure they are supportive and not restrictive. Good arch support is important.