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.
Shin splints is caused by an increase of running and other impact activities faster than the shin bone and the muscle attachments can adapt to. This is often referred to as a “training error”. This is by far the biggest thing to manage. There is no perfect rule for how quickly you can safely increase your running volume each week. A common guide is the “10% rule”, which proposes that in order to minimise risk of injury one should not increase their weekly running volume by more than 10%. This is far from perfect but gives a reasonable starting point to work from.
The ﬁrst and most important step, as this will guide everything that follows, is ﬁnd out if it’s really shin splints. This may sound obvious, but it is very important because it is common for things like tibial stress fractures to be mis-diagnosed as shin splints, as stress fractures do not show up on two-thirds of initial x-rays. If you instead have stress fractures it is very important that you cease all aggravating activities to prevent it from progressing to something much more serious. If it is truly shin splints, we can likely keep you training at some level whilst you recover.
Taking a thorough history and performing speciﬁc clinical tests we can determine if a referral for imaging is indicated, as well as your diagnosis and contributing factors, and together we can come up with a treatment plan to get you back to doing what you love.