Medial Tibial Stress Syndrome (Shin Splints)

Shin splints is a term commonly used to describe activity-induced pain in the lower leg. Shin splints is broken down into 3 categories. Medial tibial stress syndrome, Compartment Syndrome, Peroneal muscle strain. 

Is described as pain along the distomedial tibia due to irritation of the insertional fascia or periosteum under the tibialis posterior muscle or soleus muscle. 

Simply described as very small micro-tears in the leg muscles at their bony attachment

Etiology:
It is usually an overuse injury caused by abnormal biomechanics of the feet and lower limb. Commonly found in running and jumping sports.

Excessive pronation causes strain of the medial posterior muscle and other muscles of the lower leg which can lead to excessive loading and strain of the medial posterior border of the tibia.

Treatment:

Custom orthotics made from a non-weight-bearing 3D cast can reduce the amount of over pronation thus reducing the strain on the soft tissue of the lower leg. 

Other treatments that can be helpful is icing the affected area, two to three times a day for about 10 minutes. With MTSS, there is inflammation of the soft tissue and icing can help with reducing the inflammation. Stretching is also important, as tight muscles, especially the gastrocnemius and soleus, holding for 30 seconds, two to three times per leg. 

Physiotherapists can assess for muscle weakness, imbalance and tightness and provide the appropriate treatment plan. Massage  therapy is another option to decrease muscle tightness and break down adhesions. If pain persists, referring back to the physician for x-rays or bone scan may be necessary to rule out tibial stress fractures.