Medial tibial stress syndrome (shin splints)

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‘Shin splints’ is an umbrella term for lower leg pain that occurs below the knee. Medial tibial stress syndrome is a more accurate term to describe pain originating from the inside of the leg. It is a common cause of leg pain in runners due to increased stress and muscle traction on the inside of the tibia.

Symptoms

Patients will experience diffuse pain across the inside boarder of the shin which usually decreases with warming up. Sharp pain that is at a very specific point and that does not go away with rest may indicate a stress fracture.

Causes

Factors that cause increased strain on the shin include: excessive foot pronation (flat feet), inadequate stretching, worn shoes, muscle fatigue and training errors. MTSS can often be summarized by four words: too much, too soon.

Treatment

Treatment for medial tibial stress syndrome is based on symptomatic relief, identifying risk factors and treatment of pathology. Symptomatic treatment consists of:
• Rest, ice and anti-inflammatory medication
• Avoidance of aggravating activity and running of soft surfaces
• Cross training (swimming or cycling)
• Correctly fitted running shoes (ask your podiatrist)

Treatment for risk factors may be:
• Correcting training errors
• Strapping the foot to support the arch
• Orthotics
• CAM boot or immobilization (resistant cases)

To treat pathology and stimulate healing the following may be considered
• Shockwave therapy (new to Bodycare Podiatry)
• Massage and dry needling
• Injection therapies