Medial Tibial Stress Syndrome (MTSS) also known as shin splints is a common overuse injury of the lower legs. Shin splints is an overload injury, occurring when the shin bone is subjected to repeated micro-damage. It typically occurs in runners and athletes that are exposed to intensive weight-bearing activities, for example high-jumpers.
Who is at risk?
The incidence of shin splints ranges between 13.6% to 20% in runners and is present in 20% of dancers. Large increases in load, volume and high impact exercise can put you at risk of developing shin splints.
Risk factors include:
- Being a female
- Previous history of MTSS
- High BMI
- Navicular drop
- Reduced hip external rotation range of motion
- Muscle imbalance
- Inflexibility and weakness of the calf
- Running on a hard or uneven surface in poorly fit running shoes, or over-striding
How does it feel?
Shin splints usually presents as increased pain on the inner side of the shin bone during exercise, with pain persisting for hours or days afterwards. It will often feel like a burning pain, especially when touching the affected area.
How can physio help?
Your physio will carry out a thorough physical exam, assessing your foot posture, calf & achilles tightness and strength, hip range of motion and most importantly, a single leg hop test. The importance of this hop test is to assess whether or not a stress fracture is present, which will warrant an immediate period of rest and potentially crutches and moon boot.
Management of shin splints is conservative, focusing on rest and activity modification with less repetitive, high impact, load-bearing exercise. A graded loading exposure program is the best course of treatment, aiming to gradually increase the bone’s load tolerance capabilities post injury.
What you and your physio can do to help with shin splints
- 2-6 weeks of rest combined with physio in the acute phases of shin splints
- During the rehab period, cross-training can be done such as low impact bike, aqua-running or elliptical training to keep aerobic fitness up
- Strength training will help with conditioning of the foot, ankle, hip or core to help avoid injury recurrence
- Balance training is crucial, this can be done with a one-legged stand or balance board
- Choosing good shoes with good shock absorption can help to prevent a new or re-injury
- In case of biomechanical problems of the foot, individuals may benefit from orthotics. An over-the-counter orthosis (flexible or semi-rigid) can help with excessive foot pronation and flat feet
If you are experiencing shin splints, don’t put up with it, call us to make an appointment with one of our experienced physiotherapists. Call (08) 6389 2947 or click here to book online.