Medial Tibial Stress Syndrome (MTSS), more commonly known as shin splints, is an overuse injury of the lower leg musculature. Shin splints typically occur when too much stress is localised at the tibia (shin) bone, causing inflammation and pain in the muscles, tendons, and periosteum (bone lining).
Typically, this occurs when there is an increase in physical activity, leading to the musculoskeletal tissues becoming overworked. If shin splints are not diagnosed and treated in time, serious complications such as tibial stress fractures or chronic compartment syndrome can arise. Addressing such issues will require the need for orthopaedic or reconstructive surgery.
Causes of Shin Splints
Shin splints are often caused by a sharp increase in physical intensity or volume of exercise, such as working out after a long period of inactivity. This sudden burst of activity causes the muscles around the tibia bone to become overused and fatigued, resulting in pain.
Other common factors contributing to shin splints are:
- Overpronation
- Flat feet
- Unsupportive footwear
- Inadequate muscle stretching
- Activity-specific ground surface density
Individuals at a higher risk for developing shin splints include runners, military personnel, active sportspeople, and dancers.
Signs and Symptoms of Shin Splints
- Pain at the inside edge of the tibia (shin bone)
- Pain that is aggravated by manual pressure
- Sharp, or dull and aching pain
- Pain during or after vigorous activity
- Tingling and numbness radiating from the shin to the foot
Treatment
The first line of treatment is to stop all physical activities, get sufficient rest, and ice the area around the tibia to reduce pain and inflammation. If the pain does not subside after a few days of rest, or is recurrent, it is advisable to seek professional help from a podiatrist in your area. Aside from shin splints, the pain may instead be a symptom of an easily treatable condition such as tendonitis, or serious conditions like longitudinal tendon tears or stress fractures to the tibia bone.
A musculoskeletal assessment, physical examination, diagnostic ultrasound, and X-ray may be ordered to ascertain an accurate diagnosis. After a thorough assessment, your podiatrist will be able to recommend a suitable treatment plan to resolve your shin splints.
Treatments your podiatrist may use include:
- Super-inductive therapy (SIS)
- Focal and radial extracorporeal shockwave treatment (ESWT)
- Stretching exercises
- Custom orthotic insoles
Shin splints can persist and worsen overtime without adequate treatment. The main risks associated with shin splints are the development of fractures along the shin bones, nerve pain, and compression as a result of overly tight muscles. Take care to seek prompt professional treatment if the pain becomes more noticeable over time and doesn’t seem to be improving.
