Medial Tibial Stress Syndrome (MTSS), mostly commonly known to us as “Shin Splints” is a lower leg condition experienced by both high and low-level runners or athletes who are active with sports, such as tennis, squash and high impact aerobics. Patients with MTSS usually complain of pain on the inner-aspect of the shin bone (tibia), aggravated by exertion. At onset of this condition, pain is worse at the beginning of exercise, but usually warms up and decreases as exercise persists. However, as the condition advances and becomes more chronic, pain presents much earlier in exercise, persists longer and can even occur at rest.
Pathology of Shin Splints
MTSS is an overuse condition, either experienced in new runners or athletes who take up a new running or jumping activity without prior training; or experienced athletes who quickly increase their training load or change their running terrain or footwear.
In addition to this change in training-load, both types of patients usually have poor biomechanics affecting the lower leg and foot, or abnormal recruitment of three main muscles which all attach to the inside of the shin bone (tibia) where the pain is felt. These three muscles are the tibialis posterior, tibialis anterior and soleus. These three muscles work to support the arches in your foot, propel your leg forward when running, walking and jumping, as well as playing a part in shock absorption when your heel strikes the ground. If any of these muscles aren’t working as effectively as they should be, extra strain is placed on the remaining ones, causing inflammation and pain at their attachment sites connective tissue (periosteum) that joins the muscle to the bone of the tibia.
Treatment of Shin Splints
To address the biomechanical causes of MTSS, postural and movement assessment should be performed to target the abnormalities, and exercises will be tailored to correct them.
Rehabilitation sessions at Bodyworks can also be very helpful to improve movement patterning and correct biomechanical faults in a guided and tailored approach. In addition, training load should be altered in the early phase and gradually increased back to normal levels in a graded manner as to build up strength and endurance safely without injury.
How we can help
MTSS should be managed early with relative rest, ice and anti-inflammatories to settle the inflammation and manage the pain. Hands-on manual therapy such as dry needling and massage will also be used to release tight musculature due to compensatory movement patterns.
If you are experiencing lower leg pain that isn’t getting better, and want a streamlined and thorough rehabilitation, please don’t hesitate to give Bodyworks a call on 9381 5565 to discuss more or book in for a treatment session.
References
Galbraith, R. M., & Lavallee, M. E. (2009). Medial tibial stress syndrome: conservative treatment options. Current Reviews in Musculoskeletal Medicine, 2(3), 127–133. http://doi.org/10.1007/s12178-009-9055-6
