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Location of medial tibial stress pain

Shin Splints (Medial Tibial Stress Syndrome)

The term ‘Shin splints’ describes pain in the distal third of the shin, which may be towards the lateral border of the shin (anterior shin splints) or on the medial border of the shin (posterior shin splints). Shin splints are caused by overloading the shin and any surrounding soft tissue structures. This happens when the athlete increases their training load too quickly (e.g. hill running with very little rest between runs). Running and jumping often aggravate the pain, though excessive use of the ankle foot dorsi flexors can also produce these symptoms (such as when someone walks a lot in shoes that are not tightened to the foot e.g. flip flops).

Symptoms:

pain that is diffuse, in other words no ‘pin point’ pain. Pain that is aggravated by ankle dorsi flexion (bringing your toes up towards you) and pain aggravated by running. Onset can be gradual but is often triggered by a sudden increase in training load.

Treatment involves load management by reducing the frequency and intensity of running. It may also involve correcting any biomechanical risk factors. This can be achieved by using a medial arch support and increasing hip rotation and strength. There is no consensus on the gold standard of treatment. It is recommended that you are assessed by a physio initially to rule out compartment syndrome and stress fractures. Your physio can aid in your load management strategy using the principles of POLICE ( protection , optimal loading , ice, compression and elevation).

References:

Winters, M., Eskes, M., Weir, A., Moen, M., Backx, F., & Bakker, E. (2013). Treatment of Medial Tibial Stress Syndrome: A Systematic Review. Sports Medicine, 43(12), 1315–1333. https://doi.org/10.1007/s40279-013-0087-0

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