Medial Tibial Stress Syndrome (shin splints)
What are shin splints?
The term “shin splints” is used to describe a wide variety of lower leg conditions that cause pain. Medial tibial stress syndrome (MTSS) better defines this common term and distinguishes this injury from other lower leg injuries including stress fractures and compartment syndrome.
MTSS commonly occurs in the unconditioned recreational athlete who decides to embark on a new sport, running, jumping or walking program. In addition, MTSS can also affect long term conditioned athletes and runners who suddenly change their footwear, running surface, volume or intensity of their programs.
Diagnosis
MTSS is best described as an exercise induced pain in along the posteromedial border of the tibia that is over 5cm in length.
The presence of severe swelling, pain on palpation of the medial tibial boarder that is less than 5cm in length, pins and needles, numbness, cramping or pain in the posterior compartment of the lower leg may suggest a different diagnosis.
It is also important to note that when attempting to diagnose MTSS, or any lower leg injury, that the clinician completes a full subjective assessment using the biopsychosocial model. The biopsychosocial model allows the clinician to treat each and every patient holistically, assessing how factors including sleep, fear, environmental, psychological and social factors could be influencing the patient’s current presentation.
Treatment
Firstly and most importantly the information collected through both the subjective and objective assessments in addition to evidence based research and patient preferences, help the clinician to develop an appropriate and effective treatment program for each individual client.
Common treatment interventions that are used to treat MTSS include:
· Appropriate load management
· A progressive strength and plyometric program to address deficiencies identified throughout the assessment.
· Education to address findings identified using the biopsychosocial model of care.
· Gait retraining
· Footwear selection
· Return to running program
· Addressing factors that may affect a patient’s bone health:
o Diet
o Past medical history
o Medications
Are you a runner or recreational athlete struggling with shin pain? If so, book an appointment with one of our physiotherapists at Wilson Physiotherapy Group on 9817 6600 to ensure an accurate diagnosis and treatment program to get you achieving all your health and fitness goals.
References:
· Winters et al. (2013). Treatment of medial tibial stress syndrome: a systematic review. Sports Medicine, 43(12), 1315-1333.