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  • Tim Bushnell

What Are Shin Splints and How Do I Get Rid of Them?

Updated: May 27

TBS Physio makes the content of this blog available for general information only. The information in this blog is not a substitute for appropriate clinical advice from your health professional. You should speak to your health professional for personalised clinical advice.


As the Winter Season has begun, you've probably heard the word 'Shin Splints' going around at Joeys. Shin Splints, properly known as Medial Tibial Stress Syndrome (MTSS), is characterised by pain along the inner edge of the shin (tibia).


An athlete running up stairs














WHAT IS MEDIAL TIBIAL STRESS SYNDROME (MTSS)?


MTSS is an overuse continuum injury that occurs when the muscles, tendons, and bone in the lower leg are subjected to repetitive stress and overload. This often happens during impact activities like running, jumping, and especially sudden changes in direction. The repetitive stress initially leads to inflammation in the outer layer of the tibia (periosteal layer), resulting in pain and discomfort along the inner aspect of the shin. If not managed appropriately, this can progress to active bone stress and stress fracture in the tibia.


SYMPTOMS

  • Dull, aching pain along the inner border of the shin, which worsens during impact activity (running, jumping, etc.) and improves with rest. In more advanced stages of the MTSS continuum, pain may persist after exercise and the following day.

  • Tenderness and swelling in the affected area.

  • Pain that is aggravated by palpation or external pressure.


COMMON CAUSES

  • OVERUSE:

    • Increasing your training volume or intensity too quickly without planning adequate rest and recovery

    • This is especially relevant as an adolescent as your bones are going through peak height velocities (‘growth spurts’)


  • BIOMECHANICAL ISSUES:

    • Flat feet (overpronation)

    • Tight calf muscles

    • Poor running mechanics

    • Weakness in the glutes/calf complex/posterior chain


  • IMPROPER FOOTWEAR:

    • Wearing worn-out or unsupportive shoes can contribute to poor shock absorption and improper foot mechanics, leading to increased strain on the shin


  • RUNNING SURFACE:

    • Running on hard surfaces (concrete) or uneven terrain can exacerbate the impact forces on your lower legs


MANAGEMENT STRATEGIES

  • TRAINING LOAD MANAGEMENT:

    • Carefully plan your running and impact activity so that your muscle and bone have time to recover and adapt between sessions. This will allow for bone remodelling as well as adaptation of muscles and tendons to your training loads. This is by far the most important management strategy.

    • A good tip is often to avoid high training loads on consecutive days (e.g. having one day off in between high loads). This will allow symptoms to settle without having to completely rest. Complete off-feet conditioning using the ski erg or bike on your days off to maintain conditioning.

    • In mild cases, complete rest from running and impact activity can actually be counterintuitive, as when you return to running there will be a relative spike in load which further compounds the issue.


  • STRENGTH AND MOBILITY EXERCISES:

    • Incorporate specific exercises to improve mobility in the calf and ankle complex and strengthen the muscles of the lower limb to provide better support and stability.

    • Follow @tbsphysio on Instagram to see our favourite exercises for Shin Splints.


  • ICE:

    • Applying ice to the affected area for 15-20 minutes after completing all running and impact activity for the day.


  • ANTI-INFLAMMATORIES:

    • Research suggests that use of nonsteroidal anti-inflammatories may help with symptoms. Consult with your doctor or pharmacist to determine if this is suitable for you.


  • GRADUAL INCREASE IN LOAD:

    • Once symptoms start to improve, you can gradually reintroduce higher training loads on consecutive days.

    • It is important to still carefully plan your weekly training load to allow for the bone tissue to adapt to the training you are doing.


  • GOOD FOOTWEAR:

    • Ensure you wear supportive, properly fitting shoes that provide adequate cushioning and stability.

    • Running in joggers during training will provide more shock absorption than boots.

    • Running barefoot when playing sports like touch football will increase the loads through your shins and worsen symptoms.

    • Consider speaking with a physiotherapist for a biomechanical assessment to see if there are any underlying issues that may be contributing to MTSS.


Shin Splints can be frustrating, but with the right management plan, you should be able to continue playing in your sport or physical activity. If you can’t seem to get on top of persistent shin pain, feel free to reach out to us.


Follow us on Instagram @tbsphysio to see our top exercises to help you stay on the field this season.




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