You may have heard of shin splints – or even experienced them yourself – but what exactly are they?

Medial tibial stress syndrome (MTSS), or more commonly known as ‘shin splints’, is an overuse injury of the lower leg. It’s often seen in runners, athletes and military personnel. Sudden increases in training load or repetitive high-impact exercise can increase the risk.

Signs and symptoms

• Pain in the lower two-thirds of the inner-back part of the shinbone (tibia) during or after exercise that eases with rest
• Tenderness to touch along at least 5 cm of the inner-back part of the shinbone
• No red flags such as cramping, burning pain, numbness or tingling in the foot, severe swelling, redness, or loss of pulse.

Management strategies

• Manage load: Relative rest and activity modification are key. This may include temporarily reducing running volume, adjusting incline or increasing cadence. Running at a pain-free (or near pain-free) level is often better for recovery.
• Other treatments: Currently, there’s a lack of effective treatments supported by research. For example, adding calf stretching/strengthening or compression stocking to a graded running program was no more effective than the running program alone. While not very effective for reducing pain, I still advocate for strength training for the benefits that running alone can’t provide, such as increasing and maintaining muscle mass and bone mineral density.

Prognosis

• With appropriate load management, most people recover well – though it often takes time. In one study, athletes returned to running (defined as running outdoors for 18 consecutive minutes at a ‘hard to talk’ pace) in about 105 days (15 weeks) on average.

Because MTSS can mimic more serious conditions such as stress fractures, compartment syndrome or vascular issues, always consult a trusted health professional for advice specific to you.