SHIN SPLINTS - Medial Tibial Stress Syndrome (MTSS)

What are Shin Splints?

Shin Splints is a condition where there is pain, tenderness, and sometimes swelling along the middle, inside of the tibia (shin) bone. While the cause is debated as to whether this pain comes from a muscle, tendon, or bone, it usually occurs from doing too much too soon, in any sport. This results in the tibia bones’ inability to handle the stress and pounding from running, as well as damage to the connective tissue that wraps and supports all of these structures in the lower leg and foot, leading to the debilitation and activity-limiting pain you are likely experiencing.

The hallmark sign of Shin Splints is the extreme tenderness along the inside of the shin that seems to improve as a runner warms up but begins to worsen, last longer, and eventually prevent running and jumping as time passes without care. From this, this condition is more aptly named in the sports medicine community as Medial Tibial Stress Syndrome.

Common Causes of Medial Tibial Stress Syndrome - Shin Splints

The cause of Medial Tibial Stress Syndrome is still debated. It is likely a combination of the factors, which is why if you have been suffering from shin splints for a month or so and are just trying to run through them, it is important to get an evaluation, a structured plan around your goals, and some treatment to get you over the hump.

• Terrible Too’s: Too Much, Too Fast, Too Hard, Too Soon. A rapid increase in volume and intensity spells disaster for runners.

• Improper Biomechanics: Specifically, poor ankle dorsiflexion and pronation control.

• Tight or Weak Supporting Musculature: Hip, hamstrings, and calf complex weakness is a common issue among runners and must be addressed with a structured rehab and strength training plan.

• Poor Warm-Up & Mobility: Many runners skip their warm-up and maybe stretch every other day. This needs to change.

• Lack Of Training Variety: The same shoes, distance, speed, and terrain. Try performing intervals, running on the trails, and alternating long and short runs. Variety helps!

• Poor Strength Capacity: Simply, your body is not strong enough to handle the stress of running at the volume and intensity you are trying to perform. Strength training is a must for runners.

How Do We Treat Shin Splints?

ASSESSMENT: The first and most important step in treatment is a thorough evaluation and history. We must have an accurate diagnosis to formulate the best treatment plan for you and your goals. This also includes our 3-tiered running-specific evaluation that helps us guide you back to unrestricted, pain-free running.

IN-OFFICE CARE: Our in-office care is made of 3 phases:

(1) Soft Tissue Care: This may include IASTM, Myofascial Work, Assisted Stretching, and Dry Needling. We aim to decrease muscle tension, sensitivity, and pain.

(2) Proper Joint Mobility & Movement Patterns: Joint manipulation is essential for proper movement through the running gait cycle. Restrictions in the foot, ankle, or hip can lead to compensation patterns and potential problems in the future.

(3) Corrective Exercise: Soft tissue work and joint manipulation will only have a temporary effect if they are not followed by corrective exercise. We aim to ‘reprogram’ your movements and build strength to handle the stress of running.

HOME CARE: Home care will include regular mobility work on your problem areas, effective warm-up strategies to further progress your running, and strength exercises to continue rehab outside the office.

RETURN TO RUNNING: We want to maintain some running while you progress through care. This may require a sharp decrease in volume and intensity at first but will stair-step back to your normal running as care progresses.

More videos to help you with Running Shin Splints relief and get you back to running pain-free.