Medial Tibial Stress Syndrome commonly known as shin splints is a condition associated with stress and pain at the inner border of the lower leg. It is specifically the inside of the tibia bone that is affected. This is particularly common in running and jumping sports but can occur during any activity that causes repetitive stress in this area. Activities that involve running up or downhill or on uneven surfaces are associated with developing shin splints. Recent changes in footwear or beginning a new exercise regimen can also be associated with onset of symptoms.
The pain is produced when there is damage done to the fibers that connect the muscle and fascia to the shin bone. Muscle and fascia connect to the periosteum (membrane that covers the bone) of the tibia via Sharpey’s fibers. Contraction of the muscles produces a force that pulls on this connection causing microdamage and inflammation. Shin splint pain can be a deep, dull throbbing or razor-like and sharp. This of course is worse with activity. Being that Sharpey’s fibers and the periosteum are what carry the sensation of the bone, it can almost feel like a fracture. In fact, stress fracture is something that a physician needs to rule out during examination. It is also possible for repetitive strain of the muscles of the front of the shin to be confused with shin splints.
This condition is typically associated with faulty mechanics like over pronation of the foot, flat feet, tight gastrocsoleus complex (calf muscles), achilles abnormalities, weak intrinsic foot muscles, and weak dorsiflexors (especially anterior tibialis).
Acute care involves rest, ice, and gentle therapies like pulsed ultrasound and soft tissue techniques. As care progresses joint manipulation, rehab, and foot orthotics should be considered. The goal of treatment is to change the biomechanics improving the efficiency of the patient’s gait and thereby reducing the repetitive stress.