Shin Splints (MTSS)
If you’re a runner, dancer, or play field sports, you may have experienced a nagging pain along the inside of your shin. This is a common issue known as Medial Tibial Stress Syndrome (MTSS) - more often referred to as shin splints.
What is MTSS?
MTSS is an overuse injury that causes pain along the inner border of the tibia (shin bone). It occurs when the muscles, tendons, and/or bone in the lower leg become overworked from repetitive stress—particularly during activities involving impact or sudden increases in load.
What Causes It?
The exact cause of MTSS can vary, but common contributing factors include:
- Sudden increase in training volume or intensity
- Running on hard or uneven surfaces
- Biomechanical issues, like flat feet or overpronation
- Poor or worn-out footwear
- Muscle imbalances, particularly weak calf or hip muscles
- Inadequate rest, recovery and/or nutrition
Over time, repeated loading on the tibia leads to microtrauma in the bone and surrounding tissues, resulting in inflammation and pain.
Common Symptoms:
People with MTSS typically report:
- Dull, aching pain along the inner side of the shin
- Pain that worsens with activity and improves with rest
- Tenderness to touch along the lower third of the tibia
- In some cases, mild swelling in the area
It’s important to distinguish MTSS from more serious conditions like stress fractures, which tend to cause more localised, sharp pain.
How is it Treated?
The good news is that MTSS is very manageable with the right approach:
✅ Load Management
Reduce or temporarily stop high-impact activity (e.g. running)
Switch to low-impact alternatives like swimming or cycling
✅ Biomechanical Correction
Assess foot mechanics
Orthotics or supportive footwear may be helpful
✅ Strengthening & Flexibility
Strengthen calves, hips, and foot muscles
Improve flexibility of the calf, soleus, and hamstrings
✅ Manual Therapy
Massage, dry needling, or taping techniques to relieve muscle tension
✅ Gradual Return to Sport
Slowly reintroduce load with a structured, progressive plan
Takeaway.
MTSS can be frustrating, but it’s not something to “push through”. With the right treatment plan and a focus on prevention, you can return to full activity. If you’re dealing with shin pain, consider booking in with one of our physiotherapists for an assessment.
Written by physiotherapist, Quinn Lee.