Medial tibial stress syndrome
What is it?
Medial tibial stress syndrome is inflammation and pain on the inside of your shin bone (tibia). This condition is sometimes wrongly called shin splints. The term shin splints is a general term used to describe shin pain. Shin pain can be caused by a variety of different conditions, one of which may be medial tibial stress syndrome.
Symptoms
The main symptom is pain along the inner edge of your shin bone. The area may also be tender and swollen. You usually get pain when you start exercising, but it goes once you've warmed up. After exercise the pain may get worse again as the area becomes more inflamed.
Causes
Medial tibial stress syndrome is an overuse injury . When the arch of your foot repeatedly flattens during running, the muscles in your foot can cause increased stress on your shin bone resulting in pain.
Medial tibial stress syndrome can also occur if you have a high arched foot (underpronation).
- You're more likely to get medial tibial stress syndrome if you wear the wrong footwear
- over train on hard surfaces
- have body movement (biomechanical) problems
- have poor core stability in your pelvis
- have poor flexibility in your lower leg muscles, especially your calf muscles
Treatment
You should seek treatment from a sports medicine professional, such as a physiotherapist or sports medicine doctor. Treatment will depend on why you developed your injury in the first place. It may include:
- resting the injured area
- stretching the calf muscles to improve flexibility
- massage to release tight muscles
- pelvic and trunk stability exercises
It's important that your foot and lower leg movement (biomechanics) are assessed. You may be referred to a podiatrist for a gait analysis. A podiatrist is a healthcare professional who specialises in conditions affecting the lower leg, ankle and foot. He or she may recommend orthotic treatment (special insoles worn inside your shoes) to prevent the injury coming back.
Do
- Apply ice to the injured area until the swelling goes down. Don't apply ice directly to your skin as it can give you an 'ice burn' - place a cloth between the ice and skin.
- Stretch your leg muscles
Don't
- Ignore the pain. It may initially settle as you warm up during exercise, but exercise can lead to further damage making your injury worse. You may start getting pain throughout your exercise routine and you may end up with a stress fracture on your shin bone.
Peer reviewed by Simon Fairthorne MCSP, Bupa Sports Medicine physiotherapist
Publication date: June 2009
