'Shin splints' are better known amongst sports physiotherapists as Medial Tibial Stress Syndrome (MTSS). MTSS is pain in the lower leg usually on the inside of the tibia. MTSS is very prevalent amongst those involved in high impact sports such as basketball, netball, football and athletics. Pain is believed to stem from excessive impact or bowing stress to the medial tibia and can vary from a low grade to a high grade where a stress fracture can occur.
Those at risk of shin splints usually play high impact sports, have poor foot and lower limb mechanics, poor calf strength, poor shock absorption strategies and are more at risk if going through a growth spurt. Training load and footwear choices often play a significant role in injury progression.
Patients suffering from MTSS often feel a dull, diffuse pain on the medial shin at the beginning of physical activity which can occasionally but not always improve as the area warms up. The pain can, however, vary in location and intensity and may cause debilitating pain which causes an individual to withdraw from sport. If more severe symptoms can persist with walking in the days following high impact activity. The area on the inside of the shin will be tender to touch and the athlete may feel as if their calf is extremely tight.
Successful physiotherapy treatment of shin splints consists of addressing all possible contributing factors, which can often be many and varied. Athletes will need specific assessment to determine their more relevant contributing factors, and to determine whether or not a stress fracture may be present or in the process of developing. Treatment may include load management strategies, addressing lower biomechanics through specific strength training or recommendations regarding footwear and orthotic use.