Shin Splints (AKA: Tibial Stress Syndrome)
What is it?
- MTSS (shin splints) is a clinical pain syndrome involving an overuse injury of the lower injury. Pain is typically along the back and inside portion of the tibia that is exercise induced or activity related.
- Medial Tibial Stress Syndrome exists on a continuum where the more running that occurs can cause pain which requires activity modification and strengthening. If not addressed, this can progress from just pain all the way to a stress fracture.
Patient Education to avoid Re-Injury
Acute Phase:
- Active rest, ice, NSAIDS (ibuprofen), and even crutches to normalize gait pattern if severe .
Subacute phase:
- Decrease running distance, intensity, & frequency by 50%.
- Cross-train with other low-impact activities such as swimming, running on softer surfaces, or biking.
- Proper footwear: implementing shock absorbing soles and insoles and changing shoes every 250-500 miles.
How Physical Therapy Can Help? Graded Exercise, Bone Strengthening, & Muscular Strengthening
A gradual return to exercise is crucial in preventing MTSS from reoccurring. Graded Running programs help strengthen the tibial cortex, and progressive loading promotes further bone remodeling.
- Reduce and scale back any activities that exacerbate symptoms/pain.
- Slowly increase training intensity & duration.
- Incorporate sport-specific exercise & loading! Ex: Hill running, jumping activities (all of which remains PAIN FREE).
Muscular Strengthening: Inadequate load absorption running is a key contributing factor to MTSS; therefore strengthening the necessary musculature helps reduce the stress the bone takes with running.
Special Emphasis on:
- Gastroc/soleus complex, flexor digitorum longus, tibialis anterior/posterior, and fibularis muscles to increase control and load absorption will better dissipate forces to the tibia.
- Trunk and Hip Stabilizers: abdominals, gluteals, & hip musculature, which can improve running mechanics and reduce lower extremity overuse injury reincidence.
