Shin Splints/Medial Tibial Stress Syndrome

  • Repetitive stress injury of the anteromedial shin (inside of the lower leg)

  • Most common running related injury

  • Typically involves excessive loading of the issues due to an increase in training intensity, distance or duration 

    • Can also be due to running on hard surfaces, wearing shoes with poor shock absorption or engaging in new activity (long walk on the beach)

  • Anterior shin splints: affects dorsiflexor muscles (tibialis anterior)

    • Most common in runners who heel strike because this muscle acts as a break to the lower front of the foot as the heel strikes the ground

    • Also common in downhill hiking

  • Posterior shin splints: affects the posterior compartment with the calf and the posterior tibialis muscle

    • Posterior tibialis muscle works with the calf to point toe and turn it in ward

    • Common in forefoot strikers

    • Common in people who go from running in cushioned shoes to barefoot shoes or who run on hard or difficult surfaces such as sand because they strike the ground with the ball of their foot and posterior tibialis and calf muscles have to work harder to absorb the shock. 

    • Signs/symptoms: 

      • Pain in the front and inside of the shin

      • Pain is provoked when area is stressed such as running or walking downhill

      • Tender to touch over shin bone

      • Pain may be sharp in nature or ache/throb after the activity