Medial Tibial Stress Syndrome - (Shin Splints)

A commonly reported problem by many patients we see is “shin splints”, or medial tibial stress syndrome (MTSS). This is usually described as a general pain on the inside of the lower shin which is typically felt at the beginning of activity and improves after warming up.

What are shin splints?

Shin splints describe pain along the inner edge of the tibia caused by repeated stress and strain on the bone and surrounding muscles. This condition is common among runners, dancers, and athletes who increase training intensity too quickly. Shin splints can affect one or both legs.

What do shin splints feel like?

People with shin splints usually feel a dull, aching pain along the front or inner edge of the lower leg. Pain may worsen during activity and improve with rest or warming up. In some cases, swelling or tenderness may also be present.

What causes shin splints?

Shin splints occur when the tibia and surrounding muscles are subjected to repeated stress. Common contributing factors include sudden increases in training intensity, running on hard surfaces, improper footwear, tight muscles, and fatigue. Female athletes and those with lower bone mineral density are at higher risk.

Please find this video example of the self-release technique for shin splints:

What are the complications of shin splints?

If left untreated, shin splints may progress to stress fractures or chronic pain, which can limit activity and training. Early management is important to prevent more serious injury and allow continued participation in sport or exercise.

How are shin splints diagnosed?

Diagnosis is based on medical history, symptom description, and a physical assessment. Health professionals may palpate the shin, assess movement patterns, and review training loads. Imaging is rarely required unless symptoms are severe or another condition is suspected.

What are the side effects of treatment for shin splints?

Treatment is generally safe, but some interventions such as taping or orthotics may cause minor skin irritation. Ice therapy can cause temporary discomfort if applied too long, and activity modification may temporarily limit performance.

Short-Term Treatment Options for Medial Tibial Stress Syndrome

Short-term options include:

• Reducing activity intensity or modifying training.

• Self-release or massage of muscles along the shin.

• Taping to support the foot and reduce impact.

• Ice therapy after activity to reduce pain and inflammation.

Longer-Term Management

Increasing the strength and endurance of the lower leg muscles, managing training loads, and ensuring proper footwear are key to preventing recurrence. A structured strengthening program can make activity more sustainable over time.

Speak to a Physiotherapist

If shin pain is limiting your training or daily activities, our physiotherapists in North Adelaide can assess your condition and develop a personalised management plan to help you recover safely and prevent recurrence.

Luke Chetcuti

Sports Physiotherapist, North Adelaide

Brukner & Khan (2017), Brukner & Khan’s Clinical Sport Medicine (5th Edition), Volume 1, Injuries