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Medial tibial stress syndrome (MTSS) is commonly known as ‘shin splints’.  It is characterized by pain along the inside of the shin bone (tibia) during running or brisk walking.  Medial tibial stress syndrome has been classified into two distinct types;

  • Type 1

Is a stress reaction on the inside border of the shin bone. It is the preceding stage to a stress fracture.


  • Type 2

Is irritation of the outer surface (periosteum) of the inside of the shin bone where the Soleus and Tibialis Posterior muscles attach.

Regardless of the type, MTSS is mostly caused by overuse, with those who run regularly on hard or uneven surfaces being particularly affected.  However, there are a number of factors, such as altered foot, knee and hip posture, which can make a person susceptible to the syndrome.


Treatment for Medial Tibial Stress Syndrome
  • RICE – rest, ice, compression & elevation
  • Activity modification or reduction
  • If biomechanics is a contributory cause – orthotics may be considered
  • Non-steroidal anti-inflammatory drugs  (tablets and gels)
What can you do?
  • Reduce or modify current activities – water activities and non-weight bearing exercise
  • Gradually resume normal activity 
  • Ice after training/ activity 15 minutes on, 2 hours off, 15 minutes on
  • Footwear assessment – it may be time for a new or more appropriate pair
  • Keep an exercise and activity log to monitor how activity affects pain levels
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