Shin Splints (MTSS)
Medial tibial stress syndrome (shin splints) presents with diffuse medial tibial pain related to training load and biomechanical stress.
Lower Leg - PathologyBiomechanical Mechanism
Overpronation, weak tibialis posterior/anterior, and rapid load progression increase tibial stress.
Clinical Rationale
MTSS is often driven by overload and biomechanical deficits. Load management and strengthening reduce symptoms.
Practical Solution
Manage load and build lower-leg strength to improve tissue tolerance.
Common Compensations
- Altered gait
- Reduced impact tolerance
- Foot pronation
Correctives
- Reduce training volume
- Foot intrinsic strengthening
- Tibialis strengthening
- Gradual return to impact
Progression
- 1Level 1: Pain reduction
- 2Level 2: Strengthening
- 3Level 3: Low-impact conditioning
- 4Level 4: Return to running
Regression
- Reduce impact
- Shorten sessions
- Avoid hills
Red Flags
- Focal bone pain
- Night pain
- Swelling
Differential Diagnosis
Stress fractureCompartment syndromeTendinopathy
Related Assessments
single leg heel raise test assessment
Related Exercises
tibialis strengtheningshort foot
