Shin Splints
Do you get pain in your legs when you run or exercise?
Do you think you have shin splints and want to know more about them and how to treat them?
Shin splints is an umbrella term for exercise-induced leg pain. There are many conditions that can cause leg pain and shin splints are often confused with or referred to as Medial Tibial Stress Syndrome (MTSS). MTSS is often characterised by pain in the medial side of the shin bone. However, that’s not the only thing that can cause symptoms in that area. Conditions such as compartment syndrome or tibial stress fracture can cause leg pain as well.
A thorough clinical examination is essential to make sure that you have the correct diagnosis which will help to create the correct treatment plan.
Types of shin splints
- Medial Tibial Stress Syndrome (MTSS)
- Medial Tibial Stress Fracture (MTSF)
As mentioned, the most common cause of shin splints we see is MTSS. Here is your chance to learn more about this condition and how we can help you.
What are shin splints?
Medial tibial stress syndrome (MTSS), commonly referred to as shin splints, is an inflammation on muscle tendons and bone tissues around the tibia. The pain occurs in the tibia where the muscles attach to the bones.
MTSS is a common leg pain condition among competitive athletes and runners, and most of the time the cause is unknown.
Most individuals who have symptoms from MTSS are active people, who either run or participate in jumping activities such as dancing. It’s a common athletic injury affecting 9-17% of runners, and 22% of injuries in dancers. It is a self-limiting condition and does resolve with rest.
Symptoms of shin splits
- Tenderness, soreness, or pain along the inner side of your shinbone during exercise
- Mild swelling in your lower leg
- Pain often diminishes upon stopping exercise
- However sometimes pain can continue during exercise which can be indicative of a medial tibial stress fracture (MTSF)

what causes shin splints?
MTSS can be caused by various activities. It is an overuse injury caused by repetitive microtrauma on the tibia which leads to a stress reaction injury within the bone.
Excessive stress on the tibia can cause it to bend during activities and will over time cause excessive stress in the bone resulting in injury. Foot biomechanics such as a flat feet and a forefoot varus can also be factors.

Risk Factors of Shin Splints
There are many risk factors that can lead to developing shin splints:
- Being Female: women are at least twice more likely to develop shin splints than men.
- Being Athlete Triad: disordered eating, amenorrhea, and osteoporosis
- Training errors: frequency, duration, intensity etc
- Surface type and inclination
- Footwear: type shoe and age of footwear (worn out shoes loss support)
- Bone shape and density
- Biomechanics: forefoot varus or flat feet
- Diet
- Previous injuries

Podiatrist can help assess your leg pain and help find the correct diagnosis for the splints you are experiencing and implement a personalised treatment plan.
How to treat shin splints?
Treatment of MTSS is multifactorial and can take up to 4 months to resolve can consist of the following:
- Icing in initial stages
- Rest
- Anti-inflammatory medication
- Modify training
- Footwear review and changes
- In-shoe padding
- Strength training
- Custom orthotics
- Physiotherapy
- Acupuncture
- Taping
- Nutritional assessment

Custom orthotics for shin splints
Custom orthotics can be used to effectively treat MTSS by addressing biomechanical factors such as flat feet (foot pronation) and forefoot varus. Foot pronation and forefoot varus are associated with an increased risk of developing MTSS or even MTSF.
Custom orthotics help alter and redistribute forces acting on the feet which reduces foot pronation and further reduces bending of the tibia. Also adding a wedge on the orthotics can help realign the foot and the tibia which will further reduce bending stress on this bone.

Cost
Biomechanical Assessment
Custom Made Orthotics
complications of shin splints
If left unresolved, MTSS can lead to a stress fracture of the tibia.
how do you prevent shin splints?
Long term management of MTSS is based on prevention. There is no one preventative measure that is consistently effective, so prevention is a combination of different things.
Here are some of the ways you can prevent shin splints:
- Avoid training errors: return to sport gradually sudden increases in exercise frequency and intensity can lead to injury.
- Exercise on level surface: irregular surfaces such as grass or sand can cause more stress on the tibia. Exercise on level surface with firmness to reduce risk of injury.
- Footwear: change your running shoes when they are worn out.
- Strengthen training: muscle fatigue following strenuous exercise, or an underlying weakness can lead to MTSS.
- Biomechanics: address biomechanical issues with orthotics.
- Diet
frequently asked questions
Rest and changing activity can help treat shin splints. Consider cycling, swimming, hydrotherapy, or upper body exercises.
In the initial stages of shin splints, icing is recommended.
Shin splints can take up to six months to heal.
If your shin splints are in the initial stages, oral NSAIDS can help treat symptoms.
There are many treatments you can do at home to help with shin splints. Examples include:
- Rest
- Icing
- Changing your footwear
Treatment for shin splints is non-invasive and is often implemented by patients at home.
- Korsh J, Matijakovich D, Gatt C. Adolescent Shin Pain. Pediatr Ann. 2017;46(1):e29-e32.
- Martinez RE, Lopez EB, Cox RW, Stankevitz D, Larkins L, Baker RT, et al. Exploring treatment of medial tibial stress syndrome via posture and the MyoKinesthetic system. J Bodyw Mov Ther. 2020;24(1):82-7.
- Mattock J, Steele JR, Mickle KJ. A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners. BMC Sports Sci Med Rehabil. 2018;10:20.
- McClure CJ, Oh R. Medial Tibial Stress Syndrome. Treasure Island (FL)2020.
- Moen MH, Holtslag L, Bakker E, Barten C, Weir A, Tol JL, et al. The treatment of medial tibial stress syndrome in athletes; a randomized clinical trial. Sports Med Arthrosc Rehabil Ther Technol. 2012;4:12.
- Nakamura M, Ohya S, Aoki T, Suzuki D, Hirabayashi R, Kikumoto T, et al. Differences in muscle attachment proportion within the most common location of medial tibial stress syndrome in vivo. Orthop Traumatol Surg Res. 2019;105(7):1419-22.
- Newman P, Adams R, Waddington G. Two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test. Br J Sports Med. 2012;46(12):861-4.
- Newman P, Waddington G, Adams R. Shockwave treatment for medial tibial stress syndrome: A randomized double-blind sham-controlled pilot trial. J Sci Med Sport. 2017;20(3):220-4.
- Ohya S, Nakamura M, Aoki T, Suzuki D, Kikumoto T, Nakamura E, et al. The effect of a running task on muscle shear elastic modulus of posterior lower leg. J Foot Ankle Res. 2017;10:56.
- Okunuki T, Koshino Y, Yamanaka M, Tsutsumi K, Igarashi M, Samukawa M, et al. Forefoot and hindfoot kinematics in subjects with medial tibial stress syndrome during walking and running. J Orthop Res. 2019;37(4):927-32.
- Ozgurbuz C, Yuksel O, Ergun M, Islegen C, Taskiran E, Denerel N, et al. Tibial bone density in athletes with medial tibial stress syndrome: a controlled study. J Sports Sci Med. 2011;10(4):743-7.
- Rathleff MS, Samani A, Olesen CG, Kersting UG, Madeleine P. Inverse relationship between the complexity of midfoot kinematics and muscle activation in patients with medial tibial stress syndrome. J Electromyogr Kinesiol. 2011;21(4):638-44.
- Schulze C, Finze S, Bader R, Lison A. Treatment of medial tibial stress syndrome according to the fascial distortion model: a prospective case control study. ScientificWorldJournal. 2014;2014:790626.
- Verrelst R, Willems TM, De Clercq D, Roosen P, Goossens L, Witvrouw E. The role of hip abductor and external rotator muscle strength in the development of exertional medial tibial pain: a prospective study. Br J Sports Med. 2014;48(21):1564-9.
- Winkelmann ZK, Anderson D, Games KE, Eberman LE. Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review. J Athl Train. 2016;51(12):1049-52.
- Winters M. Medial tibial stress syndrome: diagnosis, treatment and outcome assessment (PhD Academy Award). Br J Sports Med. 2018;52(18):1213-4.
- Winters M. [The diagnosis and management of medial tibial stress syndrome : An evidence update-German version]. Unfallchirurg. 2019;122(11):848-53.
- Winters M, Bakker EWP, Moen MH, Barten CC, Teeuwen R, Weir A. Medial tibial stress syndrome can be diagnosed reliably using history and physical examination. Br J Sports Med. 2018;52(19):1267-72.
- Yagi S, Muneta T, Sekiya I. Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners. Knee Surg Sports Traumatol Arthrosc. 2013;21(3):556-63.
- Yates B, White S. The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. Am J Sports Med. 2004;32(3):772-80.
- Yuksel O, Ozgurbuz C, Ergun M, Islegen C, Taskiran E, Denerel N, et al. Inversion/Eversion strength dysbalance in patients with medial tibial stress syndrome. J Sports Sci Med. 2011;10(4):737-42.
read this next

Running is a highly beneficial exercise popular for its convenience and numerous health benefits.

What are custom made orthotics and how do they differ from other orthotics?