Medial Tibial Stress Syndrome

Medial tibial stress syndrome, more commonly known as a type of ‘shin splints’, is an overuse injury of the lower legs that commonly affects runners, athletes and those in jumping sports. This frustrating condition is occurring frequently recently as people return to sport and activity after lockdowns. What can be done about it?

A study by Winters in 2019 looking at the condition and its management found no good evidence proving effectiveness of treatments including rest, ice massage, gait retraining and shockwave therapy.

While this doesn’t sound very promising for finding relief, it does highlight some key aspects of the condition. Being an overuse injury, the most important aspect to keep in mind is how much ‘use’ the legs are getting – in terms of duration, frequency, and intensity of exercise. Being able to balance this amount of use, and how much the legs can tolerate it, is key to avoiding flare-ups.

Additionally, keep in mind that there is generally a long timeframe associated with recovery – it can take 3 months to achieve a good outcome of returning to activity with minimal pain, or even 9-12 months if the condition has been around for a while already. However, don’t be concerned – slowly increasing exercise by 10% amounts every week, and monitoring how well your legs can handle it afterwards is a promising strategy for returning to your usual levels of activity with minimal pain. If you are returning to sport or activity after a not having done it for a while, ease into it and avoid jumping straight back into your usual amount.

If you have concerns about an injury or need advice on managing your increases in activity, discuss this with your physiotherapist.

By Louis Cato, physio student at Exercise Thought

Winters, M. (2020). The diagnosis and management of medial tibial stress syndrome. Der Unfallchirurg, 123(1), 15-19.