Introduction

As active individuals and athletes, we cherish the thrill of movement, whether it’s pounding the pavement during a run or leaping across the basketball court.

But sometimes, our zest for physical activity can lead to unwelcome discomfort.

Enter Medial Tibial Stress Syndrome (MTSS)—commonly known as shin splints.

In this article, we’ll empower you with knowledge to make informed choices, recognize early warning signs, and proactively enhance your function. Plus, we’ll include practical exercises to aid your journey.

What Are Shin Splints?

Shin splints is an umbrella term encompassing various conditions related to pain along the shinbone (tibia). Let’s focus on the most prevalent form: Medial Tibial Stress Syndrome (MTSS).

1. Medial Tibial Stress Syndrome (MTSS):
   • Description: MTSS manifests as persistent dull leg pain along the inner edge of the shin.
   • Cause: Repetitive stress on the tibial muscles and connective tissues due to overuse.
   • Symptoms: Diffuse pain along the inside border of the shin, below the knee, especially during or after exercise.
   • Risk Factors:
     • Training errors (sudden intensity or duration increases).
     • Biomechanical irregularities (improper footwear, overpronation).
     • Weak leg, stabilizers, and/or core muscles.

Recognizing MTSS

Early recognition is key. Here’s how to identify MTSS:

• Symptoms:
  • Vague, diffuse pain along the middle-distal tibia (front of the leg).
  • Pain often decreases during warm-up/running (early stage).
  • Pain onset occurs earlier with frequent training (later stages).
  • Pain occurs in single leg calf raise.
• Physician’s Exam:
  • Rule out stress fractures.
  • Differentiate from exertional compartment syndrome (where pain increases with running).

Evidence-Based Strategies for Management

1. Rest and Activity Modification:
   • Temporarily reduce high-impact activities.
   • Cross-train with low-impact exercises (swimming, cycling).
2. Icing and Anti-Inflammatories:
   • Reduce inflammation trhough NSAIDs, red light therapy, cryotherapy.
   • Consider NSAIDs for pain management.
3. Footwear Assessment and Orthotics:
   • Ensure proper shoe fit.
   • Address biomechanical issues.
4. Strengthening and Flexibility:
   • Focus on calf/eg strengthening (especially the soleus).
   • Regularly stretch calf muscles and Achilles tendon.
5. Gradual Return to Activity:
   • Progressively reintroduce activity, monitoring symptoms.
   • Correct any form issues contributing to tibial stress.

Practical Exercises for Shin Splints Relief

There are 3 things we want to achieve with exercises to recover from shin-splints; reset, restore, and rebuild.

Reset exercises are designed to influence the central nervous system to reduce pain, and lower tone of muscles that may be protective and in-spasm.

Restore exercises help restore mobility and tissue pliability when combined with Resets.

Exercises for strength help Rebuild the tissues capacity and function.

Below are some simple exercises for this you can try at home.

Reset

Use these self myo-fascial release exercises to help get blood and lymph fluid moving and to reset your nervous system.

Restore

A few traditional stretches work great when done after the sfmr exercises above.

Rebuild

Strengthening is needed in the claf, soleus and posterior tibilais muscles and calf raises are a good tool. These should build from two leg to single leg calf raises.

Balance exercises help strengthen the foot, ankle, and hip muscles.

Core and adductor exercises may seem out of place, but they are part of the same fascial line that affects the medial shins.

To return to running and sports you want to rebuild the spring and elasticity through that kinetic chain. The bench assisted version below lets you unload so body weight so you can start building back. Then you can progress to single leg version.

Remember, patience and consistency are your allies. With these strategies and exercises, can conquer shin splints and get back to the activities you love.

TL;DR

Medial Tibial Stress Syndrome (MTSS)—commonly known as shin splints— are a common challenge for many athletes. Hopefully, we’ve equipped you with some essential knowledge to navigate this common challenge. Let’s recap:

1. Understanding MTSS:
   • MTSS involves diffuse pain along the inner edge of the shin, often exacerbated by exercise.
   • Risk factors include training errors, biomechanical issues, and muscle imbalances.
2. Recognizing Early Signs:
   • Pay attention to vague anterior leg pain along the border of the shin.
   • Tenderness along the tibia is a key physical marker.
   • If its worsening or persists see your physician.
3. Evidence-Based Strategies:
   • Rest and modify activity to allow healing.
   • Manage excessive pain and inflammation.
   • Evaluate footwear and address biomechanics.
   • Strengthen calf and foot muscles and maintain flexibility.
   • Gradually reintroduce activity with proper form.

Remember, your commitment to self-care and patience will pave the way to conquering shin splints. Whether you’re a seasoned athlete or a weekend warrior, embrace the process. Soon, you’ll be back in action, doing the things you love with renewed vigor!