Medial tibial stress syndrome (MTSS, or Shin Splints) is a very common injury related to increased stress on our shin bone. It can be commonly due to a large increase in training over a short period of time, resulting in periosteal edema on our shin bone and ultimately pain.
It’s more than likely that you’ve heard of someone experiencing “shin splints” before. Lake Country in Wisconsin is a very active population and the change in seasons can encourage people to go from long periods of no training to a quick increase in running.
It is extremely important to get properly diagnosed with MTSS so that you can begin rehab and prevent this from transitioning to a true bone stress injury such as a stress reaction or stress fracture.
MRI may be useful in diagnosis if it is a higher grade of MTSS, but you will likely get diagnosed by a physician or physical therapist who will use a physical exam and subjective history to diagnose you. You may have been told that all you need is to rest, however, undergoing an individualized rehab program is essential for recovering from MTSS.
MTSS or Shin Splints is inflammation and stress along the tibia bone and surrounding tissues. This inflammation can cause pain that may be made worse with activity, specifically running or high impact activities.
If you fall under any of these categories, you may be more prone to MTSS:
Symptoms of MTSS:
Although MTSS affects our shin bones, it is not considered a true bone stress injury. However, if you ignore it, the repetitive stress can progress to a tibial bone stress injury. A bone stress injury is a much more serious condition in which there has been a small crack or fracture in the bone that has been shown with imaging. Bone stress injuries require a multi-disciplinary approach, time off from your activity, and a slow return to sport guided by a physical therapist and physician.
When you have pain due to MTSS, your body may begin to compensate through other joints such as your hips, knees, ankle, or feet in order to get the job done. Eventually, this can lead to pain in other regions of your body. Secondary injuries may include tendonitis, IT band syndrome, or patellofemoral pain.
The biggest secondary injury we worry about is stress fractures. If there is no decrease in running volume and no loading program, shin splints can ultimately lead to stress fractures.
Whenever you have pain, your muscles go into protection mode. They may become tighter or you may have secondary weakness due to the pain. Ultimately, pushing through pain is going to affect your running performance and likely lead to further injury. If you’re experiencing ongoing shin splints, there’s a chance that you have bone weakness in other areas of your body as well. If this goes unaddressed, we can experience other injuries such as fractures later on in life.
While these injuries share some common symptoms, there are very different treatment paths for each of them. It is important to correctly identify if you have MTSS (Shin Splints) or a Bone Stress Injury (BSI). Here are the common identifiers for each injury:
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If you are experiencing persistent shin pain, don’t wait to talk to a professional. You could save yourself lots of time away from your activity.
Proper rehab and a full running analysis can help you identify areas of weakness, range of motion deficits, movement compensations, and training errors. Having this knowledge can give you the power to manage your injuries, prevent secondary injuries, and ultimately level up your performance!
If you are in pain and need support, we are here to help you understand what is causing your pain, get you out of pain and get back to the things you love pain-free. If you would like to learn more, call us to book an injury consultation call or a visit with one of our Doctors of Physical Therapy today!