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Overcoming MTSS: How to Treat Shin Splints and Improve Your Recovery

Medial Tibial Stress Syndrome (MTSS), also known as shin splints, is a common injury that causes pain along the shinbone, particularly among athletes and active individuals. Whether you’re a runner, a soldier, or someone who enjoys high-impact sports, MTSS can interrupt your routine and cause significant discomfort. The good news is that MTSS is treatable, and with the right approach, you can recover fully and return to the activities you love.

Illustration showing shin splint pain along the tibia (shin bone) and fibula in the lower leg.

What is Medial Tibial Stress Syndrome (MTSS)?

Medial Tibial Stress Syndrome (MTSS) refers to pain and inflammation along the inner edge of the shinbone (tibia), caused by repetitive stress. It’s commonly seen in runners, athletes involved in high-impact sports, and military personnel. The pain is usually a result of overuse, particularly when the tibia and surrounding tissues become overstrained due to high-impact activities like running or jumping​. If left untreated, MTSS can progress to more serious conditions like stress fractures, so addressing the issue early is crucial.

Common Causes of Medial Tibial Stress Syndrome (MTSS)

MTSS typically develops due to repetitive stress on the shinbone. Here are some of the primary causes:

  • Excessive Training: Increasing your training intensity, distance, or duration too quickly can overload your shin and cause MTSS​.
  • Poor Running Form: Running with improper mechanics, such as a narrow gait, poor posture, or misalignment, can place added stress on the tibia​.
  • Foot Problems: Foot hyperpronation, or excessive inward rolling of the foot, can contribute to MTSS by creating additional strain on the tibia​.
  • Worn-out Footwear: Running or exercising in shoes that no longer provide adequate support or cushioning can exacerbate MTSS​.

Symptoms of MTSS

The primary symptom of MTSS is pain along the inner part of the shin. Other common symptoms include:

  • Dull or Sharp Pain: Pain along the shin, especially during or after exercise, particularly high-impact activities like running or jumping​.
  • Pain that Worsens with Activity: The pain usually increases during exercise and may subside after warming up, but often worsens after activity​.
  • Tenderness: The shin may feel tender to the touch, particularly along the inner edge of the tibia​.
  • Persistent Pain: If left untreated, the pain may persist even when at rest or after physical activity​.

How to Treat Medial Tibial Stress Syndrome (MTSS)

1. Rest and Activity Modification

Rest is one of the most important components of treatment. Reducing or stopping high-impact activities like running, jumping, or other intense exercises can help prevent further strain on your shin. Low-impact activities such as swimming, cycling, or elliptical training can be helpful substitutes to maintain fitness without aggravating the condition​.

2. Physical Therapy and Rehabilitation

A physical therapy program can help speed up your recovery and reduce the risk of reinjury. Key components of therapy may include:

  • Stretching: Stretching exercises for the calf muscles, tibialis anterior, and hip muscles can help alleviate tightness and improve flexibility​.
  • Strengthening: Strengthening the tibialis posterior, hip abductors, and other lower leg muscles can help support the tibia and reduce the likelihood of future strain​.
  • Gait Analysis: A gait analysis may identify any running form issues or mechanical problems that are contributing to the condition. Correcting these issues can help prevent future injury​.

3. Ice and Pain Relief

Using ice therapy can help reduce inflammation and manage pain. Apply an ice pack to the affected area for 15-20 minutes after physical activity. Ultrasound or electrical stimulation may also be used by a physical therapist to alleviate swelling and promote healing​.

4. Footwear and Orthotics

Wearing the right shoes is essential for treating and preventing MTSS. Ensure that your shoes offer proper cushioning and support for your foot type. If you have flat feet or foot hyperpronation, custom orthotics may be necessary to reduce strain on the shin​.

5. Gradual Return to Activity

Once the pain subsides and you are cleared to resume activity, it’s important to return to exercise gradually. Start with low-intensity activities, and progressively increase your mileage, duration, and intensity. Avoid running on hard or uneven surfaces early on in your recovery​.

Preventing MTSS from Recurring

To reduce the risk of MTSS returning, consider these preventive measures:

  • Gradual Increase in Training: Follow the “10% rule”—increase your training intensity, distance, or frequency by no more than 10% per week to avoid overloading your shin​.
  • Strengthening Lower Leg Muscles: Regularly perform strengthening exercises for your lower legs and hips to help support your tibia and improve overall muscle balance​.
  • Proper Footwear: Make sure your shoes are suitable for your foot type and provide adequate support. Replace your running shoes regularly (every 300-500 miles) to ensure they remain effective​.
  • Cross-Training: Incorporate non-impact exercises into your routine to give your shins a break from repetitive stress. Swimming, cycling, and other low-impact activities can help maintain fitness while reducing the risk of MTSS​.

Medial Tibial Stress Syndrome (MTSS) can be painful and disruptive, but with the right treatment plan, you can recover fully and prevent future injuries. By focusing on rest, physical therapy, proper training adjustments, and footwear, you can overcome MTSS and return to the activities you enjoy. If you’re dealing with shin pain, we’re here to help.

At Cole Pain Therapy Group, we specialize in treating MTSS and other musculoskeletal conditions. Our expert team provides personalized care to help you recover safely and effectively. Contact us today to start your recovery journey and get back to doing what you love.

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Dr. Daniel Smith, DC
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(901) 377-2340

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