SHIN SPLINTS - What is it?

  • 08 Jan, 2021

Shin Splits 

AKA Medial Tibial Stress Syndrome

Medial tibial stress syndrome (MTSS) is one of the most common lower limb running injuries in runners. It’s caused by repetitive stress on the shin (tibia) and surrounding musculature. Whilst considered a clinical pain syndrome it can be correlated with inflammation and remodeling of the tissue that surrounds the bone (the periosteum), tendinopathy and/or a stress reaction of the tibia. It presents as pain along the lower portion of the tibia.

MTSS, like many other running injuries – is related to load management. This means that it is often the result of doing too much, too soon.

The duration of the condition is often prolonged; ~3 months to run at a moderate intensity with minimal pain, with returning to running at a higher level taking even longer (up to 9-12 months).

Risk Factors for MTSS include:

  • Sudden increase in intensity, duration or frequency of exercise
  • Running on hard surfaces, uneven terrain or hills
  • Increased navicular drop (indication of arch collapse in weightbearing)
  • Overpronation
  • Increased body mass index
  • Fewer years of running experience
  • Previous history of MTSS
  • Female > Males
  • Increased hip external rotation and plantarflexion range of movement
  • Prior orthotic use


MTSS is best managed by graded exercises that load the tibia as well as calf strengthening. Improving hip abductor (Gluteus Medius/Minmus) strength also aids to reduce overpronation. Other considerations when managing shin splints include shock absorbing shoes, a graded return to running and not exceeding a 2/10 pain score when completing exercise. As with any other condition it’s important to work alongside a health professional when managing MTSS.