Shin Spints, what are they?

MTSS 1Shin splints is a generalised term used to describe pain and inflammation in the front of the lower leg. However this type of pain can be caused by several different conditions and “shin splints” is generally related to a condition known as Medial Tibial Stress Syndrome (MTSS).

MTSS involves the posterior and anterior Tibial tendons/muscles and sometimes the peroneal tendons/muscles particularly peroneal longus.

MTSS is an overuse injury and can be caused by running on hard and uneven surfaces, running on tip toes and sports where a lot of jumping is involved. I f you over pronate then you are more susceptible to this injury. Over Pronation is a common problem  where the foot rolls inwards and flattens. This causes the lower leg to turn inwards which puts the knee and hip out of alignment and cause the back to twist also. Pronation  can lead to a number of other injuries.


  • Tenderness over the inside of the shin
  • Lower leg pain
  • Sometimes swelling
  • Lumps & Bumps over bone
  • Pain in the toes or foot when bent downwards
  • Redness over the inside of the shin
  • Pain starts with running or walking long distances and often settles on resting.
  • Often starts with a dull ache but quickly becomes sharper and more aggravated.

 Treatment of MTSS

  • Rest. The sooner you rest the sooner it will heal
  • Apply ice in the early stages when it is very painful and take anti inflammatory drugs such as Ibuprofen, but check with pharmacist first to make sure you can take them.
  • Wear shock absorbing insoles in shoes
  • Maintain fitness with non– weight bearing exercises.
  • Apply heat and use a heat retainer after the initial acute stage, particularly before training.
  • We can provide appropriate orthotics for your footwear.
  • Stretching, including:


Gastrocnemius stretch, keep the back leg on the ground and gently push forward. This will stretch the larger Gastrocnemius muscle which attaches above the knee. Hold for 20 seconds and repeat 3 times. This set of stretching can be done 3 times.soleus stretch

  • Soleus muscle stretch by bending the knee the gastrocnemius muscle is taken out of the stretch allowing the soleus muscle to be stretched further down the leg. If it hurts don’t do it. Hold stretch for 20  seconds and repeat 3 times. This can be done 3 times  a day providing it does not hurt.

Front of leg stretch

Front of leg stretch; kneel down and sit on your heels. Gently push down on heels to  stretch the front of the leg hold the stretch for 30 seconds and repeat 5 times

Prevention of MTSS

  • Increase training gradually. Do not run too often on hard surfaces. You can do more training if you run off-road.
  • Avoid running a lot on your toes. Not easy if you are a sprinter but varying the training surface can help.
  • Ensure you have the correct footwear and that it is not too old. A pair of running shoes will have lost most of their cushioning after 400 miles. If you run few miles but your shoes are over 6 months old then they still may need replacing.
  • Check you do not over pronate. See a podiatrist that can assess this.
  • Continue to stretch properly – especially the muscles at the back of the lower leg.
  • Get a regular sports massage. This will help keep the muscles of the lower leg supple and in good condition.
  • Apply ice to the shin after training. This may help keep inflammation down before it gets bad.