This is a common term for shin pain that is often experienced during running. It can be a misleading term and most sports medicine professionals try to avoid using it. This is because shin pain and ‘Shin Splints’ can be due to several different conditions. Medial Tibial Traction Periostitis (MTTP) is the medical term used to describe Shin Splints. It is an inflammatory condition of the front part of the shin bone called the tibia.
People suffering from MTTP will feel pain on the inner border of the shin (medial Tibial border) during and following exercise. It is important to distinguish MTTP from other causes of shin pain (‘Shin Splints’) such as Compartment Syndrome or a Tibial Stress Fracture.
MTTP typically presents with pain (dull ache) and palpable tenderness along the inside of the lower leg. At the beginning, you may experience pain early in running, which is relieved with continued activity. As the condition progresses pain may be present throughout the activity.
The pain experience with MTTP is caused by excessive pressure on the lower leg muscles. Running a lot on hard surfaces or increasing your training load too quickly is a common issue.
For the immediate treatment of symptoms Cold therapy is a very effective form of pain relief. Most patients respond well to non-operative treatment. This involves rest, strengthening and stretching exercises, followed by a gradual return to running after symptoms subside.
In order to help prevent recurrence of the condition, a bio-mechanical analysis (an analysis of posture at rest and during walking and running) with our Physios should be undertaken. This will pick up any factors that may be making a person susceptible to MTTP, so that they can be corrected before a return to activity.
Muscle imbalance and leg length inequality are frequent causes of mal-alignment that can be picked up during the Physiotherapy assessment. A common cause of Medial Tibial Stress Syndrome is Flat Feet. These would be identified during bio-mechanical analysis.
When the foot pronates at an increased velocity it puts pressure on the muscles along the front and side of the leg. This can cause overuse syndrome, stress fractures and ischaemic pain associated with increased compartmental pressure.
Arch supporting orthotics insoles can be very effective in remedying this problem (see biomechanics) but must be prescribed as there are many different types and some can make you worse rather than better. All cases of pain in the shin should be properly assessed by a Chartered Physiotherapist.