Medial Tibial Stress Syndrome (MTSS), commonly referred to as “shin splints’, is undoubtedly an issue
any clinical healthcare practitioner has spent time addressing when someone complains of lingering
lower leg pain. Male or female, high school or collegiate athlete, the weekend warrior, avid runner – the
populations affected by MTSS is immeasurable. Not only can MTSS affect a multitude of athletic
individuals, but the root cause has a lengthy list of culprits. Thus, the term “shin splints” is used as a
catch-all term.
For a long time, MTSS was looked at and treated primarily as a soft tissue issue. If someone said they
had “shin splints”, the default and appropriate response was, “you need to stretch your calves more!”.
With further research, this response is not always accurate. Although a potential cause of MTSS is
dysfunction of the triceps surae muscle group (the calf muscles), stretching the calf muscles is not the
be-all and end-all with what we know now. A clinical healthcare practitioner needs to look broader to
better understand and treat MTSS.
From a soft tissue perspective, any previous or current tendinopathy or periostitis could be a
contributing factor to MTSS pain. However, it is important to consider the bevy of external factors that
can have an impact on this pain such as poor footwear, doing activity on hard or inclined surfaces, and
an increase in training intensity or duration. All of these external factors must be considered when trying
to identify the culprit for this pain. However, additional risk factors also need to be identified for
someone suffering from MTSS: genu valgus/varus of the knees, excess tibial torsion, femoral
anteversion, or foot and arch abnormalities, are some internal factors that a clinician should identify,
just to name a few.
Determining the cause of pain such as MTSS is a reminder that no one case may be the same. As a
healthcare clinician, we must consistently ask questions and dig deeper. Be sure to utilize the feedback
provided by our patients and athletes. If an individual is not making progress in a timely manner, a
crucial detail may be missing, or a parameter of the rehabilitation needs to be adjusted. Although a
typical day in the life of a clinical healthcare practitioner is playing “detective”, it is important to
consider the signs, symptoms, and causes of MTSS with the spring season around the corner!
Learn More About MTSS from JAG Physical Therapy
Ready to understand and treat your leg pain effectively? Schedule a consultation with JAG Physical Therapy today. Let our experts guide you on the path to recovery and optimal performance!