(Medial Tibial Stress Syndrome)
|Muscles of the Lower Leg|
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- Improper stretching or failure to warm up before exercising
- Activities that involve repeated pounding of the legs on hard surfaces (such as running, basketball, or tennis)
- Increasing intensity of exercise or mileage of running without proper preparation and conditioning
- Worn-out or ill-fitting footwear
- Improper running technique or problems with the way the foot hits the ground when running
- A strength imbalance between two opposing muscle groups in the leg
- Flattened foot arches
- Running on a slope
- Pain on the inner side of the shin, described as aching or throbbing with local tenderness
- Swelling or redness of the shin (possible, but not common)
- Rest—Take a break from the activity that caused the pain. This is often enough to clear up the shin splint within a 10-day period.
- Ice—Apply ice in 15-minute periods during the first 24 hours after the injury and for several days after if needed. This helps reduce swelling, inflammation, and pain.
- Compression—Wrap the shin in an elastic bandage. This will help stop swelling and provide support for the shin and nearby soft tissues.
- Elevation—Keep the injured leg raised for the first 24 hours, including during sleep. If there is local swelling, this may help.
- Warm up gradually first and then do progressive stretching.
- Slowly increase intensity and duration of exercise.
- Cool down after exercise with light stretching.
- Run on a softer surface (such as grass, dirt, or certain outdoor tracks).
- Do not suddenly change from a softer running surface to a hard one.
- Carefully select footwear. Different shoes have different degrees of support and motion control.
- Avoid over-striding, which can put more stress on your shin.
- Wear orthotics if your doctor recommends them.
American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org
American Orthopaedic Society for Sports Medicine http://www.sportsmed.org
Canadian Society of Exercise Physiology http://www.csep.ca
Healthy Canadians http://www.healthycanadians.gc.ca
American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org . Accessed October 14, 2005.
Couture CJ and Karlson KA. Tibial stress injuries: decisive diagnosis and treatment of 'shin splints'. Phys Sportsmed . 2002 Jun;30(6):29.
Moen MH, Tol JL, Weir A, Steunebrink M, De Winter TC. Medial tibial stress syndrome: a critical review. Sports Med . 2009;39(7):523-546.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ . Accessed October 14, 2005.
Shin splints. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf . Accessed October 14, 2005.
Woods MJ. Frontera: Essentials of Physical Medicine and Rehabilitation . Philadelphia; Hanley and Belfus; 2002. Ch. 72.
Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst Rev . 2011;(7):CD001256.
- Reviewer: John C. Keel, MD
- Review Date: 09/2012 -
- Update Date: 09/28/2012 -