(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—not common
- Rest—Take a break from the activity that caused the pain. This is often enough to clear up the shin splint within several weeks.
- Ice—Apply ice in 15-minute periods during the first 24 hours and for several days after if needed. Do not apply ice directly to the skin. This helps reduce swelling, inflammation, and pain.
- Compression—Wearing an elastic compression bandage may help prevent 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 the 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.
- 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
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.
Shin splints. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00407. Updated May 2012. Accessed December 16, 2013.
Shin splints. American College of Foot and Ankle Surgeons Foot Health Facts website. Available at: http://www.foothealthfacts.org/what-is/ns%5Fshin-splints.htm. Accessed December 16, 2013.
Shin splints. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 3, 2012. Accessed December 16, 2013.
Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database Syst Rev. 2011;(7):CD001256.
- Reviewer: Peter Lucas, MD
- Review Date: 12/2013 -
- Update Date: 12/16/2013 -