Medial Tibial Stress Syndrome or “shin splints” is a frustrating condition affecting millions of runners around the world each year. If you’ve ever felt achy, sore, or even burning discomfort along the inside of the shin bone, then you know it all too well. Today we’ll explain the research on this annoying running related injury and show you how to fix medial tibial stress syndrome (MTSS).
What causes MTSS?
Often, the pain of a running injury comes from one single tissue. If you have achilles tendonitis, for example, you feel the pain in the achilles tendon. Unfortunately, medial tibial stress syndrome is not that simple.
Although there is definitely variation between athletes, there are three different body systems that interact to cause the pain a runner feels in their shin. First, the tibia bone itself may have accumulated micro-trauma (minor structural damage to the bone) and be in the early stages of a stress reaction. A stress reaction is the first stage on a journey which can lead to a full stress fracture. Second, the periosteum (a membrane with lots of nerves that provides blood to the bones) around the tibia is also usually irritated, which can cause a runner to feel pain along the shin bone. And finally, the tendons of the lower leg, which run along the inside of the shin may also be overloaded and inflamed (summary of condition).
Long story short, some combination of the shin bone, the layer around the bone, and the tendons in the area are annoyed and sending pain signals to your brain. It is different with each athlete . This pain probably began to occur due to a combination of factors including training load, sleep, life stress outside of running, nutrition, and other things. Running injuries rarely happen for one simple reason.
How to fix medial tibial stress syndrome
Because Medial Tibial Stress Syndrome is different in each runner, most of the research done on MTSS has been of low quality and not produced treatments that drive consistent results (review). In fact, exercise therapy does not consistently beat other treatments, the way it does with almost every other running related injury. This makes sense, if an irritated tendon is the cause, strengthening exercises will be the best thing. If it’s a stress reaction, the a runner should rest. The trouble is in figuring out which is which or if something else may be going on.
Recover Athletics’ recommendations for runners with Medial Tibial Stress Syndrome:
- Temporarily reduce training load (total miles, pace, workouts), to see if things improve.
- Begin strengthening the muscles and tendons of the lower leg with the exercises shown below. There is never a downside in making your body stronger, and this may address the cause of your shin splints. Of course, this is different with each athlete.
- Ensure you’re getting enough calories & nutrients. In the offices of the world’s leading running researchers and physicians, any pain that involves a bone will often also involve speaking with a nutrition expert since bone health and nutrition are closely related.
- If things do not improve, please get checked out by a DPT or MD with expertise in running related injuries. If a bone stress injury is involved, they’ll be able to help you get back on track.
A simple exercise routine for medial tibial stress syndrome
Here are some exercises a runner could use to begin strengthening the muscles and tendons of the lower leg.
Exercise 1: Ankle Inversions with Resistance Bands
Why it works: This loads the muscles and tendons of the inner shin. This can be very beneficial if tendon problems are the source of your medial tibial stress syndrome.
Exercise 2: Calf Raises off Step
Why it works: the muscles of the calf intersect with tendons that may be involved in shin splint pain. Gradually making them stronger helps theses muscles process load better. Also, the health of this muscle is directly related to the health of the tibia. Improving one can help with the other.
Exercise 3: Standing Soleus Raises
Why it works: the tendons that attach to this muscle are almost certainly involved in any case of shin splints. Strengthening the soleus with this calf raise variation also helps improve the function of the entire lower leg.
You can try these exercises in the Recover Athletics app. The Recover App helps runners fix aches and pains and prevent injury. A year’s subscription costs less than one trip to physical therapist and we have an unlimited free trial. Give the app a try today!
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