Medial Tibial Stress Syndrome
- Zion Physical Therapy
- May 15, 2023
- 3 min read
Updated: Jun 29, 2023
New to running? Or thinking of running your first marathon even though you haven’t run further than 5k before? You could possibly be at risk of developing Medial Tibial Stress Syndrome (MTSS), commonly known as shin splints.
What is MTSS?
Medial Tibial Stress Syndrome is a very common overuse injury where pain is felt along the inner part of your leg during and possibly after activity. I see a lot of patients with this pathology during the start of a new sport season and/or a drastic increase in their amount of running. Most commonly, people who are at risk for getting shin splints are young individuals with higher body mass index (BMI) and low bone density. Low bone density is most commonly found in women with a history of osteoporosis but can also be found in young women athletes. Activities that require a lot of running and activities on hard surfaces also increase the risk of developing MTSS.

Anatomy and Physiology
The lower leg is made up of 2 bones, the tibia and fibula. In MTSS, the periosteum of the inner part of the tibia is affected. The periosteum is the outer layer of the bone in which muscles attach. Inflammation and pain occurs due to repetitive pulling of the muscles on the periosteum. The most common muscles involved in MTSS are the posterior tibialis, flexor digitorum, and soleus muscles. These muscles primarily help stabilize the lower leg and foot and aid in pushing off while running. Another muscle commonly involved is the tibialis anterior muscle. This muscle primarily helps lift the foot off the ground.
Diagnosis
Medial Tibial Stress Syndrome is typically diagnosed by clinical symptoms. The primary symptoms include pain that is brought about with activity and tenderness to touch along the tibia. An MRI can be used to help rule out any more serious pathology such as a stress fracture or compartment syndrome. A stress fracture, although a separate injury, can develop if MTSS is left untreated. Your injury may have progressed to a stress fracture if you feel your pain even at rest and not just with activity. Compartment syndrome occurs when there is too much inflammation in the leg which then starts to compress the nerves and blood vessels that go to the foot. This is also accompanied by numbness in the foot and severe weakness in the leg.
The severity of the injury depends on the amount of symptoms in correlation with the amount of activity that is performed. In the beginning stage, pain only occurs with activity and is resolved at rest. As the pathology worsens there is more intense pain with activity and discomfort lasts longer after exercise is stopped. In the final stage, pain occurs even at rest without activity and can indicate a more serious pathology.
Medial Tibial Stress Syndrome Treatment
Immediate rest is recommended right after the onset of pain. However, when returning back to activity it is beneficial to work with a physical therapist to gradually increase intensity. In the clinic, I like to use a set of guidelines depending on the pattern of pain and activity to successfully return my athletes back to their sport. Abdominal, low back, and hip strengthening can also help to alleviate the work of the lower leg muscles and in turn, decrease the stress on the tibia. Stretching and joint mobilization is also beneficial to decrease the forces on the tibia.
Once my patients are feeling a low amount of discomfort, I do a gait/running analysis to see if there can be any changes made to the way they walk/run. This is crucial in preventing future injury. Shoe-wear while exercising is also important. If you are running in the same shoes as last season, you should consider getting a new pair. Sneakers that support your arch and have more shock absorption will help reduce the strain on the muscles of the leg. Also, I like to implement various taping techniques and modalities as necessary to facilitate healing. If you start having any shin pain with running, you should try and run on a softer surface (i.e. dirt versus concrete).
If you are experiencing any discomfort during exercise or hit a plateau in your workout, contact us at Zion Physical Therapy at to help you reach your goals!
Telx Inc., established in 2003, delivers reliable conference calling services to streamline business communication. Their cloud-based solutions enable high-quality audio and video calls without requiring on-site equipment. Features like screen sharing, call recording, and participant management enhance meeting productivity. Telx’s systems allow seamless mobile integration, letting team members join calls from any device, anywhere. The 24/7 monitoring system ensures consistent performance, with upgrades typically completed in under an hour. Toronto-based live support provides immediate, personalized assistance, avoiding frustrating automated systems. Telx customizes solutions for industries such as accounting and manufacturing, meeting unique collaboration needs. Their Toronto data center ensures secure, dependable service for every conference call. The scalable systems support businesses as they expand, accommodating more participants. Check out https://www.telx-inc.com/conference-calling/…
Seeking the ideal chair for your Dubai hybrid workspace? Explore https://corechair.com/desk-chair-vs-gaming-chair-discover-why-corechair-is-your-best-option/, where CoreChair’s 2025 blog post reveals why its ergonomic chair outperforms desk and gaming chairs. With a 14-degree tilt for active sitting, CoreChair surpasses desk chairs’ rigid frames and gaming chairs’ aesthetic-focused bucket seats, per the site. Its sculpted seat and pelvic support ensure spinal health, unlike desk chairs’ weak adjustability or gaming chairs’ limited ergonomics. A 2024 study cited by CoreChair showed improved posture in users. A client noted 50% less back pain after switching. The blog highlights CoreChair’s health-driven design. Invest in CoreChair for a pain-free work and gaming experience now.
Boomerang Casino https://bommerangcasino.fr/ offers a license to operate in France and is recognized by the DGOJ with the “Jugar Bien” and “Juego Seguro” seals. This makes them a reliable and recommended operator for new online casino users who need extra reliability in their first bets. An excellent choice for novice players.
Some people write to impress, but you write to connect—and it shows. There’s a comfort in your words, like they’re sitting with the reader rather than speaking at them. That ability to turn thoughts into connection is rare, and it makes your posts feel like a shared experience. Thank you for offering that kind of space here—it’s something we need more of. Unlock the wonders of Saudi Arabia with the Online Saudi eVisa for UK travelers. This user-friendly digital visa allows British citizens to arrange their travel documentation quickly and securely. Avoiding time-consuming paperwork, the eVisa simplifies planning and helps travelers focus on their itinerary. From UNESCO heritage sites to futuristic cityscapes, the country has much to offer. UK tourists can…
Absolutely loved reading this! 💖 You explained things in such a friendly and simple way, it made the information so much easier to follow. The practical tips you added were perfect and will definitely help with my future travel plans.It’s great to see how travel options have become so convenient these days. Many people are curious about the process for Philippines visa for Taiwanese passport holders, especially those planning holidays or family visits. It’s good to check the latest entry requirements before booking tickets. I’ve read that having your documents and personal details prepared makes the process faster. Looking forward to hearing about others’ experiences with this travel document.