Shin Pain


Medial Tibial Stress Syndrome (MTSS)


MTSS is commonly known as “shin splints” and is an overloading injury causing pain in the inside of the lower part of the shin.

Your body is unable to heal and recover at a fast enough rate in response to repetitive muscle contraction and bending stress on your lower leg.



Your experience with MTSS will be different from every other person. What we know from pain research is that your pain will vary during our treatments together and that this is a normal part of your healing journey.

Typically, you will have an aching feeling in the lower, inside part of your shin brought on by exercise. The pain will often resolve with rest however as the condition becomes worse pain may be present with rest.


If you have flat feet, meaning you have little or no arch, you may experience foot pain or overpronation (inward rolling of the foot), some people with flat feet experience foot pain, particularly in the ankle, heel or arch area.


MTSS is caused by a bone stress reaction when the amount of load passing through your lower leg is greater than the bones and surrounding muscles can handle.

Factors that may contribute to the development of MTSS include:

  1. Training errors (increased intensity, duration, or frequency of training too quickly),
  2. Muscle weakness (calves, glutes, hamstrings, quadricep)
  3. Biomechanics during running
  4. Low bone mineral density
  5. High BMI

How Do We Treat Mtss?

We treat MTSS by four phases:

Pain management

Aim for pain free loading: HIGH PAIN NO GAIN

Reduce load in the damaged tissue.

This can be achieved by one or a combination of:

  1. Modifying training routine: cross training, reduce intensity or frequency or duration of training.
  2. Changing training surfaces
  3. Footwear changes or customised orthoses
  4. Gait retraining; increasing step rate or step width.
Reduce load in the damaged tissue.
Make the tissues stronger.

A strengthening program based on the muscles of your body which are weak and not functioning correctly to help reduce some of the load passing through the lower leg bones; commonly for MTSS this will include:

  1. Soleus
  2. Gastrocnemius
  3. Gluteal
  4. Progressive bone loading program

For help with shin pain, call us on 08 7120 6063 or book online with our experienced team at Leading Edge Podiatry.

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