Medial Tibial Stress Syndrome (MTSS; Shin Splints; Medial Distal Tibial Syndrome, MDTS; Medial Tibial Syndrome; Stress-Related Anterior Lower Leg Pain; Spike Soreness)
Pronounced: me-d-ul tib-e-ul stress sin-drom
Medial tibial stress syndrome (MTSS) is exercise-related pain in the shins. It may be caused by an irritation of the tendons and muscles near the shin bones. MTSS is commonly known as shin splints. This injury is most often seen among runners.
Muscle and Bones of Lower Leg
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MTSS may be a treatable condition. Contact your doctor if you think you may have MTSS.
The exact cause is unknown. MTSS is called an overuse injury. It most commonly occurs from repetitive motion or stress at the shins. Causes may include:
These factors increase your chance of MTSS. Tell your doctor if you have any of these risk factors:
Participate in high-impact sports
Running Gymnastics Basketball Racquet sports Military recruits
Female runners with
(absent menstruation) and
osteoporosis Pronation of feet (feet turn inwards) Poor running surfaces Recent increase in workout or miles run Heel cord tightness
If you have any of these symptoms do not assume it is due to MTSS. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
Shin pain at a very specific point Pain when running Pain when bearing weight on the leg Pain after changing workout intensity or running surface Symptoms do not go away with rest Swelling
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist. For example, a sports medicine physician focuses on sport injuries.
The following test may be administered:
—test that uses radiation to take picture of structures in body, may be used to rule out a fracture
—test that uses tiny amounts of radioactive material and a camera to take pictures of bones; used to look for bone abnormalities; more sensitive than an x-ray
MTSS is treated with:
Rest Nonsteroidal antiinflammatory drugs (NSAIDs) Ice Crutches
may be given for severe pain
Arch supports and shock-absorbing insoles may be recommended When you feel better, slowly return to normal activities. Increase your activity level over several weeks.
Your doctor may suggest a different
pair of shoes
. A brace or walking boot may also be needed.
To help reduce your chance of getting MTSS, take the following steps:
Wear shock-absorbing insoles when running or during other high-impact exercise. Stretch before and after exercising. When starting a new sport or increasing your workout, do so gradually. Choose footwear that is best for the activity and your foot.
Last reviewed December 2008 by
John C. Keel, MD
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a
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EBSCO Publishing All rights reserved.