Medial Tibial Stress Syndrome: A Runner’s Guide to Overcoming Shin Splints with Up N Adam Performance Training and Physiotherapy

As a runner, medial tibial stress syndrome (MTSS), or shin splints, can be a frustrating roadblock, affecting up to 35% of runners. At Up N Adam Performance Training and Physiotherapy, we’re here to help you conquer MTSS with cutting-edge, evidence-based care tailored specifically for runners. Our latest blog dives into what MTSS is, the muscles and tendons involved, its causes (including running biomechanics), and a sneak peek into our best-practice physiotherapy rehab approach. Read on for a taster of how we’ll get you back to pain-free running!

What is Medial Tibial Stress Syndrome (MTSS)?

MTSS is an overuse injury causing pain along the inner border of the shin bone (tibia), often triggered by repetitive stress on the bone, periosteum, and surrounding muscles. It’s common in runners who increase training too quickly or have biomechanical issues. Left unchecked, it can progress to stress fractures, so early intervention is key.

Muscles and Tendons Involved

MTSS affects the deep posterior compartment muscles, including:

• Tibialis posterior: Stabilises the arch and controls pronation.

• Flexor digitorum longus (FDL): Supports the arch and flexes the toes.

• Soleus: Absorbs impact during running.

These muscles’ tendons pull on the tibia’s periosteum, and overuse can irritate this tissue, causing pain. Dysfunction in these muscles increases tibial loading, contributing to injury.

Causes of MTSS: Direct and Indirect Factors

Direct causes include repetitive overloading, traction stress from tendons, and tibial bone stress. Indirect causes involve:

• Training Errors: Sudden mileage spikes or consistent road running.

• Biomechanics: Overpronation, excessive ankle eversion, pelvic drop, &/or weak hips.

• Intrinsic Factors: Higher BMI, female gender, or previous MTSS history.

A Taster of Our Best-Practice Physio Rehab at Up N Adam

At Up N Adam Performance Training and Physiotherapy, we don’t just treat symptoms—we address the root cause of your MTSS to ensure lasting recovery and prevention. Here’s a glimpse of what our expert physios will do to get you running pain-free:

• Slo-Mo Video Analysis of Run Technique

We use state-of-the-art slow-motion video analysis to assess your running form, pinpointing biomechanical issues like overpronation, excessive pelvic drop, or inefficient foot strike. We’ll discuss specific changes, such as increasing cadence or adjusting foot placement, to reduce tibial stress.

• Strength Testing

We conduct targeted strength assessments to identify weaknesses in key muscles like the soleus, tibialis posterior, or gluteus medius. This helps us tailor a program to address imbalances contributing to MTSS.

• Treatment to Settle Tight and Irritated Tissue

Our hands-on treatments, including soft tissue massage, myofascial release, dry needling or kinesiology taping, target tight calf muscles and irritated shin tissues to reduce pain and improve mobility.

• Further Investigation if Needed

If we suspect a bone stress injury (e.g., a stress fracture), we’ll refer you for imaging (like an MRI or bone scan) to confirm the diagnosis and guide treatment.

• Smart Load Management

We rarely stop running altogether. Instead, we adjust your training to an appropriate level based on your diagnosis, ensuring you stay active while healing. Think reduced volume or cross-training like swimming to maintain fitness.

• Sports Podiatry Referral

If foot mechanics or footwear are contributing, we’ll refer you to a trusted sports podiatrist for custom orthotics or shoe recommendations to optimise your biomechanics. We have close ties with Kurt Robertson & his team at Newcastle Podiatry https://newcastlepodiatry.com.au/

• Comprehensive Strength and Stretching Program

We design a personalised program to “fix” the problem, not just mask it. Expect exercises like eccentric calf raises, hip abductor strengthening, and targeted stretches to address weaknesses and improve flexibility. Our goal is long-term resilience, so you run stronger and prevent recurrence.

• Why Choose Up N Adam?

Our team combines expertise with a passion for helping runners thrive. We use the latest research and technology to deliver individualised care that goes beyond a quick fix. Whether you’re a beginner or an elite runner, we’re committed to getting you back on the trails or track—pain-free and stronger than ever.

Ready to Run Pain-Free?

Don’t let shin splints hold you back! Book an appointment with Up N Adam Performance Training and Physiotherapy for a thorough assessment and a tailored rehab plan. Visit https://www.upnadamptphysio.com/ or call us on 40677137 to start your journey to recovery.

References:

• Ramteke SU, Jaiswal PR. Physical Therapy Perspectives for Medial Tibial Stress Syndrome in a Novice Runner: A Case Report. Cureus. 2024.

• Rehabilitation Management of Medial Tibial Stress Syndrome in Recreational Runners: A Narrative Review. Crimson Publishers.

• Biomechanical characteristics of the lower extremities during running in male long-distance runners with a history of medial tibial stress syndrome. BMC Musculoskelet Disord. 2023.

• Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. MDPI. 2020.

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com

Bookings also available on our website for:

• Dietitian - Sweat testing, weight-loss or to optimise your training nutrition / fueling

• VO2 Max testing - to discover more effective ways to train efficiently

• Strength & Conditioning Programs - contact us via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage - to relieve accumulative muscle tension & keep you training well.