Patricia Griffin Kellicker, BSN
Medial tibial stress syndrome (MTSS) is pain in the shins. It is the irritation of muscles, tendons, and other tissue of the lower leg. MTSS, or shin splints, are most common in those who do intense exercises like runners or military personnel.
MTSS is most often caused by a sudden increase in the intensity or frequency of exercise. The muscles and tendons over the shin become irritated and inflammed. Both the inflammation and the pressure it creates cause pain.
MTSS is more commonly found in people who participate in repetitive high impact sports, such as:
Other factors that may increase your chances of MTSS:
MTSS symptoms can worsen over time without rest. Early symptoms may pass faster with rest shortly after activity. As MTSS becomes more severe, symptoms will last longer even with rest. It will take longer for severe symptoms to resolve.
MTSS may cause:
Pain may be throbbing, aching, or sharp.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis can be made on this information.
Imaging tests may be done to rule out other problems, such as a fracture. An x-ray or bone scan may be used to rule out damage to the bone.
Treatment focuses on comfort measures to reduce inflammation and ease pain. Rest is the main part of treatment. Ice, compression, and elevation may also be used during recovery.
Other treatment methods may include:
Rarely, surgery may be needed if other treatment methods do not work. However, it is unknown if surgery is an effective treatment for MTSS.
To help reduce your chances of MTSS:
Ortho Info—American Academy of Orthopaedic Surgeons
Sports Med—The American Orthopaedic Society for Sports Medicine
The Canadian Orthopaedic Association
When it Hurts to Move—Canadian Orthopaedic Foundation
Shin pain. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T115559/Shin-pain#sec-Medial-Tibial-Stress-Syndrome-Shin-Splints. Updated March 23, 2015. Accessed February 21, 2017.
Shin splints. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.org/topic.cfm?topic=a00407. Updated May 2012. Accessed February 21, 2017.
Shin splints. Merck Manual Professional Version website. Available at:
http://www.merckmanuals.com/professional/injuries-poisoning/sports-injury/shin-splints. Updated October 2014. Accessed February 21, 2017.
Last reviewed December 2016 by Michael Woods, MD, FAAP
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