Shin or calf pain? It could be MTSS …..

Shin or calf pain? It could be MTSS …..

Medial Tibial Stress Syndrome (MTSS or Shin Splints) is a common overuse injury affecting athletes of all ages and fitness levels. 

It occurs when overworked deep muscles of the calf combine with excessive bending forces at the tibia during running, pulling on the lining of the bone causing inflammation (periostitis) and an eventual bone stress reaction.

Shin splints are characterised by:


  • A diffuse ache in the lower two thirds of the medial border of the shin
  • Pain coming on at the beginning of a run
  • Pain improving after warm up or “running it off”
  • Pain returning towards the end of the run
- A deep bruise-like tenderness on palpation
  • Insidious onset- increasing severity with each run
Shin splints can affect the inner and outer shin

MTSS refers to shin pain on the inside of the leg, but a similar condition can also affect the lateral shin.

Risk factors include:

  • Training overload
    Too much too soon, especially after a period of inactivity, insufficient rest between runs or inadequate warm up.
    Repeated impact on the same surface- try to mix it up between grass and road.
  • Poor biomechanics
    Insufficient or excessive midfoot/rearfoot pronation.
    Skeletal abnormality.
  • Overstriding in running gait.
  • Muscular imbalance
    Tightness/weakness of the leg, thigh, hip or core musculature. Check out this previous post for some simple calf stretches.
  • Inappropriate footwear
    Old, worn out shoes or shoes inappropriate for foot type. Check out Pure Performance, they are our preferred local provider for shoes when we treat clients with foot issues.

At Bodyworx Physio we will conduct a thorough and accurate assessment to determine the underlying cause of your shin pain and develop a rehab plan tailored specific to you.

Treatment options include:


  • Rest- between 2 and 6 weeks of complete rest from running is the single most effective treatment for shin splints to allow the tissues to heal.
  • Cycling, swimming and muscle strengthening programs are recommended before a gradual return to run program.
  • Dry needling- to release the muscles deep near the bone (Flexor Hallucis Longus, Flexor Digitorum Longus, Soleus and Tibialis Posterior) that directly contribute to symptoms.
  • Soft tissue massage either with the physio or our massage therapist.
  • Supportive/corrective taping.
  • Strengthening exercises and stretches to correct muscle imbalances.
  • Custom orthoses: we offer FREE computerised Gaitscan foot assessments that are used to make specifically moulded innersoles that are both comfortable and affordable. These support any biomechanical abnormalities, preventing re-occurrence of pain.
  • Footwear recommendation- advice on cushioning, support level and correct fit.

If shin pain has put a halt to your new year resolutions, or for more information, give us a call on (02) 4952 7033 and book an appointment today!

Contributed by Jackson Tisdell

Free Assessment Conditions Statement:

Free Assessment Session Conditions: New patients only, not redeemable for cash, there is no rebate chargeable for this session. Session includes assessment and written treatment plan constructed by a physiotherapist and any referrals deemed necessary. Please state if you wish to book this type of session when talking to reception. During this session you may elect to receive treatment if time allows, if so the session will attract the standard physiotherapy rates and private health fund rebates may be claimable on this session. Your therapist will notify you of any charges before treatment commences if you elect to receive treatment.

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