22/03/2025
🌟Shin Splints (MTSS): An Evidence-Based Physiotherapy Approach🌟
🔹 Ever treated a runner or an athlete with persistent shin pain? Chances are, it’s Medial Tibial Stress Syndrome (MTSS), commonly known as Shin Splints.
This overuse injury affects athletes, military recruits, and anyone increasing their physical activity rapidly. Without proper rehab, it can lead to stress fractures and prolonged pain.
🔬 Understanding MTSS
🔸 Pain Location: Diffuse pain along the distal two-thirds of the medial tibial border.
🔸 Risk Factors:
✔️ Biomechanical – Excessive pronation, weak tibialis anterior/posterior, tight calves.
✔️ Training Errors – Sudden activity increase, improper footwear, running on hard surfaces.
✔️ Bone Stress & Vascular Factors – Poor shock absorption, increased bone remodeling.
🩺 Physiotherapy Management: Evidence-Based Approach
1️⃣ Acute Phase (Pain Management & Load Reduction)
✅ Activity Modification: Reduce high-impact activities; cross-train (cycling/swimming).
✅ Cryotherapy & Compression: Ice (15–20 min, 3–4 times/day) + compression sleeves.
✅ Soft Tissue Mobilization: Deep tissue massage, myofascial release for tibialis posterior.
2️⃣ Subacute Phase (Biomechanical Correction & Strengthening)
🔥 Key Focus: Muscle Imbalances & Foot Mechanics
🔹 Stretching:
✔️ Gastrocnemius & Soleus stretch
✔️ Tibialis posterior stretch
🔹 Strengthening:
✔️ Tibialis Anterior & Posterior – Toe raises, theraband exercises
✔️ Intrinsic Foot Muscles – Short foot exercise, toe curls
✔️ Calf Muscles – Eccentric heel drops
✔️ Hip & Core Stability – Clamshells, glute bridges
🔹 Gait & Footwear Assessment:
🦶 Correct excessive pronation → Consider foot orthotics (short-term relief, per Moen et al., 2012).
👟 Ensure proper footwear with cushioning & arch support.
3️⃣ Return to Sport Phase (Progressive Loading & Functional Training)
🔹 Gradual Running Progression – Walk-run program, monitor pain response.
🔹 Plyometric & Proprioceptive Training – Hopping drills, single-l
