Medial tibial stress syndrome (MTSS), also known as shin splints, is an overuse injury that frequently occurs in runners. The pain associated is presented over the anterior tibia, commonly known as the shin. If you’ve experienced or are currently experiencing shin splints, you may be wondering why? You might think that you’re warming up well or you’ve been running for some time and the pain has come out of nowhere. Let’s discuss the reasons behind it as well as ways to help! Some risk factors include:
Large (and/or sudden) increases in load, volume, or high impact exercise
Reduced range of motion or weakness of hip external rotation
Calf muscle weakness or inflexibility
Weakness of the medial longitudinal arch (inner arch of the foot)
Due to the risk factors above, stress is put on the anterior tibia. If left untreated, microdamage accumulates and presents as pain.
Large increases in load, volume, and high impact exercise without proper training doesn’t give the surrounding musculature time to adapt to this increase. The lack of adaptation may cause greater stress on the muscles leading to added stress on the bone.
A reduced range of motion or weakness of hip external rotation causes a knee valgum, which is when the knee collapses inwards causing overall misalignment of the leg, ultimately leading to an increase in stress on the tibia.
Weakness or inflexibility of the calf muscles means they can fatigue early and cause other, smaller muscles in the front of the leg to take over. These muscles are not used to the increase in load and may stress the anterior tibia overtime.
The inner arch of the foot is supported by the posterior tibial tendon, ligaments, plantar aponeurosis, and the flexor hallucis longus and brevis muscles. When there is weakness or injury to any of these structures, the arch becomes “flattened” and is known as pes planus (AKA flat feet). When the arch is not supported, it puts a strain on those muscles which puts stress on the tibia.
After going through all the ways shin splints may occur and feeling as though you can do nothing to fix them, here are some exercises to help. !
When talking about increasing range of motion and strength of hip external rotation, try these stretches and exercises out:
Piriformis stretch
Single leg banded knee hold
Calf flexibility and strength can be helped with the following exercises:
Knee to wall lunge stretch
Raised single leg calf raises
Lastly, strengthening of the muscles supporting the inner arch of the foot include:
Ball between heels raises
Arch raise
In the end, there is much more that goes into shin splints than just the shins. Running involves many different mechanisms of movement and each should be focused on for stretching and strengthening. Check out our instagram post on April 11 to see how to complete all of these exercises!