Medial tibial stress syndrome (shin splints)

Medial tibial stress syndrome (commonly known as shin splints) is an overuse injury affecting the inner border of the tibia, the main bone of the lower leg. It is highly prevalent among runners, athletes who engage in repetitive jumping, and individuals who abruptly increase their physical activity levels. Pain typically onset during exercise and, in more advanced stages, can persist even at rest. 

This condition occurs when the muscles, tendons, and connective tissues inserting around the tibia exert excessive and repetitive tensile stress on the periosteum, the membrane covering the bone. Contributing factors such as training errors, biomechanical abnormalities, muscle strength deficits, or inadequate footwear can predispose individuals to this injury. 

How do we treat medial tibial stress syndrome? Pain along the inner aspect of the tibia.

Treatment begins with a comprehensive clinical assessment to identify the underlying causes of the condition.  We target not only the painful area but also the contributing factors maintaining the injury. 

Among the modalities utilized are: 

• Manual therapy to reduce muscle tension in the calf musculature and restore joint mobility to the involved structures. 

• Dry needling in cases where myofascial trigger points contribute to pain or muscular overload in the region. 

• Percutaneous neuromodulation to modulate pain perception and facilitate optimal neuromuscular function when indicated. 

• Percutaneous electrolysis in cases with associated tendinopathy. • Myofascial release techniques aimed at improving tissue quality and elasticity.• Radiofrequency therapy, utilizing high-frequency currents to produce a controlled temperature increase within the  

deep tissues. This application can enhance local blood circulation, improve tissue compliance, and contribute to pain reduction. 

• Functional taping or kinesiotaping as an adjunct therapy to reduce mechanical loading during specific activities. 

The importance of therapeutic exercise 

Currently, clinical scientific evidence highlights therapeutic exercise as one of the most critical tools in recovering from medial tibial stress syndrome. 

Consequently, we design individualized programs focused on: 

• Strengthening the calf, foot, and hip musculature. 

• Improving the load-bearing capacity of the tissues. 

• Correcting stability deficits and motor control impairments. 

• Optimizing running gait mechanics or sport-specific movement patterns. 

• Facilitating a progressive and safe return to physical activity.

Prevention of recurrence 

Recovery does not end when the pain subsides. Analyzing training habits, gait or running biomechanics, footwear, and the patient's physical capacity is essential to reduce the risk of re-injury and maintain long-term outcomes.

Our goal is not only to eliminate pain but to enable patients to return to their activities with confidence, safety, and the lowest possible risk of recurrence.