Unveiling the Ache: Understanding Medial Tibial Stress Syndrome (MTSS) A.K.A Shin Splints

Unveiling the Ache: Understanding Medial Tibial Stress Syndrome (MTSS) A.K.A Shin Splints

Medial Tibial Stress Syndrome (MTSS), commonly known as shin splints, is an overuse injury affecting the lower leg. Characterized by increased pressure along the tibia (shin bone), MTSS manifests as pain along the inside and/or posterior part of the tibia. This condition often arises from a combination of physical activity changes, muscular imbalances, biomechanical issues, and external factors.


  • Increased Physical Activity or Overuse:
  • Engaging in running or jumping sports, particularly after a break or sudden program changes, can contribute to MTSS.
  • Muscular Imbalances:
  • Imbalances in the muscles of the lower leg may play a role in MTSS development.
  • Biomechanical Imbalances:
  • Issues in lower limb biomechanics can contribute to increased pressure on the tibia.
  • External Factors:
  • Running on hard or uneven surfaces and inadequate shock absorption in footwear can also be factors.

Management Strategies:

  • Ice Application:
  • Applying ice to the affected area can help alleviate pain and reduce inflammation associated with MTSS.
  • Calf Stretching:
  • Addressing calf tightness is crucial. Different stretching positions, such as straight-knee for the gastrocnemius and bent-knee for the soleus, should be incorporated to target all relevant muscles.
  • Glute Strengthening:
  • Muscle and biomechanical imbalances in the hip and pelvis can impact the lower leg. Strengthening the glute muscles contributes to correcting these imbalances.
  • Activity Modification:
  • If pain persists or worsens, reducing training load or activity levels to a more manageable intensity allows for continued activity while minimizing discomfort.

MTSS, or shin splints, can be a challenging condition, but understanding its causes and adopting a multifaceted approach to management is key. From ice application to targeted stretching and strengthening exercises, a comprehensive strategy enhances the potential for successful recovery. If you're experiencing persistent pain, consulting with a physiotherapist ensures personalized guidance to address your specific needs and facilitate a smooth return to pain-free activity. Stay tuned for our upcoming blog, where we'll explore advanced exercises for MTSS rehabilitation.

Andrew Huynh

Hi everyone, I’m Andrew and I head ESPR Therapy & Training. I’m passionate about helping people discover their potential and achieving their goals. For me, that means building resilience and strength (both physical and mental) in you to overcome whatever obstacles you’re facing. I completed my Bachelors in physiotherapy at the University of Sydney in 2017 which has taken me to both public and private sectors. A key highlight of my career is working within an elite NPL 1 soccer team which involved modifying training loads and integrating rehab programs to help athletes recover and return to the field ASAP. Over the years, I developed an interest in the area of strength and conditioning which led me to complete an internship at one of Sydney’s most renowned S&C gyms - Ethos Performance. From this, I learnt how to program training blocks so that athletes can gain the specific movement qualities that will enhance their sporting performance. I have also completed further study & training in pain science and dry needling which allowed me to understand and minimise patients symptoms. Outside of work, I train regularly in MMA and spoil my 2 beautiful pupperinos - Nala and Kira - to bush walks and hikes. If you have an injury or training goals, I’ve got your back!