Shin splints (medically called Medial tibial stress syndrome (MTSS) is defined by the American Academy of Orthopaedic Surgeons as “pain along the inner edge of the shinbone (tibia)”. Shin splints are a common injury that affects athletes who engage in running sports or physical activity, including running and jumping. They are characterized by general pain in the lower part of the leg between the knee and the ankle.

MTSS injuries are specifically located in the middle to lower thirds of the inside of the tibia the large inner bone of the lower leg. MTSS is most likely caused by repeated trauma to the connective muscle tissue surrounding the tibia. Shin splints can be attributed to overloading the lower leg due to bio-mechanical irregularities and an increase in stress exerted on the tibia. A sudden increase in intensity or frequency in activity level fatigues muscles too quickly to properly help absorb shock, forcing the tibia to absorb most of that shock. This stress is associated with the onset of shin splints Muscle imbalance, including weak core muscles, inflexibility and tightness of lower leg muscles, including the gastrocnemius, soleus, and plantar muscles (commonly the flexor digitorum longus) can increase the possibility of shin splints.

The main diagnostic criterion clinicians look at for shin splints are a physical examination and clinical history. The physical examination focuses on palpable, or gentle pressure, tenderness over a 4-6 inch section on the lower, inside shin area. The pain has been described as a dull ache to an intense pain that increases during exercise, and some individuals experience swelling in the pain area. Clinical history focuses on an individual’s previously history with MTSS. People who have previously had shin splints are more likely to have it again.