What is medial tibial stress syndrome? (By Gemma Crane, Podiatrist)
MTSS is often referred to as shin splints. It is a painful condition that occurs on the front edge of the tibia (shin bone), towards the lower end, that worsens with running. This is typically an overuse injury and depending on your level of activity and cause of the symptoms, treatment options can vary.
What causes medial tibial stress syndrome?
Intrinsic (muscle forces) and extrinsic (body weight and ground reaction forces) create stress on the bone and if our activity levels mean that we continually over-load the bone, a stress reaction can occur. This leads to unrepaired microdamage accumulation at the site of injury. This can be seen on an MRI, although most of the time this condition can be diagnosed accurately by clinical examination and history taking. High impact activities such as running, hopping and jumping are likely to trigger symptoms.
There are several reasons someone might develop MTSS, but often it is a result of an increase in the volume of running, or intensity of training without the capacity in the bone to cope with this. There may also be an underlying mechanical reason that could put you at risk. Certain rapid, rolling in movements of the foot, known as pronation can contribute to loading forces. Weakness of some muscle groups, especially the calves, quadriceps and gluteals are also thought to have an effect.
Other factors such as diet can also influence bone health. A condition affecting both men and women, called relative energy deficiency in sport (RED-S) leads to an increased risk of bone stress reactions. Adequate sleep and rest days should also be considered as research has shown that bone repair and strengthening occurs during these periods.
Treatment
Your clinician will base your treatment plan on your own individual needs and goals. In the first part of a recovery programme, you will be advised to refrain from high impact activity such as running and jumping. Once you are pain-free and able to tolerate short bursts of jogging on the spot or jumping, a return to running programme involving walk breaks can be introduced. Adequate sleep and rest days and an optimum diet must also be addressed.
Your clinician is likely to advise an exercise strengthening programme that focuses on building strength in the calves, quadriceps and gluteal muscles. This type of exercise also stimulates bone production and increases load tolerance. Subtle changes in your gait might also be advised, particularly increasing your step rate, to help prevent over-striding and your stride width. In-shoe supports called orthoses may be advised to help reduce the forces on the tibia. This is usually something that may only be required for a period of time rather than permanently.
A multi-disciplinary approach to your recovery may be advised involving physiotherapist, Podiatrist and sometimes dietician.
If you are suffering with foot or leg pain, get in touch to find out how we can help on 01933 594444, alternatively, you can book online at our booking page.
