Common Conditions

Shin Splints

Symptoms, Common Causes and Treatments

What is Shin Splints?

Shin Splints, also known as Medial tibial stress syndrome (MTSS), is a common condition among long-distance runners and athletes in jumping sports. It is an overuse injury caused by repetitive loading on the tibia, along with excessive traction from the nearby leg muscles, e.g. soleus and tibialis posterior.

Symptoms of Shin Splints

The pain is located near the lower two-thirds of medial shin bone (tibia). It is usually worse after repetitive running and jumping, where the pain could persist for hours and days after exercising. The pain is usually coupled with soreness and tightness in the leg muscles.

Differential diagnoses

The first differential diagnosis is exertional compartment syndrome, which is described as an acute onset of extreme pain, heaviness and tightness in the leg upon exercising. This is due to excessive increase in muscle volume during exercise, placing a tremendous amount of pressure on nearby blood vessels thus lowering blood supply.

The second differential diagnosis is tibial stress fracture, which is thought to be the more serious stage of MTSS. Due to repetitive and excessive loading on the tibia, the bone is unable to regenerate and maintain the bone density. The structural integrity of the bone begins to break down, causing pain from weight-bearing.

An accurate diagnosis is highly important as it completely changes treatment approach.

Physiotherapy Management

Manual Therapy

Soft tissue massage is often done to muscles near the shin bone such as soleus and tibialis posterior to lower the traction on the bone. Furthermore, joint mobilisation could be done to loosen up stiffness around the ankle or knee joint to facilitate movement of the tibia.

Advanced Modalities

Current literature suggests that shockwave and ultrasound therapy could help relieve the inflammation around painful sites.

Exercise Therapy

Progressive strengthening of leg muscles such as tibialis anterior, tibialis posterior, soleus and gastrocnemius are highly important prior to return to running. Specific strengthening might be needed near the toes or hip joint if weakness is detected from assessment.

Biomechanical Modification

The tibia could be overloaded due to weaknesses or stiffness coming from another joint, e.g. hip or ankle. A thorough biomechanical assessment on running technique and footwear is usually indicated so underlying deficits could be addressed to prevent recurrences.

Education

Medial tibial stress syndrome is believed to be a load problem. Therefore, patient education on load management and progressive overload is crucial to aid a safe return to sports.

Testimonials & Reviews

After suffering years of chronic knee issues after ACL reconstructive surgery I was recommended to this clinic and the results were amazing. The centre does not only focus on pain relief but with an extremely holistic approach, assesses the root cause of pain and focuses on return to sports and performance once the pain diminishes. Most physiotherapy centres in Hong Kong do not even offer this level of attention to detail and service and would highly recommend to anyone having chronic pains or want to have proper post orthopaedic surgery rehabilitation!

Arnold Woo

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I had never been a believer in physio therapy in the past or that my experience with multiple chain medical physiotherapy center had brought me nothing but temporary improvements. Until I had came across mobilize physiotherapy where they take the extra mile to examine your situation and tailor a physiotherapy session. The physiotherapists at Mobilize not only identifies the root cause and provide massages for pain relievers but also to provide take home exercises for improvements. I was never rush out the door for the next session and they ensure that I had receive the right treatment before the session ends.
I would highly recommend this physiotherapy center.

Edmond Chan

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I came to them with chronic neck and knee issues, and they didn't just provide massage therapy. They took the time to thoroughly evaluate the source of my problems and develop a comprehensive treatment plan.
Through a combination of targeted hands-on therapy, customized strengthening exercises, and patient education, they helped me regain mobility and address the root causes of my pain. I learned the correct ways to strengthen the muscles and improve my posture to prevent future issues.
The staff is incredibly knowledgeable, taking the time to explain everything and ensure I understood how to continue my progress at home. Thanks to their expertise and dedication, I'm now pain-free and able to return to my regular activities without any limitations.

Arthur Liu

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Very professional therapy that doesn't only focus on passive treatment but also targets training of weak spots to improve overall performance and physiological sustainability.

Felix Lo

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Will was very professional. He was very thorough with the assessment and suggested different exercises for me to improve my condition. Recommended 👍🏾

Keith So

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I can't recommend my physio partner enough! They are always patient and provide valuable guidance to help me relieve chronic pain and improve my performance in jiu-jitsu. Their expertise has been invaluable to me. Highly recommended!

Felix Kung

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