Abstract
Medial tibial stress syndrome (MTSS), which also known as “shin splints,” is leg pain due to repetitive stresses. It is common among athletes, especially runners. It is estimated that up to 35% of all athletes have MTSS. As a consequence, the athletes spend less time in training and some of them refrain from exercises because of the exercise-induced pain, which adversely affects their career. The exact cause is still unclear. Some studies in the literature have suggested that the underlying mechanism is microdamage due to repetitive stresses. Risk factors include female gender, increased range of hip external rotation in males, navicular bone drop, increased body mass index, and training intensity. Patients usually complain of bilateral pain mainly in the anterior and/or medial side of their distal leg. Pain is aggravated by activity and relieved by rest. The examination may reveal swelling and tenderness, especially in the tibial posteromedial aspect along with other suggestive signs. Imaging modalities including radiographs, computed tomography, magnetic resonance imaging, and bone scintigraphy can be utilized to rule out other causes of similar presentation. Prevention is by repetitive stress avoidance, shock absorbing insoles, appropriate treatment of other stress-induced injuries, and screening for anatomical abnormalities. It is mostly treated conservatively with rest, ice and pain control. Athletes can keep training by doing different exercises that do not cause recurrent stresses. Surgery, which is rarely performed, is a treatment option in recalcitrant cases.
Published Version
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