(Medial Tibial Stress Syndrome, MTSS; Medial Distal Tibial Syndrome, MDTS; Medial Tibial Syndrome; Stress-Related Anterior Lower Leg Pain; Spike Soreness)
How to Say It: me-d-ul tib-e-ul stress sin-drom
by Cynthia M. Johnson, MA
Shin splints (medial tibial stress syndrome) is shin pain from overuse or repetitive stress.
MTSS happens when muscles and tendons over the shin become irritated and inflamed. It is caused by a sudden increase in activity levels.
This problem is more common in people who do repetitive, high-impact activities, such as:
Other things that may raise the risk are:
The main problem is sharp or dull pain along the shinbone. Other problems may be:
The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the shin. This is often enough to make the diagnosis.
Images of the shin may be taken to check for other problems. This can be done with:
The goal of treatment is to manage symptoms and promote healing. Rest will be needed for several weeks. Other choices are:
People who do not get better with these methods may need surgery. This is not common.
The risk of this problem may be lowered by:
Ortho Info—American Academy of Orthopaedic Surgeons
Sports Med—The American Orthopaedic Society for Sports Medicine
The Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Robertson GA, Wood AM. Lower limb stress fractures in sport: Optimising their management and outcome. World J Orthop 2017 Mar 18;8(3):242.
Shin pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/shin-pain. Accessed February 18, 2021.
Shin splints. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/shin-splints. Accessed February 18, 2021.
Shin splints. Merck Manual Professional Version website. Available at:
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Accessed February 18, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT
Last Updated: 4/2/2021