Dr. Timothy Young Talks About Posterior Shin Splints (Medial Tibial Stress Syndrome)

Causes: Shin splints are common problem. These can either affect the front of the shin or the side of the shin (most commonly the medial or inside of the shin). A posterior shin splint is the inside of the shin or medial aspect that involves the posterior tibial muscle. The purpose of this muscle is primarily to stabilize the foot during the stance phase of gait and running. It is also one of the primary muscle tendon complexes to help limit and slow pronation. The most common individuals to have this problem are athletes and especially runners. It is not uncommon to have this problem from too much too soon (overtraining). But it can also happen from individuals to train very well but just have mechanics that put extra stress and an extra workload on the posterior tibial muscle. Therefore patients that pronate a lot are more prone to this problem. 

Diagnosis: This problem can range from muscle fatigue and overuse, to actual damage where the muscle attaches to the outer layer of bone (periosteum), to more severe cases that can become stress fractures. Diagnosing this can be done with physical examination. A stress fracture can be more difficult to diagnose and is often pinpoint pain over the tibia or shin bone.  It can be diagnosed in severe cases with an x-ray, or earlier onset cases can be diagnosed with a bone scan or MRI. Sometimes an ultrasound can be helpful also. 

Treatment:  Severe cases and stress fractures require a cast boot and rest.  Chronic non-severe cases respond to mechanical treatment and support that can include wearing good shoes. 

-Pronation control stability type of athletic shoes and avoiding going barefoot.   

-Stretching and icing after activities always helpful. Anti-inflammatories may just mask the problem. 

-Taping such as KT tape can be helpful.  

-You can also purchase a shin splints sleeve either at a local sporting goods store such as Dicks sporting goods, or online at Amazon.  

-Chronic and difficult cases are treated with prescription orthotics.   

-Shockwave therapy is another excellent treatment for chronic and difficult cases.  

If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today.