It typically presents as tenderness and pain along the lower third of the inner shin. Despite how common the condition is, there appears to still be lots of misconceptions in the community about its causes and treatment.
The root cause is usually quite simple. When you run, each foot strike sends force up the leg. The area of bone affected in MTSS absorbs a significant portion of that impact.
If your running load suddenly increases without adequate time to recover, this part of the shin bone can become inflamed and painful.
If ignored this swelling can progress to a complete stress fracture; a serious injury which needs weeks of immobilisation.
Fortunately, treatment is often just as straightforward as the cause. Reducing your running volume for a couple of weeks and allowing more recovery time between sessions — ideally two full days, will ease the symptoms.
During this period, maintaining fitness through lower-impact activities like swimming, cycling, cross-training, or strength work is key.
Once pain subsides, a gradual return to running (starting on softer surfaces) using ice post-exercise, and building up volume steadily, will often prevent a recurrence.
In more persistent or severe cases, additional strategies are needed.
These can include investing in new footwear, modifying your running technique, using show orthotics/insert, improving ankle mobility, and targeting key muscle groups for strengthening.
So if scaling back your running doesn’t resolve your shin pain, it’s worth having your shins assessed by an experienced physiotherapist.
Pat Arnold is a director and sports physiotherapist at Echuca Moama Physiotherapy. Appointments with Pat and his colleagues can be made by phoning 5480 0860 or book online at echucamoamaphysio.com.au
