Shin pain (Medial Tibial Periostitis)

The term ‘shin splints’ is often used by athletes to describe pain along the length of the tibia (shin pain). There are many causes of shin pain, therefore the broad term of shin splints is not in itself accurate and is now considered outdated in the medical field.

Causes of shin pain include compartment syndrome, which we look at under its own heading, nerve entrapment, vascular insufficiency, inflammation and bone stress.

A physiotherapist will be able to differentially diagnose the cause of shin pain in patients through a thorough clinical examination.

This section will focus on a very common cause of shin pain among athletes, often mistakenly called shin splints, and that is medial tibial periostitis. This is the medical term for bone stress in the tibia without the presence of a fracture. Medial tibial periostitis most commonly affects runners.

Symptoms of medial tibial periostitis are:

  • Diffuse pain along the inside length of the shin
  • Pain is strong at the start of running, it then eases with warm up but gets worse after exercise has finished
  • Pain is usually longstanding and has worsened over time

The cause of medial tibial periostitis can be any of the following:

  • Overpronation of the feet (flat feet)
  • Poor running technique
  • Unsupportive or inflexible running shoes that create poor biomechanics
  • Low bone density
  • Muscle dysfunction
  • Inappropriate running surface

Our aim with physiotherapy treatment of patients with medial tibial periostitis is to help you return to running pain-free. We focus on immediate pain relief through any number of our treatment modalities including ice, heat, ultrasound and electrical stimulation. Taping the foot to prevent pronation and advice on correct footwear once we have assessed your foot posture can help with long-term pain relief. We will also correct any muscle imbalances that may be contributing the medial tibial periostitis through a regimen of passive stretching and muscle strengthening exercises and we will design an individual cross-training exercise programme for you, to maintain your fitness until you can run again. This may include bike riding, swimming or weight training to name a few. As your rehabilitation progresses, you can gradually resume running while still under our care.