M is for Medial Tibial Stress Syndrome

November 26, 2012

Medial Tibial Stress Syndrome is the most common cause of shin splints or leg pain in runners.

Medial Tibial Stress Syndrome (MTSS), commonly known as shin splints, is a condition that causes pain and discomfort along the inner edge of the shin bone (tibia). The exact cause of MTSS is not fully understood, it is believed to result from a combination of factors related to running and biomechanics. The assumed risk factor of MTSS in runners include:

  1. Overuse and Training Errors: One of the primary causes of MTSS is overuse or repetitive stress on the lower leg. This can occur when runners increase their training intensity, duration, or frequency too rapidly without allowing adequate time for rest and recovery. Insufficient rest periods and excessive mileage can place excessive stress on the muscles, tendons, and bones of the lower leg, leading to MTSS.
  2. Biomechanical Factors: Issues with running biomechanics can contribute to the development of MTSS. These include factors such as overpronation (excessive inward rolling of the foot), inadequate foot arch support, abnormal foot or leg alignment, or muscle imbalances in the lower leg. These biomechanical abnormalities can lead to increased stress on the tibial bone and surrounding soft tissues.
  3. Poor Running Shoes: Wearing improper or worn-out running shoes that lack adequate cushioning and support can contribute to the development of MTSS. Inadequate shock absorption and lack of stability can increase the stress on the lower leg during running, leading to pain and inflammation.
  4. Surface and Terrain: Running on hard or uneven surfaces, such as concrete or uneven trails, can increase the impact forces on the legs and contribute to MTSS. Hard surfaces do not absorb shock as effectively, placing greater stress on the muscles and bones of the lower leg.
  5. Muscular Imbalances and Weakness: Weakness or imbalances in the muscles of the lower leg, such as the calf muscles (gastrocnemius and soleus), can affect the distribution of forces during running. When certain muscles are weak or overactive, it can lead to altered biomechanics and increased stress on the tibia, contributing to MTSS.
  6. Footwear Factors: Other footwear-related factors, such as improper shoe sizing or tightness, can also contribute to MTSS. Shoes that are too tight can restrict natural foot movement and increase pressure on specific areas of the foot and shin, leading to discomfort and pain.


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