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(Medial Tibial Stress Syndrome)
Medial tibial stress syndrome (MTSS) refers to a painful leg and shin condition that causes pain on
the inside of the shin (the front part of the leg between the knee and
MTSS is commonly referred to as “shin splints” due to the
location of pain over the shin bone; pain can be felt on the inside or
the front of the shin bone.
You know, MTSS is one of the most common athletic
It affects both the muscle on the inside of the shin and the
bone to which it attaches, causing the connection between them to become
irritated or even develop minor tears due to overwork.
MTSS may affect
up to 35% of athletes who run and jump, such as
- distance runners (ie people who participate in marathons, biathlons)
- tennis players
personnel, dancers, and other active people also can develop MTSS.
Our senior physiotherapists help people who develop MTSS
- recover pain-free
- learn exercises and tactics to prevent reinjury
What is Shin Splints (Medial Tibial Stress Syndrome)?
Medial tibial stress syndrome (MTSS) develops when there is too much stress is
placed (once or repeatedly, as in with repetitive/cumulative strain) on the tibia (main shin bone).
The muscles that attach to the
tibia can cause an overload of stress on the bone, and strain themselves
at their insertion onto the bone as well.
These muscles include the
- posterior tibialis muscle
- soleus muscle
- flexor digitorum
The most common risk factors of MTSS include:
- Flattening of the arch of the foot (overpronation) while standing and walking/running (ie flat feet)
- Participation in a sport that requires repetitive jumping and/or running
- Excessive hip motion (moving the hip through a greater range than is typical)
- A high body mass index (>20.2 BMI)
- A previous running injury
How Does Medial tibial stress syndrome Feel like?
If you have developed MTSS, you may feel pain in the middle or bottom
third of the inside of the shin. The pain may be sharp when you touch
the tender area, or occur as an ache during or after exercise.
Typically, however, the pain is initially provoked with activity and
improves with rest.
When MTSS is developing in its early stages, the pain may be present
during the beginning of exercise and less noticeable as exercise
Over time, the condition will progressively worsen and pain may be felt
throughout any exercise regimen and continue even long after exercise.
How Is Medial tibial stress syndrome Diagnosed?
Our senior physiotherapists will perform a thorough examination that will
include taking a full health history and observing you as you walk and
perform the activity that causes your symptoms, such as running or
We will further perform a series of tests and
measures of your musculoskeletal system that assess your
- flexibility and
- pain response
The most reliable symptom of
MTSS is pain felt when pressure is applied to specific locations on the
If the results of the examination suggest MTSS, we will discuss with you the goals of treatment and develop a
specialized physiotherapy program for you.
If a more serious condition
could be contributing to your pain, you may be referred to an orthopedic doctor for further tests.
how our senior physiotherapists can help
We will determine what risk factors have caused
your MTSS and will teach you how to address those causes. A treatment
plan will be developed that is specific to you and what your body needs
to recover and to prevent reinjury.
To relieve pain, we may prescribe:
To help strengthen weak muscles, we may teach you:
- Exercises that increase the strength of hip rotation, hip abduction
(lifting the leg away from the other leg), and hip extension (lifting
the leg behind your body) to decrease stress to the lower leg
- Exercises that increase your arch and shin muscle strength to
decrease the overpronation (flattening out) of the arch of the foot
Your treatment also may include:
- Calf and foot muscle stretches
- Single-leg exercises including squats, reaching exercises, or heel raises
- Modified take-off and landing techniques for jumping athletes
- Modified leg and foot control during walking and running
- Suggestions for footwear that provides better support when walking or exercising
We also may prescribe orthotics or shoe inserts
that support the arch of the foot if your feet flatten out too much, or
if your foot muscles are weak.
Our senior physiotherapists help athletes with medial tibial stress syndrome alter their training
schedules to safely return to sport, and offer specific guidance for
reducing the possibility of reinjury.
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trained, qualified, experienced and passionate to provide high level of
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Patients who sustained injuries to their elbows, forearms, hands, wrists
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following injuries or post-operations as well as custom made hand splints.
Commonly treated hand pain injuries includes
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Clinical Pilates is a form of physical exercise that focuses on posture,
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See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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