Pain - Shin Splints Blog Series Part 3


Medial tibial stress fractures


It is described as pain along the tibia (shin bone) which is caused by a break in the continuity of the bone.


It is usually very common in activities involving running, impact and jumping sports. Limb and foot alignment and asymmetries between right and left can be the cause.

Clinical features

  • Pain is of a gradual onset, can correlate with an increase in training load
  • Pain can occur with walking, at rest or even at night
  • Local tenderness of the tibia
  • Foot examination can show a rigid foot with a high arch or a very flat foot
  • There may also be a leg length discrepancy
  • Gold standard for diagnosis is MRI and bone scan

Risk Factors

  • Running on rigid surfaces
  • Reduced cortical (bone) strength
  • Reduced cross-sectional area of cortical bone
  • Reduced muscle cross-sectional area

Treatment includes:

  • Initial period of rest
  • Use of a pneumatic brace
  • Once pain free walking and no bony tenderness, progress exercises
  • May need to start with low impact exercises like swimming or cycling
  • Can use soft tissue techniques to improve thickening around tibia
  • Correction of biomechanical abnormalities (especially with gait)
  • Modify footwear
  • Use of orthotics

If you are experiencing any of these symptoms, our experienced physiotherapists can help. Call us on 9361 3777 to make an appointment.