STRESS
As fall sports gear up and (hopefully!) the humidity drops, it's the perfect time to get outside—whether you're lacing up for a run, hitting the soccer field, or playing a game of ultimate frisbee. But with all that activity comes the risk of some common overuse injuries—especially Medial Tibial Stress Syndrome (MTSS), which you might know by its old name: shin splints.
Why the New Name?
What we used to casually call “shin splints” has a more specific medical name now: Medial Tibial Stress Syndrome. The term was first introduced in 1982 by researchers Drez and Mubarak to better describe exercise-related pain along the shin bone (tibia).
Before that, “shin splints” was a catch-all term used by athletes and clinicians alike. But MTSS gives us a clearer understanding of the condition's cause and progression—and importantly, it highlights that this pain can be a warning sign of developing stress fractures. Today, MTSS is the preferred diagnosis in medical, academic and sports literature.
So, What Is Medial Tibial Stress Syndrome?
MTSS is an overuse injury most often seen in runners, but it can also show up in sports like soccer, lacrosse, gymnastics and dance. Athletes usually describe it as a sharp or aching pain along the inner edge of the shin bone, especially during or after running and jumping.
Common risk factors include:
· Sudden increase in training volume or intensity
· Poor footwear or worn-out shoes
· Improper running form or biomechanics
· Uneven surfaces
· Greater prevalence in females (especially adolescent athletes)
The underlying issue involves inflammation of the periosteum—the vessel-rich tissue surrounding your tibia (shin bone) —caused by repeated traction from muscles like the tibialis posterior and soleus, which play key roles in foot and ankle movement. If untreated, this inflammation can progress to microfractures, and in severe cases, full stress fractures requiring casting or even surgery.
How Do I Know If I Have MTSS?
A medical provider—whether it's your primary care physician, nurse practitioner, or physician assistant—can often diagnose MTSS based on your symptoms and physical exam. XRs may be utilized to rule out a fracture. Management of MTSS, however, is best managed by an orthopedic or sports medicine specialist for a more tailored treatment plan.
If you're experiencing shin pain and wondering if it might be MTSS, it is best not to “wait and see”. Easily schedule an appointment with one of our Orthopedic/Sports Medicine experts.
I Have MTSS. Now What?
Just like when you're feeling overwhelmed and need a break, your bones do too. The first and most important treatment for MTSS? Rest.
Allowing time for recovery is crucial. Pushing through the pain can worsen the injury and extend your recovery—or end your season altogether.
Treatment typically includes:
· Rest from pain-inducing activity (running, jumping)
· Cross-training with low-impact exercises (like swimming or cycling)
· Physical therapy or strength training to support proper biomechanics
· Gradual return to sport, guided by a medical provider
With proper care and early intervention, MTSS is highly treatable—and most athletes can make a full return to activity. The key is to listen to your body and give it the recovery time it needs.
KORTEBEIN, PATRICK M.; KAUFMAN, KENTON R.; BASFORD, JEFFREY R.; STUART, MICHAEL J.. Medial tibial stress syndrome. Medicine & Science in Sports & Exercise 32():p S27-S33, March 2000.
Physiopedia. 2023. Medial tibial stress syndrome. In Physio‑pedia. Retrieved August 6, 2025, from https://www.physio-pedia.com/Medial_Tibial_Stress_Syndrome
