Overview of medial tibial stress syndrome
[NB1]
- Medial tibial stress syndrome refers to exercise-related posteromedial lower leg pain associated with repetitive stress to the bone (tibia).
- The syndrome is a continuum between ‘stress reaction’ in the bone, to ‘stress fracture’, to ‘complete fracture’.
- Management is nonsurgical and aims to reduce loading on the bone affected.
Note: NB1: This list is a summary guide only; refer to full text.
Medial tibial stress syndrome (formerly known as ‘shin splints’) is defined as exercise-related pain along the middle to distal posteromedial border of the tibia. Previously thought to be traction-induced tibial periostitis, more recent reports suggest ‘stress lesions’ may be associated with repetitive bone stress, which can also occur in other bones. The syndrome represents a continuum of injury including:
- stress reaction—a painful area of cortical bone weakness that occurs when repetitive stress weakens the bony trabeculae before strengthening occurs; this may be a precursor to stress fracture
- stress fracture—an undisplaced fracture associated with ongoing stress to weakened bone
- complete fracture—a formal bone break.