There are various causes for leg pain in active people.  One common diagnosis is called medial tibial stress syndrome, which many people know as shin splints.  For the sake of our average reader, we’re going to use the term shin splints for the remainder of this blog post.  Just keep in mind that the technical term is medial tibial stress syndrome and there are different locations for “shin splints”.  This blog post will refer to posterior shin splints (medial tibial stress syndrome).

leg pain

There are two bones in the leg.  The large one on the inside is called the tibia.  The small one on the outside is called the fibula.  Shin splints are usually characterised by pain and tenderness along the back-inside edge of the tibia.  As mentioned above, the pain is usually worsened with activities like walking and running but it can also be painless at rest.  Shin splints are an irritation and dysfunction of the junction where the soft-tissue inserts on the bone (the tibia).

When we suspect someone with shin splints, we have to consider other diagnostic possibilities.  Although diagnostic imaging isn’t directly necessary for shin splints, it can help to rule out other possibilities.  An example of this would be a bone scan to rule out a stress fracture, a common condition that can present with similar symptoms to posterior shin splints (medial tibial stress syndrome).

Shin Splints / Medial Tibial Stress Syndrome – Risk Factors

Some risk factors for shin splints (medial tibial stress syndrome) have been identified in the literature.  They are as follows…

  • High BMI (Body Mass Index) – Body mass index is a commonly used calculation in musculoskeletal research. It is derived from a ratio of body mass to height. A high BMI would suggest a person that is relatively heavy for their height. This is associated with the development of shin splints (medial tibial stress syndrome).
  • Decreased Internal Hip Range of Motion – A reduced ability to turn your hip inwards is associated with posterior shin splints (medial tibial stress syndrome).
  • Positive Navicular Drop Test – This is an orthopedic test performed by your knowledgeable practitioner. It tests the position / mobility of a bone in your foot called the navicular.
  • Increased Angle of Plantar Flexion – Simply put, if you can point your ankle down toward the ground a little further than your average person, you’re likely at risk for shin splints (medial tibial stress syndrome).

We treat medial tibial stress syndrome (shin splints) quite regularly.  Please don’t hesitate to call or email us for further information or to schedule an examination…we can help you!


Newman P, Adams R & Waddington G. two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test. Br J Sports Med 2012; 46: 861-864.

Moen MH, Bongers T, Bakker EW et al. risk factors and prognostic indicators for medial tibial stress syndrome. Scand J Med Sci Sports 2012: 22: 34-39.