Sydney Sports Podiatry
Shin Pain / Shin Splints / Medial Tibial Stress Syndrome (MTSS)
Shin splints is a common sports injury characterised by pain on the lower two-thirds of the posterior-medial tibial border (the inner edge of the leg bone). The pain is typically non-focal and extends over a distance of more than 5cm, usually affecting both legs. Pain may be present at the beginning of exercise, disappear (or worsen) during activity, and then return as the body cools down, sometimes lasting for several hours.
Factors contributing to shin splints include:
- Biomechanical factors, such as over-pronation or rigid high arches
- Overuse or training load errors (“too much, too soon”)
- Running or jumping on hard or uneven surfaces
- Muscle strength imbalances or tightness
- Leg length differences
- Inappropriate footwear

There are three primary structures affected by shin splints:
- Muscle: The tibialis posterior muscle runs along the inner border of the tibia (leg bone) and plays a key role in controlling pronation (rolling-in) and supination (rolling-out) of the foot during gait and running. If this muscle is excessively loaded, it may contribute to the development of shin splints.
- Periosteum: This is the outer layer of the bone where the muscle tendon attaches. When the tendon is excessively loaded, the periosteum can become inflamed.
- Bone: The tibia (leg bone) can undergo stress reactions, which may progress to stress fractures in serious cases if not managed appropriately.
Management – Strategies for Recovery
Initial Self-Management:
- Rest: Allowing the affected structures time to recover.
- Ice and Compression: To assist in managing localized discomfort.
- Activity Modification: Reducing training load after sufficient rest or opting for low-impact activities, such as cycling, instead of running.
Clinical Support at Sydney Sports Podiatry:
Our podiatrists provide a comprehensive approach to managing shin pain. Depending on the results of your clinical consultation, your management plan may include:
- Biomechanical Assessment: To investigate the underlying factors contributing to your shin pain.
- Load Management: Utilising foot taping to offload affected structures and providing activity modification advice.
- Rehabilitation: Tailored strengthening and stretching plans focused on the lower limb.
- Clinical Therapies: Dry needling, massage, or Shockwave Therapy, where clinically indicated.
- Orthotic Therapy: The prescription of custom orthotics to support foot mechanics and manage load.
- Footwear Assessment: Recommendations for appropriate athletic footwear based on your foot type and activity level.



