What is Medial Tibial Stress Syndrome?

If you’ve been running for even ten minutes and have throbbing leg pain, you may have something called, medial tibial stress syndrome. Here’s a breakdown of that shooting pain you’re feeling. 

Medial tibial stress syndrome, also known as “shin splints,” is a common, but painful condition where you feel pain in the tibia while running. Typically it’s due to overuse and occurs during repetitive activities, like running, jogging, and even jumping. The pain can intensify for chubby or overweight runners who have started a training program where there is increased mileage or speed training. This syndrome is very common for runners, and more often in women.

shin splints
For more info, read Shin Splints

Causes of Medial Tibial Stress Syndrome

Medial tibial stress syndrome happens when there is inflammation or irritation where calf muscles attach to the shin bone. It’s common for it to happen when running uphill or downhill. Sometimes it can be caused by improper or overused shoes. The most common cause is a sudden increase in running like when starting a half marathon training program.  

Higher risk of Medial Tibial Stress Syndrome

People who are at higher risk for this injury include those with issues around ankle and foot alignment and weakness in lower extremities. Many times this manifests in younger people with high body mass index and low bone density. These factors combined with improper shoes, or an increase in training duration or intensity can increase the likelihood of pain. 

Symptoms of Medial Tibial Stress Syndrome 

The most common symptom is pain in the shin bone. Like any other injury, pain can range from a mild dull ache to excruciating pain. The pain is typically located along the inside of the shin bone, from the middle to the lower section of the shin. Sometimes the pain occurs at the beginning of a run but becomes more manageable as you continue to run. The good news is that the shin pain subsides when you stop running and rest. There are more severe cases, where the pain continues all day, even when you’re not running and even while resting. More severe symptoms can be evidence of other injuries like a stress fracture. 


If you experience any prolonged pain, visit a healthcare professional. Medial tibial stress syndrome is diagnosed based on a physical examination of the lower leg. If your doctor is unsure, an X-ray, MRI, or bone scan may be used to rule out a more serious condition. 


If you go to your doctor and are diagnosed with this particular injury, the treatment is similar to other running-related ailments. If you guessed R.I.C.E, you’re correct.

The first part of your treatment protocol is to modify your training, based on your pain level. This allows inflammation and pain to resolve. If you’re unable to walk, stop your training. If you’re pain-free when you jog or walk, cut your training to that level of activity. Ultimately, you should only do what your body will allow. 

Rest or take your training down a notch. Use ice on the painful area. Take anti-inflammatories like Advil. You can also use compression socks and sit with your leg elevated. 

custom orthotics

If your doctor prescribed physical therapy, do that. This can include lower leg strengthening exercises and stretches. Some people benefit from orthotics that redistribute while you run.