Shin Splints

General Information on Shin Splints:

Shin Splints / Medial tibial stress syndrome (MTSS) is one of the most common complaints of the lower leg in the athletic population. Incidences between 4% and 35% have been reported in both military and athletic studies. Different mechanisms have been proposed for shin splints / MTSS. Recent evidence suggests that shin splints / MTSS are related to mechanical overloading of the bone and resulting in decreased bone density.

In the treatment of shin splints / MTSS a therapy in which bone cells are upregulated would possibly enhance bone density and thus decrease symptoms. Studies that tried to enhance the number of bone cells in the treatment of stress fractures and the non-union of fractures provided evidence for the plausibility of this theory. In those studies extracorporeal shockwave therapy (ESWT) was used to stimulate the bone through micro trauma.

I have attached a recent study which shows the effectiveness of Shockwave Therapy for shin splints / MTSS treatment.

Shockwave treatment for medial tibial stress syndrome in athletes; a prospective controlled study (2011)

M H Moen, 1 S Rayer, 2 M Schipper, 2 S Schmikli, 1 A Weir, 3 J L Tol, 3 F J G Back


Objective The purpose of this study was to describe the results of two treatment regimens for medial tibial stress syndrome (MTSS); a graded running programme and the same running programme with additional shockwave therapy (extracorporeal shockwave therapy; ESWT).


A prospective observational controlled trial. Setting Two different sports medicine departments. Participants 42 athletes with MTSS were included.


Patients from one hospital were treated with a graded running programme, while patients from the other hospital were treated with the same graded running programme and focused ESWT (five sessions in 9 weeks).

Main Outcome:

Measures Time to full recovery (the endpoint was being able to run 18 min consecutively without pain at a fixed intensity).


The time to full recovery was significantly faster in the ESWT group compared with the patients who only performed a graded running programme, respectively 59.7±25.8 and 91.6±43.0 days (p=0.008).


This prospective observational study showed that MTSS patients may benefit from ESWT in addition to a graded running programme. ESWT as an additional treatment warrants further investigation in a prospective controlled trial with the addition of randomisation and double blinding.


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