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Rady Children's Specialists

Shin Splints (Medial Tibial Stress Syndrome)

Medial tibial stress syndrome (MTSS) is a condition that causes pain over the shin bone (tibia). It is the most common cause of shin splints. It is usually due to overuse and occurs in athletes who participate in repetitive activities, especially running and jumping. The condition can also occur in athletes who have sudden increase in the duration or intensity of their training.


Symptoms of MTSS include:

  • Pain over the shin bone.
  • Pain that’s present at the beginning of the workout, resolves during activity, and then returns upon completion of the exercise.
  • Pain usually relieved by rest, except in chronic, severe cases.


MTSS is diagnosed based on physical exam, and X-rays should be done to be sure that there is no stress fracture.


Treatment is a period of rest from your current activity. Cross-training can sometimes be done, such as swimming or cycling. Ice and anti-inflammatory medications can be helpful. Stretching is also important to prevent recurrence. The duration of rest depends on the child and the severity of the pain; however, four to six weeks is a reasonable estimate. Occasionally, a shoe insert can be helpful to prevent recurrence, especially if the child tends to pronate his or her foot, or have relatively flat feet. The injury will not heal without rest and can lead to a more severe injury, such as a stress fracture.