How symptoms differentiate from a Tibial Bone Stress Injury to Medial Tibial Stress Syndrome (Shin Splints)

Tibial bone stress injury and medial tibial stress syndrome are both common overuse injuries which affect the lower limb. Both conditions are often put under the same umbrella however, looking at the latest research, there is a distinct difference between their symptoms and underlying causes. 

Tibial bone stress injuries are extremely complex and are generally caused from repetitive force/load to the tibia. They are linked to macro or micro energy deficiencies which impairs the rate of bone healing, therefore resulting in a bone stress injury. They are graded from 1-4b depending on the level of damage to the tibia. Grade 1-3 is often seen as a stress reponse whereas, grade 4a and 4b is classified as a stress fracture. Below are the symptoms/observations for a tibial bone stress injury:

1. Pain location: Generally, the pain is isolated to 5-10cm 

2. Pain intensity: Incredibly painful within an isolated spot when running, jumping, hopping etc.

3. Unable to push through the pain during activity, will have to stop

4. Previous history of bone stress injury

5. Present with mico or macro energy deficiency

6. Recent training spike

Medial tibial stress syndrome is often located through the posterior medial aspect of the tibia and caused from tight plantarflexor muscles. As a result of the tension, this causes bowing and/or excessive traction between the tibia and periosteum resulting in inflammation and/or bone overload. Below are the symptoms for medial tibial stress syndrome:

1. Pain location: Generally, the pain is spread over a greater distance of 5-10 cm to the poteriormedial tibia

2. Pain intensity: Warm up and towards the end of activity is often the worse however, can push through

3. Poorly conditioned/higher BMI

4. Training errors

5. Tight plantarflexors

Overall, they are incredibly important to differentiate given the different management strategies required. If you are concerned that you have one of these conditions, please don’t hessite to contact us to assist you with diagnoses and incorporating a thorough management plan to best suite the condition.

Written by Cooper Garoni