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Mar 16

Written by: Cherri Choate, DPM

Shin splints is a common injury among athletes.  More recently, the correct term for this condition is "medial tibial stress syndrome" (MTSS), and new research has shown important connections to training practices and foot pathology.  Currently, the two most commonly accepted causes for MTSS are overuse and presence of foot pathology that leads to over pronation.  What is interesting is that the overuse and pronation issues can be treated and prevented by similar shoe/orthotic modifications. 

As the posterior muscle group that normally acts to prevent pronation over works, it pulls on the interosseus membrane between the tibia and fibula, which leads to a type of "perostitis" along the tibia.   A similar stress occurs in overuse from jumping-type activities.  To prevent the development of this problem, the recommendation is to encourage "warming up"  to stretch out the muscle as this will discourage the excessive pulling as the muscle will be longer and less tight.  In addition, any orthotic modification that increases supination moment arms, via: medial heel skive, inverted orthotic, wide plate,  or minimal fill, will likely decrease the "overuse" of the anti-pronation muscles.  Lastly, a shoe that has a firm medial midsole and a stiff heel counter should act in the same way by increasing the supinatory moment arms and discouraging over pronation motion.



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