On The Mend: Medial Tibial Stress Syndrome

Here in the Tundra, the snow is melting at a fast rate. We are expecting daytime highs in the 50's and 60's in the coming week. Those warm temps can't come fast enough. I want to hit the trails and take some stress off the legs from pounding the hard asphalt.

After a long run about 10-days back, I experienced some pain along the inside of my left shin. It's been bugging me ever since. It took a dive for the worse after the Treadmill 1-Mile World Championship. So much, in fact, that I took two full days off from training this week despite the fact I have a 5K coming up this weekend and a very important 5K in Fargo a week later. I've been icing, resting, and using compression practically round the clock.

This Saturday's 5K will be a speed workout and see how the shin area responds. Interesting to note, this Saturday's race in Becker is the site of my pelvic stress fracture from last year. Maybe I need to start skipping this race!

After consulting my injury bible (Running Well), I have come to the conclusion that I may very well be suffering from Medial Tibial Stress Syndrome (MTSS). MTSS is pain and inflammation on the medial border of the tibia, usually felt during and after running. It can be caused by running too much on hard surfaces, overpronation, a weak tibialis posterior muscle (which lifts the arch of the foot), or tight calf muscles, which cause the foot to pronate further. All the muscles involved in controlling pronation can be affected by MTSS and become sore and inflamed.

MTSS can also affect the fascia (the connective tissue that joins the muscle to the bone) and the periosteum (the outer layer of the bone) itself. If the periosteum is inflamed, you'll feel specific tenderness along the edge of the bone.

I've also made sure I've been getting my regular massages but have missed my last two due to other conflicts. I did get in my massage on Thursday and the difference is noticeable. So I have scheduled an extra massage for next week.

To treat MTSS it is important to massage the tight muscles along the inside of the calf before running, and stretch them after warming up. Ice and massage after running will help settle the inflammation, but don't run through the pain. A balance of strength on the front and back of the lower leg is important. Strengthen the calf and shim muscles using eccentric calf exercises. To see a video demonstration, click here.

Also check your shoes and consider getting a gait analysis. And as I stressed, vary the surfaces that you run on, avoiding excessive slant. I can't wait to hit the trails.

I have also been using KT Tape during my run workouts. It sort of helps, whether it is a mental thing or not.