Ep 389: Shin Splints - Have We Been Getting It All Wrong? (with Laura Anderson)

In episode 389 of The Physical Performance Show, Timothy Studley, physiotherapist at Pogo Physio, is joined by physiotherapist and PhD researcher Laura Anderson for a deep dive into shin splints, traditionally known as Medial Tibial Stress Syndrome (MTSS). Laura is the owner of The Injury Clinic in Geelong and is wrapping up a PhD on running retraining for runners with MTSS.

Tim and Laura explore why MTSS may need a new name, what we do and don't know about the underlying pathology, and how to differentiate it from other causes of lower leg pain, particularly tibial bone stress injury. They also cover risk factors, load management, strengthening and plyometrics, and the limited role of gait retraining. It's a conversation that challenges conventional thinking for runners and clinicians alike.

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💯 Today's episode is brought to you by Pogo Physio's Telehealth consultations. If you're an endurance runner battling bone, tendon or joint-related concerns, our online telehealth consultations are an ideal platform to help get you back to your physical best. Book online at https://pogophysio.com.au.

IN THIS EPISODE YOU'LL HEAR:

Why MTSS is so poorly understood despite being commonly cited as one of the top three running injuries Why the JOSPT editorial argues MTSS needs a new name, and why "load-induced medial leg pain" (LIMP) was proposed: it's a pain presentation, not a syndrome, and it doesn't imply a bone stress injury The hypothesised tissue sources (soft tissue traction, deep crural fascia, cortical bone changes) and why none are conclusive, given similar findings in people without symptoms How the name "medial tibial stress syndrome" may drive bone-focused management and be nocebic for patients The main differentials: tibial bone stress injury, compartment syndromes, popliteal artery entrapment and nerve-related presentations Typical LIMP characteristics: gradual onset, may or may not warm up, usually eases within about 24 hours, and diffuse tenderness along the medial border (≥5 cm) compared with the more focal tenderness of bone stress injury Why LIMP and bone stress injury can co-exist, and why the athlete's story, training load history and symptom behaviour over time matter for diagnosis Why LIMP is typically persistent and recurrent, and why a previous history is a risk factor Risk factors: dynamic factors (foot function in walking and running, contralateral pelvic drop, plantar flexor endurance, lower limb muscle stiffness) are more c