Medial tibial stress syndrome is the most common cause of leg pain runners. It was previously called shin splints. Up to a third of military recruits have been reported as getting this during their basic training.

Generally the diagnosis of medial tibial stress syndrome is made when there is pain along the middle part of the posterior aspect of the medial border of the tibia that gets worse with increased activity. Generally the pain is not present when not exercising unless it is palpated.

The differential diagnosis of leg pain in athletes includes medial tibial stress syndrome, stress fractures, chronic exertional compartment syndrome, deep vein thrombosis, a herniation of the muscle or fascia or other muscle strains.
X-rays and bone scans can be used if needed to rule out a stress fracture.

There are a number of theories as to what causes medial tibial stress syndrome, but the most popular are a tensile force on the bone from the muscles; a tensile force on the fascia by the muscles; and an increased bending moment of the tibia.

Treatment involves dealing with the inflammation (e.g. NSAIDs etc); stretching and strengthening routines; reducing the pathological forces on the tibia with foot orthotics or footwear modification; and then a gradual return to full training activity.

For more on Medial Tibial Stress Syndrome see:

Medial Tibial Stress Syndrome

Medial Tibial Stress Syndrome

Medial Tibial Stress Syndrome

Medial Tibial Stress Syndrome