A periostitis of the medial margin of the tibia (shin-bone). Medial tibial stress syndrome (MTSS) is characterized by a cramping or aching pain, tenderness, and possibly swelling on the inner side of the shin. Unlike compartment syndrome, the pain starts with the onset of activity, decreases as the activity continues, but returns after the cessation of the activity. The main cause of MTSS is repeated loading of the leg on hard surfaces. On examination by palpation, there is always a tender area in the lower third of the inner aspect of the tibia. Athletes with high arches, tight calf muscles, and weak Achilles tendons are predisposed to this condition. Treatment is by rest, ice, compression, and elevation (see RICE); rest from the precipitating activity being the most important component. If the condition becomes chronic, surgical separation of the periosteum from the inner side of the tibia is sometimes performed. See also anterior compartment syndrome, medial tibial stress fracture, shin splints.
Subjects: Sports and Exercise Medicine.