The tibia is the main weight-bearing bone of the lower leg. The middle to the lower end of the tibia bears a lot of stress, so most symptoms will occur in this region, collectively known as shin splints. It can be roughly divided into three types:

Self File | Shin Splints脛骨痛症 _Leg Pain Causes, Physiotherapy Treatment


  • Medial tibial stress syndrome
    Muscle and skeletal tissues are irritated due to long-term overuse. Pain is usually concentrated on the medial border of the tibia and is the most common condition.


  • Compartment syndrome
    When exercising, the pressure in the muscles increases or severe swelling is caused by direct contusion, which hinders blood circulation in the compartments. Symptoms ease after rest or reduce swelling. Rarely in severe cases, the nerve inside the compartment is acutely compressed to cause numbness and sudden loss of muscle power. One should be sent to the hospital immediately for acute management to avoid permanent injury to the nerve.


  • Stress fracture
    When the shin muscles are too tight or fatigued, the stress of muscle contraction can stretch the periosteum excessively. Initially, there will be some small fine cracks on the tibia that are not visible. If you do not get the proper recovery and continue to overuse, it will become a stress fracture. The patient's tibia will have obvious tender points. Symptoms will initially appear during strenuous exercise, and will eventually become painful even at rest.


Tight calf muscles can cause excessive stress on the periosteum of the tibia. Some lower limb structural abnormalities (such as knee valgus and flat feet) are also the main causes of medial tibial stress syndrome. High flexibility of the foot, flat foot, increased foot pronation, or excessive adduction of lower limbs greatly increase the stress of the tibialis posterior muscle.  If the tibialis posterior muscle is not strong enough to withstand additional pulling force, chronic inflammation will occur.


Conversely, high arches can also cause problems because high arches are less effective in absorbing shock, which increases the stress on the tibia.


In addition, a wrong running posture of the forefoot landing may cause tibial pain due to the increased stress of the lower limbs.



Risk Factors

Too high intensity of training, too many running mileages, progression of speed and slope training in a short time can cause problems. Coupled with insufficient warm-up and tense calf muscles. Other factors include wearing sneakers with low shock absorption, hard training ground, and obesity causing excessive stress on the lower limbs.



Common Symptoms
  • Deep pain in medial tibia
  • Inflamed calf on medial side
  • Tibia with bulge
  • The pain is more severe at the beginning of a run, but reduces when the muscles relax after warmup, but the pain increases again when the running time goes on

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Physiotherapists will have some manual therapy and soft tissue release techniques to relieve muscle tension, and acupuncture on tibial muscles is also very effective. However, if the symptoms are severe and chronic, the patient must take a period of rest to avoid painful activities.  Jogging in the water or cycling are considered safe activities to continue. Do more leg stretching and strengthening can reduce the stress on the periosteum. In addition, ice can have analgesic and anti-inflammatory effects. If there is an abnormality in the structure of the lower limbs, an orthopedic insole can be worn to reduce the tibial stress.

Self File | 脛骨痛症 Shin Splints_腳痛成因物理治療運動1

Self File | 脛骨痛症 Shin Splints_腳痛成因物理治療運動2


Self File | 脛骨痛症 Shin Splints_腳痛成因物理治療運動3

Self File | 脛骨痛症 Shin Splints_腳痛成因物理治療運動4



Preventive Measures

Practice more calf stretching exercises and soft tissue release techniques to promote recovery.






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