Physiotherapy Approaches for Managing Shin Splint in Marathon Runners: A Narrative Review

Medial Tibial Stress Syndrome (MTSS), often known as shin splints, is a common injury among marathon runners that is characterised by pain along the tibia, or inner part of the shinbone and now a days shin splints are common in marathon runners. It occurs due to overuse injury among marathon runners, and characterised by pain and discomfort along the medial tibial border (lower leg). In this injury, physiotherapy plays an important and crucial role to manage the shin splints. This narrative review explores various physiotherapy approaches for managing shin splints, generally focussing on conservative and evidence-based interventions. Key strategies include activity modification, cryotherapy, and Kinesio taping, which provide pain relief and improve postural control. Biomechanics adjustments, such as the use of orthotics and transitioning to a heel-toe running style, are shown to reduce tibial stress. Strengthening and stretching exercises target the tibialis posterior and anterior muscles to enhance flexibility and prevent recurrence. Novel techniques, such as cupping therapy, improve circulation and reduce muscle tightness, while Transcutaneous Electrical Nerve Stimulation (TENS) aids in pain management. Although shock-absorbing insoles and supportive footwear show promise, evidence for their long-term efficacy remains inconclusive. Combining modalities, such as kinesio taping and structured training programmes, offers a comprehensive management strategy. This review highlights the importance of a tailored, multidisciplinary approach to alleviate symptoms, prevent recurrence, and optimise performance in marathon runners with shin splints. Further research is needed to evaluate the long-term benefits of these interventions.