Medial tibial stress syndrome is a common injury that usually affects runners but can affect other activities where extended periods of running or hiking/walking are present. Shin splints can be caused by overloading the posterior leg muscles that surround the border of the tibia, which can then tug and exert pressure on the border of the tibia.

The outer border of the tibia has pain sensitive receptors that can cause pain. Other causes include biomechanical irregularities, inflexibilities and tightness or muscular imbalances which lead to excessive tension on the border of the tibia. One common cause is due to a change or sudden increase in training of activity intensity and duration which leads to shin splints because the tendons and muscles are unable to absorb the impact of the shock force as they become fatigued. Treatments for shin splints that have been shown to be effective are Active Release Technique, Functional Range Release, Graston, Acupuncture, Rehabilitation and stretching and orthotics/inserts.