Mediaal tibiaal stress syndroom ('shin splints'); een literatuuronderzoek

Using articles obtained after extensive literature search this article discusses anatomy, histopathology, risk factors, diagnostic imaging, therapy and prevention of medial tibial stress syndrome, formerly called 'shin splints', 'shin soreness', 'periostitis' and 'medial tibial syndrome'. Medial tibial stress syndrome exists in 4 to 35 percent of athletes with pain in the lower leg during exercise. Most probably this pathology is caused by dysfunctional adaptation of the tibial cortex, with a minor role for traction of the foot flexors on the periosteum. Pronation with standing or landing on the foot, positive navicular drop test, greater internal and external hip range of motion and lower lean calf girth were prospectively found intrinsic risk factors. Running more than 32 kilometers per week is a prospectively found external risk factor. Medial tibial stress syndrome is mainly a clinical diagnosis. Additional imaging such as bone scan, CT-scan and MRI can be performed, although its value is limited. Rest as primary treatment seems equal to any intervention. For prevention, application of a neoprene or semi-rigid inlay reduces the incidence of medial tibial stress syndrome. The quality of a lot of studies used in this review was poor, so conclusions should be treated with care.