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Posterior Shin Splints | Causes and treatment options

Posterior shin splints describes tendinitis of the posterior tibial muscle and tendon. The posterior tibial muscle and tendon originate in the lower leg, deep to the calf muscle. What causes posterior shin splints? This article explores the onset and treatment options for this painful form of ankle pain.

What are shin splints?tibialis posterior muscle and tendon

How do I treat posterior shin splints?

In my previous blog post, I discussed the more common form of shin splints, anterior shin splints.  Posterior shin splints is the term used to describe tendonitis of the medial ankle.  Although not truly shin pain, posterior shin splints have found their way into our medical vernacular.  Posterior shin splints are actually a form of tendinitis of the medial ankle.

Posterior shin splints describe tendinitis of the posterior tibial muscle and tendon.  The posterior tibial muscle and tendon originate in the lower leg, deep to the calf muscle.  The tendon of the posterior tibial muscle descends to the medial ankle and rounds the ankle extending to the medial arch.  The primary function of the posterior tibial tendon is to support the arch through the weight-bearing phase of gait.  The most common location of pain seen in posterior shin splints is at the medial ankle bone (medial malleolus) and 6-10 centimeters proximal to the ankle.

Posterior shin splints is an athletic term used to describe tendinitis of the medial ankle.  The same problem, when described in a less active and older population, is called stage 1 posterior tibial tendon dysfunction (PTTD).  Although the terms posterior shin splints and PTTD describe the same condition, they are used to describe two distinctly different populations of people.

The symptoms of posterior shin splints include:

  • Medial ankle pain upon the onset of activity
  • Increased medial ankle pain with toe raise
  • Palpable pain along the course of the posterior tibial tendon

The differential diagnosis for posterior shin splints includes:

Treatment of posterior shin splints includes:

  • Rest
  • Ice before and after activities
  • Support of the arch with a rigid arch support
  • Shoes with a stiff shank

Posterior shin splints are a type of overuse syndrome that typically respond to rest and support of the arch.  If you suspect symptoms of posterior shin splints and you've tried these initial methods of treatment but you still have pain, please consult your podiatrist, orthopedist or family doctor for evaluation.


Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Advisor

Updated 3/23/2021

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