The Shoulder Physio Podcast #53: Shin Splints: The Most Misunderstood Running Injury with Laura Anderson PhD(c)
Feb 24, 2026
Laura Anderson, physiotherapist and PhD researcher studying medial tibial stress, argues for renaming ‘medial tibial stress syndrome’ to Load-Induced Medial Leg Pain (LIMP). She explains why the old name drives fear and poor care. Topics include what tissues might be involved, inconsistent imaging, clinical clues to distinguish bone injury from LIMP, load-management strategies, allowable pain rules, strengthening, gait retraining risks, and prevention research.
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Use Neutral Load Language To Reduce Catastrophe
- Label matters: choose neutral, load-focused language to reduce patient panic and align expectations.
- Calling it Load-Induced Medial Leg Pain helps explain management centred on balancing load tolerance and capacity.
LIMP Often Becomes A Slow Longstanding Problem
- The natural history of LIMP is poorly defined but often long-standing and recurrent.
- Anecdotally many runners have symptoms for months to years and progress back to running can be slow.
Different Risk Clusters For Bone Stress Versus LIMP
- Risk factors overlap but tibial bone stress injuries cluster with bone-health risks (RED-S, prior stress fractures).
- MTSS/LIMP commonly appears in lower-level runners and military recruits and is less linked to bone-health deficits.