A risk factor for shin splints: soleus overactivity

Runners calves

Photo by Nicolas Hoizey


Recently, we wrote an article on Soleus muscle involvement in MTSS here. This resulted in some brilliant feedback and knowledge sharing, so thank you! 

While only the second author of a recent paper, a researcher our team loves to watch is Maarten H. Moen, who operates out of the Netherlands. But, we were beaten to seeing this new paper sent to us by Doug Richie (cheers, Doug!).

With previous retrospective studies looking into over-activity of the soleus muscle, with the long duration of tractional forces leading to severe strains to the distal third of the posteromedial tibial, this prospective study wanted to identify whether or not soleus (and tibialis anterior) activity are indeed risk factors for MTSS.

Article Title:

Is high soleus muscle activity during the stance phase of the running cycle a potential risk factor for the development of medial tibial stress syndrome? A prospective study.


Aynollah Naderi, Maarten H. Moen, and Hans Degens.

Why should you read it?

The researchers showed that the following variables help predict the risk of MTSS with 88.6% accuracy:

  1. Body-mass index
  2. Previous history of medial tibial stress syndrome 
  3. Dynamic arch index (ratio of midfoot contact area relative to the whole footprint excluding toes)
  4. Low prior experience of vigorous physical activity 
  5. Peak RMS (root mean squared) of soleus during propulsion 

However, while peak soleus activity is a predictor, the prior four variables provide a quicker screening tool for risk factors. Tibialis anterior activity was not identified as a contributing factor. 

Key Takeaways:

  1. A quick and easy screening tool to identify patients at risk (with 88.6% accuracy)
  2. The strain placed on the tibia by the soleus is a risk factor. Without proper recovery, this strain is repeated over and over again and may ultimately lead to MTSS

Want a free in-service for your clinic?

I currently run free in-services for all clinics which count towards your CPD hours (only confirmed in Australia). If you would like me to run through this all in more detail, please click the link below to book a free time.

About the author:

Ben Lindsay is the Managing Director and engineer behind the Solushin medical device. A former national medalist swimmer, Ben aspires to learn from physicians, physiotherapists and podiatrists so he can develop tools to improve the quality of care for their patients.

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