034 - Got Shin Pain? Check the Hips
From Shin Splints to Stability: How the Hips Fix the Legs
Medial Tibial Stress Syndrome (MTSS)—commonly known as shin splints—is more than just a nuisance for runners and tactical professionals. It’s a signal of kinetic chain failure. And if you’re only treating the pain? You’re missing the point.
This study proves that correcting the root cause, weak hip abductors and poor frontal plane control, can drastically reduce pelvic drop and dynamic knee valgus, both of which feed the MTSS fire.
Study Breakdown:
Subjects: 40 recreational runners with MTSS
Design: RCT comparing traditional PT vs. PT + functional hip abductor training
Outcome Measures:
Frontal Plane Projection Angle (FPPA) – a measure of dynamic knee valgus
Contralateral Pelvic Drop Angle – a marker of glute med weakness
Key Results:
Group B (hip abductor training) saw:
🔻 42% reduction in dynamic knee valgus (FPPA)
🔻 50% drop in pelvic drop angle
Group A (standard rehab) showed far less improvement and even worsened in knee alignment.
Training was done over 8 weeks—simple, progressive, evidence-based.
Tactical Implications
1. Weak Glutes = Broken Kinetic Chain
MTSS isn't just a shin problem; it's a hip control issue manifesting down the chain.
2. Valgus Isn’t Just a Word, It’s a Risk Multiplier
Unchecked valgus increases strain across the ankle, tibia, and knee. Reduce it, and you reduce the damage.
3. Train the Hip, Protect the Shin
Exercises like single-leg bridges, lateral step-ups, and standing abduction built the kind of pelvic control that matters when running under load or fatigue.
4. PT Alone Isn’t Enough
A “traditional” rehab approach doesn’t cut it. Targeted, glute-dominant strength work has to be part of the fix.
Stay Thick.
Lashien SA, Abdelnaeem AO, Gomaa EF. Effect of hip abductors training on pelvic drop and knee valgus in runners with medial tibial stress syndrome: a randomized controlled trial. J Orthop Surg Res. 2024;19(1):700. Published 2024 Oct 29. doi:10.1186/s13018-024-05139-3