Medial tibial stress syndrome (shin splints)
Meaning of medial tibial stress syndrome (shin splints): For the purposes of this Statement of Principles, medial tibial stress syndrome (shin splints): (a) means a bone stress reaction or periosteal inflammation manifesting as exercise-induced pain along the posteromedial aspect of the distal two-thirds of the tibia which typically resolves or reduces with rest; and (b) excludes: (i) fracture, including stress fracture; (ii) lower leg tendinopathies or bursitis; (iii) nerve entrapments (sural or superficial peroneal); (iv) popliteal artery entrapment syndrome; (v) acute sprain and acute strain; and (vi) vascular insufficiency.
Reasonable Hypothesis (RH) — Statement of Principles No. 96 of 2023
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting medial tibial stress syndrome (shin splints) or death from medial tibial stress syndrome (shin splints) with the circumstances of a person's relevant service:
- (1)running or jogging an average of at least 30 kilometres per week for the 4 weeks before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
- (2)undertaking weight bearing exercise involving repeated activity of the lower leg on the affected side for: (a) a minimum intensity of 5 METS; and (b) for at least 4 hours per week; and for at least the 4 weeks before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
Note: Examples of weight bearing exercise involving repeated activity of the lower leg at a minimum intensity of 5 METS include marching, sustained brisk walking, playing football, and dancing.
Note: MET is defined in the Schedule 1 - Dictionary.
- (3)increasing the frequency, duration or intensity of weight bearing activity involving the lower leg on the affected side: (a) by at least 100 percent; and (b) to a minimum intensity of 5 METs; and (c) for at least 2 hours per day; within the 2 weeks before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
Note: MET is defined in the Schedule 1 - Dictionary.
- (4)having pes planus of the affected limb before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
- (5)inability to obtain appropriate clinical management for medial tibial stress syndrome (shin splints) before the clinical worsening of medial tibial stress syndrome (shin splints);
Balance of Probabilities (BoP) — Statement of Principles No. 97 of 2023
5 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, medial tibial stress syndrome (shin splints) or death from medial tibial stress syndrome (shin splints) is connected with the circumstances of a person's relevant service:
- (1)running or jogging an average of at least 60 kilometres per week for the 4 weeks before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
- (2)undertaking weight bearing exercise involving repeated activity of the lower leg on the affected side for: (a) a minimum intensity of 5 METS; and (b) for at least 6 hours per week; and for at least the 4 weeks before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
Note: Examples of weight bearing exercise involving repeated activity of the lower leg at a minimum intensity of 5 METS include marching, sustained brisk walking, playing football, and dancing.
Note: MET is defined in the Schedule 1 - Dictionary.
- (3)increasing the frequency, duration or intensity of weight bearing activity involving the lower leg on the affected side: (a) by at least 100 percent; and (b) to a minimum intensity of 5 METs; and (c) for at least 4 hours per day; within the 2 weeks before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
Note: MET is defined in the Schedule 1 - Dictionary.
- (4)having pes planus of the affected limb before the clinical onset or clinical worsening of medial tibial stress syndrome (shin splints);
- (5)inability to obtain appropriate clinical management for medial tibial stress syndrome (shin splints) before the clinical worsening of medial tibial stress syndrome (shin splints);
