Medial tibial stress syndrome is most often seen in which group?

• A. Swimmers
• B. Office workers
• C. Rugby players
• D. Runners and people with flat feet

Answer: (D)

Medial tibial stress syndrome (shin splints) is an overuse injury from repetitive impact loading on the tibia, especially along the posteromedial border. It is most strongly linked to activities with substantial running and loading, and to foot mechanics that increase medial tibial stress. That’s why the group most commonly affected is runners, particularly those with flat feet (overpronation), which increases load on the inner tibia. Swimmers and office workers have less repetitive weight-bearing stress, so they’re less commonly affected. Rugby players do run, but the combination of long-distance running plus flat feet makes runners and people with flat feet the typical presentation.