The posteromedial border of the tibial shaft is the junction between the posterior surface (giving origin to tibialis posterior) and the medial surface (subcutaneous and palpable). It runs from the medial tibial condyle to the medial malleolus and is the site of periosteal stress reaction in medial tibial stress syndrome (shin splints).
The posteromedial tibial border is the primary site of tenderness in medial tibial stress syndrome, distinguishing it from the anterolateral pain of anterior compartment problems. MRI shows periosteal oedema and cortical stress reaction along this border in shin splints. Tibial stress fractures in their early stages present as focal posteromedial tenderness before radiographic changes appear. The posterior tibial artery and tibial nerve run adjacent to this border in the deep posterior compartment.
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