Upon entering the military recruits are challenged physically, this is exceptionally difficult for women as their anatomy predisposes them to more impact injuries than men. Female military recruits are placed at a higher risk for shin splints, a repetition injury known in the medical field as medial tibial stress syndrome (MTSS). This review paper explores studies about MTSS, its prevalence, and expression in military recruits, particularly as its expression differs across gender. This paper will cover how the external environment of boot camp results in a higher prevalence of MTSS than the general population and how increased occurrence of MTSS in females has been attributed to specific physical attributes. This includes smaller tibial cross-sectional dimensions, greater than average hip range of motion, and differences in lower extremity mechanics during running and other repetitive physical activities. The external environment of boot camp coupled with these intrinsic factors highlight the importance of providing running education for women prior to arrival at boot camp and designing training regiments that account for these physiological differences.