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Medial Tibial Stress Syndrome, Sports Medicine

Alecia Gende, DO and Britt Marcussen, MD, FAAFP, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Typically an overuse injury, with exercise-induced pain over the posteromedial border of the middle to distal 2/3 of the tibia

  • Exact pathophysiology is unknown, thought due to tractio...

DIAGNOSIS

HISTORY

  • Often insidious and progressive

  • Temporally related to sudden increase in intensity/duration of activity, or change in playing/running surface from a softer surface to a harder surface ...

TREATMENT

Acute treatment 6[C]: 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and ice most beneficial in acute stages

  • Complete rest if possible

  • Otherwise, graded running program, gradual increase in inc...

ONGOING CARE

  • Changes in training techniques:

    • Increase rest days.

    • Add in cross-training days with non–weight-bearing activity such as swimming and biking.

    • Slow increase in training intensity/duration, wit...

REFERENCES

1
Winkelmann ZK, Anderson D, Games KE, et al. Risk factors for medial tibial stress syndrome in active individuals: an evidence-based review. J Athl Train.  2016;51(12):1049–1052.
2
Sharm...

ADDITIONAL READING

  • Korakakis V, Whiteley R, Tzavara A, et al. The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of pat...

CLINICAL PEARLS

  • Activity should be avoided until pain and tenderness resolve, followed by a slow, structured return to prior level of activity.

  • There is no good evidence that special taping or an ACE b...

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