Definition
Medial Tibial Stress Syndrome
- pain along the tibial origin of tibialis posterior or soleus
Clinical
Pain anterior aspect of shin
- running
- soccer
- basketball
DDx
Compartment Syndrome
Stress fracture of tibia
Mechanism
Usually 2° to changes in activity
- increase in mileage
- alteration in terrain
- change of shoes
Pain usually follows activity
- gradually intrudes into workout
- eventually precludes activity
Xray
May show periosteal reaction
Management
Rest
Achilles stretching
Shock absorbing insoles
Graduated return to running
ECSW
Moen et al Br J Sports Med 2011
- improved results with ECSW