MEDIAL TIBIAL STRESS SYNDROME
Description
Medial tibial stress syndrome (MTSS) is characterized by pain around the medial aspect of the lower leg. (Hashim et al., 2024)
Repetitive stress that generates microdamage beyond the repair threshold could be a mechanism for developing MTSS. (Deshmukh et al., 2022)
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It is the second most prevalent running injury, accounting for 9,1% of all running injuries. (Kakouris et al., 2021)
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Significant increasing loads, volume and high impact exercise are important risk factors, together with female gender, previous history of MTSS, high BMI, navicular drop, ankle plantar flexion/hip external rotation ROM. (McClure et al. 2023)
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1. DECREASE PAIN
Modify the activities/running program to decrease the pain level.
Running volume ↓ (e.g. 20-30% less than current volume, decrease more if necessary)
Running intensity ↓↓ (reduce interval pace and/or interval volume)
Modify other activities that put stress on the tibial bone
2. INCREASE STRENGTH
Increase the strength of the lower legs.
Train lower leg muscles
Focus extra on calf muscle strength
Keep aerobic fitness high within comfort (e.g. cycling, crosstraining if possible, swimming, aquajogging...)
(Warden et al., 2022)
(Deshmukh et al., 2022)3. INCREASE PLYOMETRICS
Increase the plyometrics capacity.
Start with non-reactive jumps
Continue with reactive jumps
Progress from long (>0,25s) to short (<0,25s) plyometrics
Progress to running-specific drills
Load plyometrics in multiple directions
(Warden et al., 2022)
4. INCREASE RUNNING LOAD
Increase the running volume and intensity.
Start with building up volume
Continue with adding more intensity
As a novice runner, try not to build up more than 10-15% weekly (30% is associated with increased injury risk)
Use external (time, distance) and internal (RPE socre) loads to monitore training progression
Plan a deload week after every 3 weeks (use 60-70% of the mean load of the previous 3 weeks)
(Warden et al., 2022)
REHABILITATION
If you have a doctor's prescription and require professional assistance with your injury, you are welcome to schedule an appointment with us.
Posts are not medical advice!
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