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Current developments concerning medial tibial stress syndrome.

by Debbie I Craig
Phys Sportsmed ()


Medial tibial stress syndrome (MTSS) is one of the most common lower\nleg injuries in athletes who run. Studies have reported MTSS to occur\nin 4% to 20% of this population. It can be defined as an overuse\ninjury that creates pain over an area covering the distal to middle\nthird of the posteriomedial tibial border, which occurs during exercise\nand creates cyclic loading. Differential diagnosis includes ischemic\ndisorders and stress fractures. Although the pathology of this injury\nis understood, the etiology is less agreed upon. This makes it difficult\nfor clinicians to diagnose and treat this common injury. The purpose\nof this article is to present health care practitioners with the\nmost current information regarding MTSS so they can better diagnose\nand treat this common injury. To this end, a literature review was\nconducted, with the most current results presented. The areas of\netiological theories, imaging techniques, and treatment options for\nMTSS were searched. Five of the most prevalent etiological theories\nare presented with supporting evidence. Of the imaging tools available\nto the clinician, magnetic resonance imaging (MRI) and bone scintigraphy\nhave comparable specificity and sensitivity. Clinicians should first\nmake the clinical diagnosis of MTSS, however, because of high percentages\nof positive MRI scans in asymptomatic patients. There have been few\nrandomized controlled trials investigating treatment options for\nathletes with MTSS. Those that have been performed rendered no significant\nfindings, leading researchers to conclude that rest is equal to or\nbetter than other treatment options. Given the evidence, treatment\nsuggestions for practitioners caring for athletes with MTSS are provided.

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