Medial tibial stress syndrome is one of the overload pathologies of the lower limb which, as the name implies, affects the tibia. Like all overuse pathologies, it occurs in subjects who perform repetitive gestures, represented in this case by the continuous impacts of the lower limb with the terrain typical of running or those who practice jumping sports.
In runners the incidence of this pathology is about 20%.
Symptoms of Medial Tibial Stress Syndrome
First of all, tibial pain is typically localized to a well-defined portion, particularly the distal two-thirds of the medial margin.
Pain occurs during or after physical activity and is aggravated by it. Instead the pain reduces with rest. There is no cramping or burning pain in the posterior compartment, but some tingling and / or numbness of the foot can be present.
Causes of Medial Tibial Syndrome
This pathology is essentially caused by physical overload. In fact, the continuous stress at the tibial level creates micro-damage at the level of the cortical bone. When the workload is excessive or there is not enough recovery time between the different sessions of exposure to mechanical load, these microdamages are not repaired and the system will suffer from it. In fact, periostitis is typically present at the site of the injury, although it is not clear whether this is the cause or effect of the disease.
Some risk factors may be: inflexible calf muscles and tense Achilles tendon (they put more stress on muscle attachments). Excessive pronation (the feet rotate too much inward on impact with the ground), running on hard surfaces. Inadequate or worn shoes. Excessive training or a rapid increase in load or intensity.
Beginner runners are the most susceptible to this problem for various reasons, usually due to the fact that the leg muscles have not been prepared and trained for work before starting training.
Treatment
Stop running, especially in severe pain; if, on the other hand, the pain is light, reduce the load and intensity of training and avoid downhill routes on circular tracks.
Apply ice to the mid-tibial bone area for ten minutes every two hours to reduce inflammation.
When it is possible to self-massage the area with Arnica oil along the inside of the tibia. Stretch the gastrocnemius and soleus muscles, hold for 30 seconds and then slowly relax.
Repeat on both legs two or three times a day.
Remember to warm up well prior training and stretch well straight after the runs.
Resume running workouts gradually. In all, it takes 2 to 4 weeks to heal.
Useful tips:
- Always wear correct running shoes and, if necessary, or wear orthotics to prevent excessive pronation.
- Always apply ice after your run.
- Preferably run on soft surfaces.
- Avoid making very wide strides, which place excessive stress on the mid-tibial bone.
- Make a gradual training program, and especially remember to include rests in the training program.