Medial Tibial Stress Syndrome
How to identify MTSS?
You will feel pain along the postero-medial border of the tibia that occurs due to exercise…’’ and in addition: ‘‘pain by palpation of the posteromedial border of the tibia is present over a length of five or more consecutive centimeters’’.
Pathology
Currently, it is thought that MTSS is a bony overload injury; i.e., the tibial bone bends during weight-bearing activities causing strain in the tibia. This strain normally causes micro damage in the bone, which leads to bone adaptation processes to strengthen the bone to resist tibial bending. When this strain exceeds a certain threshold and becomes overloaded, the osteoclast activity may outpace osteoblast activity, leading to local tibial osteopenia.
Treatment (According to research articles published after year 2010)
1. Iontophoresis, Ice Massage, Phonophoresis and Ultrasound found effective in management of MTSS.
2. Low-Energy Laser Treatment didn't add beneficial effect in relieving pain in MTSS.
3. Graded Running Program, Stretching/Strengthening and Sports Compression Stockings didn't find effective for long term pain relief in MTSS.
4. Pulsed Electromagnetic Field didnt find significant in treating MTSS.
5. Extracorporeal Shockwave Therapy found somewhat effective in treating MTSS.
Conclusion
From research article we can conclude that Ice massage, Iotophoresis, Ultrasound, Phonophoresis and rest is most effective way to treat MTSS.
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