Medial Tibial Stress Syndrome: Focused on Tibial Fascial-traction Theory and Prevention Strategies

Abstract

PURPOSE This review article purpose to define and clarify the mechanism of MTSS, especially the tibial fascial-traction theory of MTSS. Additionally, the effectiveness of prevention strategies based on the tibial fascial-traction theory of MTSS was also assessed. BODY Shin splints is a well-known name of MTSS. It is commonly described as pain which occurs in the posteromedial border of the tibia caused by repetitive stresses. Some studies have addressed the tibial fascial-traction theory of MTSS as a possible mechanism in which traction forces are applied on the tibial periosteum though the soleal aponeurosis. Also, traction forces are applied on connective tissues by the soleus, tibialis posterior, and flexor digitorum longus. Prevention strategies are an avoidance of the repetitive stresses, running re-education such as an avoidance the forefoot strike patterns in runners who have risk factors for MTSS. Additionally, shoe modification such as motion control and stability shoes, and strengthening the ankle invertors are recommended. CONCLUSIONS This review article provided an overall review of the tibial-fascial traction theory of MTSS and recommendations for prevention strategies based on this theory. Keywords: Medial tibial stress syndrome / Prevention / Tibial fascial-traction theory