Treatment of medial tibial stress syndrome according to the fascial distortion model: a prospective case control study.

Christoph Schulze,Susanne Finze,Andreas Lison,Rainer Bader

doi:10.1155/2014/790626

Abstract

Medial tibial stress syndrome (MTSS) is a common problem among athletes and soldiers. There is no proven theory that could explain the pathophysiology of shin splints. The therapies described so far are time-consuming and involve a high risk of relapse. The method according to the fascial distortion model (FDM) addresses local changes in the area of the lower leg fascia. It is suited to reduce pain and functional impairments associated with this symptom complex by applying targeted manual techniques. 32 patients (male: 30; female: 2) participated in this study. Visual analogue scale (VAS) was used for the quantification of pain. Scores were also given to rate the maximum painless exercise tolerance of the patients. Subsequently treatment of the crural fascia was performed. Patients retested ability of running and jumping. Therapy was continued until full exercise tolerance or painlessness was reached. A significant reduction of the VAS pain score from 5.2 to 1.1 could be achieved (P < 0.001). The impairment of exercise tolerance could be reduced from 7 to 2 points (P < 0.001). The duration of treatment was 6.3 (SD: 4.3) days on average. The FDM therapy is a potential effective method for acute treatment of MTSS.

Highlights

In 1966 the term “shin splints” was defined by the American Medical Association in the “Standard Definition of Athletic Injuries.” At that time, the definition was as follows: “pain and discomfort in the leg from repetitive running on hard surfaces or forcible extensive use of flexors. . .” [1]
Various names have been introduced for the complex of this kind of musculoskeletal disorder: medial tibial syndrome, medial tibial stress syndrome (MTSS) [4], shin soreness [7], anterior compartment syndrome [1], and posteromedial compartment syndrome [1]
After the first day of treatment, 13% of all patients were completely free of symptoms, and the overall score was improved from 7 to 4.9 after the first treatment (P < 0.001; Figure 5). The results of this clinical study show that the treatment method according to the fascial distortion model is a quick and effective option to relieve patients of pain and restore their exercise tolerance

Summary

Introduction

In 1966 the term “shin splints” was defined by the American Medical Association in the “Standard Definition of Athletic Injuries.” At that time, the definition was as follows: “pain and discomfort in the leg from repetitive running on hard surfaces or forcible extensive use of flexors. . .” [1]. The definition was as follows: “pain and discomfort in the leg from repetitive running on hard surfaces or forcible extensive use of flexors. Pain reduces in times without physical stress but relapses when the athletes do sports again [2]. Various theories on the cause of pain in the lower leg were elaborated. Some authors assumed elevated muscle compartment pressures in the lower leg [3]. No increased compartment pressures were determined in the lower legs. Flattening of the longitudinal arch of the foot, increased plantar flexion in the upper ankle joint, and a restriction of internal hip rotation are described as biomechanical factors contributing to the development of MTSS [10, 11]. The diagnosis of soft tissue injury is made through clinical examination; other related conditions may be ruled out with imaging or other diagnostic testing [13]

Methods

Results

Conclusion