Course Description:

Medial tibial stress syndrome (MTSS) is an exercise-induced lower leg disorder that is considered one of the most common lower extremity injuries in athletes and military personnel. Pain is experienced along the posteromedial border of the tibia during running and other impact-bearing activities. The pathogenesis of MTSS is poorly understood, but it is theorized that MTSS involves either various muscles pulling the periosteum from the tibia (traction theory) or inadequacy of the tibia to respond to imposed forces, resulting in bone deformation (bone stress-failure theory). Furthermore, there are numerous causes of and risk factors for MTSS that can make managing the condition complicated. Treatment for MTSS is typically conservative, with some patients needing to modify training regimens while others need to discontinue any physical activities for a prolonged period of time. MTSS can lead to a tibial stress fracture, thus knowledge of the management of MTSS is essential for safe return to physical activity level as well as to avoid progression to a more serious condition.