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Updated: Jun 17, 2026

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Current developments concerning medial tibial stress syndrome.

Debbie I Craig1

  • 1Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ 86011-5094, USA. debbie.craig@nau.edu

The Physician and Sportsmedicine
|January 6, 2010
PubMed
Summary

Medial tibial stress syndrome (MTSS) is a common running injury. Rest appears to be as effective as other treatments for MTSS, and clinical diagnosis is recommended before imaging.

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Area of Science:

  • Sports Medicine
  • Orthopedics
  • Biomechanics

Background:

  • Medial tibial stress syndrome (MTSS) affects 4-20% of runners as a common overuse injury.
  • Characterized by posteromedial tibial border pain during exercise due to cyclic loading.
  • Differential diagnosis includes ischemic disorders and stress fractures, complicating clinical management.

Purpose of the Study:

  • To provide healthcare practitioners with current information on diagnosing and treating MTSS.
  • To review etiological theories, imaging techniques, and treatment options for MTSS.

Main Methods:

  • Literature review focusing on etiological theories, imaging, and treatment of MTSS.
  • Analysis of five prevalent etiological theories with supporting evidence.
  • Evaluation of diagnostic imaging tools like MRI and bone scintigraphy.

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Main Results:

  • Magnetic resonance imaging (MRI) and bone scintigraphy show comparable sensitivity and specificity.
  • High rates of positive MRI scans in asymptomatic individuals necessitate prioritizing clinical diagnosis.
  • Limited randomized controlled trials show rest is as effective as other treatments for MTSS.

Conclusions:

  • Clinical diagnosis of MTSS is crucial, especially given imaging findings in asymptomatic individuals.
  • Rest is a recommended and effective treatment option for athletes with MTSS.
  • Evidence-based treatment suggestions are provided for practitioners managing MTSS in athletes.