Medial tibial stress syndrome

Medial Tibial Stress Syndrome (MTSS) is an overuse pathological condition, characterized by pain and tenderness along the posteromedial border of the tibia. The duration and severity of symptoms, in some cases, may lead to marked functional impairment and undermine athletic performance.There is a lack of consensus across literature regarding several aspects of MTSS. The purpose of this narrative review is to synthesize current evidence and highlight key elements related to MTSS.Findings indicate that MTSS is a multifactorial condition involving periosteal traction, bone overload and impaired remodeling. Epidemiological data are heterogeneous, but MTSS remains prevalent among athletes and military personnel. Multiple intrinsic and extrinsic risk factors contribute to its onset. Diagnosis is primarily clinical, supported by imaging. Conservative management, consisting of rest, anti-inflammatory medications and physiotherapy, remains the cornerstone, while the evidence for surgical intervention is limited and methodologically weak.