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

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 so-leus, 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 strength-ening 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.