Rehabilitation approach for medial tibial stress syndrome: A physiotherapy case report

ABSTRACT Medial tibial stress syndrome (MTSS) is a frequent lower extremity overuse injury. It usually affects athletes who engage in strenuous weight-bearing exercises, such as runners and jumpers. In the spectrum of tibial stress fractures, it is an early stress injury that manifests as pain over the anterior tibia brought on by exercise. The purpose of this case study is to analyze the impact of physiotherapy program on recovery in MTSS, which involves a structured exercise intervention aimed to treat MTSS. The exercise protocol included stretching, strengthening, and other prescribed exercises. The exercises were administered for approximately 1 h per session, 5 days a week for 6 weeks. The study evaluated outcomes encompassing pain, range of motion (ROM), balance, and muscle strength. Significant improvements were observed in clinical outcomes following the intervention. Pain levels decreased from 3/10 at rest and 6/10 during activity to 0/10 in both conditions postintervention. Static balance, assessed via single-leg stance, improved from slight instability to normal control. Manual muscle testing demonstrated maximal strength in the hip extensors, hip abductors, and ankle plantar and dorsiflexors. Additionally, the ROM in the knee, hip, and ankle joints improved to within normal limits after 6 weeks of intervention. A structured 6-week physiotherapy program resulted in significant pain reduction, restoration of ROM, enhancement of muscular strength, and normalization of balance in a patient with MTSS.