Management for medial tibial stress syndrome
Medial tibial stress syndrome is difficult to treat and there is no strong evidence for any treatment. Management for the underlying stress reaction or stress fracture is nonsurgical and involves maintenance of fitness and:
- reduced training load until pain resolves
- undertaking alternative activities such as cycling, swimming, or running in the deep end of a pool using a floatation device
- a gradual return to previous training levels once the pain has resolved.
There is little evidence for the use of analgesia, though if pain is interrupting sleep, paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) may be considered; see Analgesia for soft-tissue limb conditions.