The Immediate Effect of Extracorporeal Shockwave Therapy for Chronic Medial Tibial Stress Syndrome

Medial Tibial Stress Syndrome can be a recalcitrant overuse injury in the military.
Objectives: To report the immediate effect and clinical experiences of extracorporeal shockwave therapy as part of a comprehensive treatment program for patients with chronic Medial Tibial Stress Syndrome.

Design: Historic cohort.
Methods: Patients received an individualized treatment program, including radial shockwave therapy for 16 weeks. The length of tenderness along the posterior medial tibial border was measured in centimeters during the weeks of shockwave therapy. Pain during and after shockwave therapy was recorded. Patients were asked if they would recommend shockwave therapy.

Results: 37 male cases were included, median age 23 (IQR 8) years. On average, shockwave therapy did not reduce the length of tenderness during the weeks of application. All patients (100%) reported shockwave to be painful (≥ 6 out of 10), but tolerable by self-application. After the initial shockwave session 25/37 patients (68%) reported no post treatment hours of pain, after session four 33/37 patients (89%). Thirty patients (81%) would recommend shockwave therapy.

Conclusion: Radial extracorporeal shockwave therapy did not reduce the length of tenderness along the posterior medial tibial border during the weeks of application in patients with chronic Medial Tibial Stress Syndrome. It is a painful treatment, but tolerable by self-application. The majority of patients did not experience post treatment pain. In this group of patients 81% would recommend shockwave therapy. More studies are necessary to establish if extracorporeal shockwave therapy for Medial Tibial Stress Syndrome is clinically effective.

Keywords: Exercise Related Leg Pain, Chronic Exertional Compartment Syndrome, Military, Occupational.