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Definition + Etiology
- Medial Tibial Periostitis (MTSS, MTTP): Overuse, overtraining, hard surface, poor shoe choice, bad warmup, bad biomechanics, Pes planus, tight posterior leg MMs (Soleus eccentrically resists pronation, overpronation = traction on attachments)
- CECS: Changes in mechanical properties of fascia
- Age: + children, - seniors
CIs + Precautions
MTP (MTSS, MTTP): ?????????????????????
CECS: Acute = medical emergeancy
MTP (MTSS, MTTP):
Tenderness 5cm diffuse
area at post-med margin
of middle-distal 1/3rd of tibia. Pain on RRoM plantarflexion, passive soleus stretch or unilateral hopping. Pain decreases with warmup, returns after activity.
Localized swelling possible. + women.
- CECS: Achy and tight in compartment
- No pain at rest. Pain gruadually builds during activity (10-15 mins), decreases at rest
- Swelling can comprimize blood supply, cause NN or MM damage
- MM weaknesss and parestesia possible
- MM herniation?
- Nature/behavior of pain
- Change in exercise, shoe, repetitive ADLs.
- Health, diet
- Local swelling, erythema, biomechanics of foot (pes planus, rigid cavus etc), lower leg, knee,
- Diffuse tenderness over 5cm area
- Pain in vertical orientation
Soleus PRoM and RRoM pain
- Decr inflammation
- Adress underlying cause
- Rest from activity/modification
- pt Edu - retrain posture/gait
- Decr scar tissue formation, adhesions
- Balance MM/retrain proprioception
- MFR, Soleus/FDL TrP/MFR + passive ankle movements
- jt mobes
- MLD, fine vibes, light strokes for inflammation
- Frictions in sub-acute
- Stimulate hypotonic MM
- Contract/Relax, PRoM
- Cool/cold for swelling
- DMH prior to Tx for chronic
- Proper warm, gruadual return to activity (start slow, go slow)
- Pain-free cross-training, MM balancing
- Gait re-education
- Change training surface
- Footwear change (every 300 miles)