Medial Tibial Stress Syndrome Shockwave Therapy

SHIN PAIN TIBIALIS ANTERIOR SYNDROME AND MEDIAL

TIBIAL STRESS  SYNDROME (MTSS)

Inflammation of the tibial edge can occur due to excessive strain. Anterior compartment syndromes arise when a muscle becomes too big for the sheath that surrounds it causing pain. The big muscle on the outside of the shin is called the tibialis anterior and is surrounded by a sheath. This is called the anterior compartment of the lower leg. Compartment syndromes can be acute or chronic. Medial stress syndromes are successfully treated with shockwave therapy.

What is MTSS (Shin Splints)?

MTSS, commonly referred to as ‘shin splints’ – is an injury usually caused by frequent overuse or repetitive-stress injury of the lower leg(s).

The condition is most often found in athletes, especially runners and football (soccer) players, and in dancers and is felt as diffuse pain of the legs and is associated with exertion. Initially it feels worse at the start of exercise, gradually subsides during training, and may stop minutes after exercise. However, later, pain may be felt with less activity and may even occur while resting.

Training errors and ‘over training’ such as, ‘too much’ or ‘too fast’ are the most common reasons that cause MTSS. Women appear to be more affected than men, and have a greater risk for the progression of this to stress fractures.

It is almost always associated with biomechanical abnormalities of the legs, including knee abnormalities, tibial torsion, femoral anteversion, foot arch abnormalities or simply differences in leg-length. Sometimes, just using the ‘wrong’ footwear, including worn-out trainers, can be contributions to the problem. A variety of tibial stress injuries can be involved in MTSS including tendinopathy, periostitis, and dysfunction of the tibialis posterior, tibialis anterior and soleus muscles.

How Shockwave Therapy Can Overcome MTSS

If rest, a changed training regime or simply new trainers or shoes don’t solve the problem, the traditional solution was to have invasive surgery that would have interrupted training and may have initiated further trouble. However, undertaking a course of shock wave therapy can be a faster solution and will allow athletes to continue training or competing or allow dancers to carry on rehearsing or appearing without interruption. According to the American Journal of Sports Medicine, 15 months following initial treatment 40 of the 47 subjects in a shockwave treatment group had been able to return to their preferred sport at their preinjury level, compared to only 22 of the 47 control subjects. Conclusion: Radial SWT as applied was an effective treatment for MTSS. 1

What Happens Before Shockwave Treatment

Before we can begin to treat you, we will need to ask you about your history of leg pain (or read the notes of your physician) and examine the area so that we can understand the clinical history behind your condition. This is so that we can ensure that the ailment being treated is actually MTSS or Tibialis Anterior Syndrome and is therefore treatable with shockwave therapy.

During Shockwave Therapy for MTSS or Tibialis Anterior Syndrome

We will isolate the area that needs to be treated, then using our focussed shockwave equipment we will start sending gentle impulses to the area. Discomfort will be kept to a minimum and gradually the impulses will become more intense, although little pain will be felt and if it is it will gradually dissipate over a few days.

How Long Will the Shockwave Therapy Take to Work?

Generally, shockwave for MTSS or Tibialis Anterior Syndrome will resolve after three to four sessions, depending on your condition and how long you may have suffered with it. Early diagnosis can reduce the number of sessions needed.

It is important that you work with your physical therapist to ensure that you have an exercise regime and massage to ensure full recovery.

Many clients feel immediate relief, and after subsequent treatments you should notice a definite improvement leading to a partial or total reduction in the original pain felt.

What Are the Alternatives to Shockwave Therapy for MTSS?

One of the most attractive aspects of shock wave treatment is that it is a non-invasive for problems that are sometimes challenging to treat. This is sometimes described, medically, as being treated extraorporeally, i.e. outside of the body. Furthermore, since it is non-invasive, there is no lengthy recover period, little or no time off from work or away from training or dance rehearsals, or risk of causing further damage and infections.

The same cannot be said with surgery, it is not uncommon for patients who have surgery to miss work for two to six weeks due to immobilization. Plus of course, if they are private patients the cost of surgery can run into several hundreds, if not thousands of pounds.

Regular or Focussed Shockwave Treatment, What is the Difference?

Since about 1990 Extracorporeal ShockWave Therapy (ESWT) has become an alternative for treating MTSS or Tibialis Anterior Syndrome in Europe. The USA were slow to catch up and it didn’t catch on there until about the year 2000. There has been some controversy between manufacturers of ESWT technologies, with each of them doggedly determined to create an exclusive market for themselves. One of the common targets for differentiation was the level of energy used in shockwave technology.

We have been working with different shockwave technologies for a number of years and have now progressed to the latest, focussed, shockwave engineering. This has demonstrated that the older, earlier machinery, we once used was much less effective and inferior than what we have now.

Contact us today to book a course of treatments your MTSS or Tibialis Anterior Syndrome.

References

  1. https://podiatryarena.com/index.php?threads/medial-tibial-stress-syndrome-and-shockwave-therapy.37453/
  2. http://www.masterpuls.nl/documents/Mediaal_Tibiaal_Stress_Syndroom_en_ESWT.pdf

 

 

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