Ankle and foot

Medial tibial stress syndrome

Mechanism: Overload of the bone-periosteum transition along the medial border of the tibia, from repeated impact in running. An increase in volume or intensity is almost always the trigger.
Recognition: Diffuse tenderness over at least five centimetres along the distal two thirds of the medial tibial border. That length is the distinction from a stress fracture, which is point tender.
Course: Belongs to the same spectrum as the stress fracture: the same overload, a different point on the line. If pain persists despite adjusted load, imaging is indicated to rule out a fracture.

Structures