For ease of discussion it will be referred to as medial tibial pain.
Medial tibial pain is a common presentation to health professionals on a daily basis and usually arrives as a chronic case. The typical distance running scenario is ongoing for 6 months or more with many homecare interventions such as rest, stretching of the calves, anti-inflammatory medication, heat application, new shoes and the cycle continues.
The lower limb interacts and is largely affected by the pelvis above (biomechanics are huge in this) and affects the positioning of the foot. The 3 major tissues that play a role in medial tibial pain in the lower limb are the soleus (lower calf) attaching onto the posterior portion of the tibia and fibula, the flexor digitorum longus (these flex the toes) also attaching to the posterior tibia and the tibialis posterior attaching to the posterior tibia and fibula and attaching the navicular (above medial arch) and base of metatarsal (base of toes)
These muscles attach to the bone via an attachment onto the periosteum. The periosteum is susceptible to large friction and traction forces in the lower one third of the tibia.
The more chronic case may be more resistant with a higher re occurrence rate. A chronic case may be 3-6 months with some cases lasting for up to 2 years
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