Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case Series
# Background Medial tibial stress syndrome (MTSS) is a common overuse injury characterized by activity-induced pain along the distal medial tibial border. Current best practice includes rest and progressive resistance training. However, some patients with MTSS may be unable to tolerate the loading...
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| Format: | Article |
| Language: | English |
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North American Sports Medicine Institute
2025-01-01
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| Series: | International Journal of Sports Physical Therapy |
| Online Access: | https://doi.org/10.26603/001c.126963 |
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| author | Anders F. Brekke Johanne Bjørklund Rosa C. Holse Christian Larsen Mikkel H. Hjortshoej |
| author_facet | Anders F. Brekke Johanne Bjørklund Rosa C. Holse Christian Larsen Mikkel H. Hjortshoej |
| author_sort | Anders F. Brekke |
| collection | DOAJ |
| description | # Background
Medial tibial stress syndrome (MTSS) is a common overuse injury characterized by activity-induced pain along the distal medial tibial border. Current best practice includes rest and progressive resistance training. However, some patients with MTSS may be unable to tolerate the loading during exercise. Blood-flow restriction training using low loads (LL-BFR) may induce similar physiological and structural adaptations as heavy resistance training but without peak loads. This could potentially allow the athlete to continue sports activities during rehabilitation.
# Purpose
The purpose of this case series was to describe an exercise program utilizing LL-BFR training for athletes with running-related MTSS.
# Study design
Case series
# Methods
Six recreational athletes (one handball player, one soccer player, and four runners) with MTSS were recruited. Inclusion criteria included pain along the distal two-thirds medial tibial border occurring during or after activity. Exclusion criteria were symptoms of compartment syndrome, tibial stress fracture, or contraindications for BFR training. Participants underwent a progressive six-week home-based LL-BFR training intervention with three sessions per week and were allowed to continue sports activities if pain was ≤ NRS 5. Outcome measures included change in standardized running performance (distance and pain level), pain pressure threshold (algometry), and self-reported physical function.
# Results
Five athletes experienced improvements in running performance (pain and/or distance) and self-reported function. One athlete sustained an injury unrelated to the LL-BFR training, and therefore the running post-test could not be completed. Adherence to exercise was high, and post-test interviews revealed positive feedback on the training method, with no side effects reported.
# Conclusion
This case series demonstrated that following a therapeutic exercise program utilizing LL-BFR training improvements in pain and function were seen in athletes with MTSS. BFR may allow clinicians to prescribe lower-load exercises, facilitating continued sports participation. Future research should compare the effectiveness of exercise programs for MTSS with and without LL-BFR training.
# Level of Evidence
Level V |
| format | Article |
| id | doaj-art-4f4d11eab50045faabfd6bb365345c0e |
| institution | Kabale University |
| issn | 2159-2896 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | North American Sports Medicine Institute |
| record_format | Article |
| series | International Journal of Sports Physical Therapy |
| spelling | doaj-art-4f4d11eab50045faabfd6bb365345c0e2025-02-11T20:29:52ZengNorth American Sports Medicine InstituteInternational Journal of Sports Physical Therapy2159-28962025-01-01201Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case SeriesAnders F. BrekkeJohanne BjørklundRosa C. HolseChristian LarsenMikkel H. Hjortshoej# Background Medial tibial stress syndrome (MTSS) is a common overuse injury characterized by activity-induced pain along the distal medial tibial border. Current best practice includes rest and progressive resistance training. However, some patients with MTSS may be unable to tolerate the loading during exercise. Blood-flow restriction training using low loads (LL-BFR) may induce similar physiological and structural adaptations as heavy resistance training but without peak loads. This could potentially allow the athlete to continue sports activities during rehabilitation. # Purpose The purpose of this case series was to describe an exercise program utilizing LL-BFR training for athletes with running-related MTSS. # Study design Case series # Methods Six recreational athletes (one handball player, one soccer player, and four runners) with MTSS were recruited. Inclusion criteria included pain along the distal two-thirds medial tibial border occurring during or after activity. Exclusion criteria were symptoms of compartment syndrome, tibial stress fracture, or contraindications for BFR training. Participants underwent a progressive six-week home-based LL-BFR training intervention with three sessions per week and were allowed to continue sports activities if pain was ≤ NRS 5. Outcome measures included change in standardized running performance (distance and pain level), pain pressure threshold (algometry), and self-reported physical function. # Results Five athletes experienced improvements in running performance (pain and/or distance) and self-reported function. One athlete sustained an injury unrelated to the LL-BFR training, and therefore the running post-test could not be completed. Adherence to exercise was high, and post-test interviews revealed positive feedback on the training method, with no side effects reported. # Conclusion This case series demonstrated that following a therapeutic exercise program utilizing LL-BFR training improvements in pain and function were seen in athletes with MTSS. BFR may allow clinicians to prescribe lower-load exercises, facilitating continued sports participation. Future research should compare the effectiveness of exercise programs for MTSS with and without LL-BFR training. # Level of Evidence Level Vhttps://doi.org/10.26603/001c.126963 |
| spellingShingle | Anders F. Brekke Johanne Bjørklund Rosa C. Holse Christian Larsen Mikkel H. Hjortshoej Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case Series International Journal of Sports Physical Therapy |
| title | Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case Series |
| title_full | Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case Series |
| title_fullStr | Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case Series |
| title_full_unstemmed | Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case Series |
| title_short | Low-Load Blood-flow Restriction Training for Medial Tibial Stress-Syndrome in Athletes: A Case Series |
| title_sort | low load blood flow restriction training for medial tibial stress syndrome in athletes a case series |
| url | https://doi.org/10.26603/001c.126963 |
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