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Shockwave treatment for medial tibial stress syndrome in athletes; a prospective controlled study
  1. M H Moen1,
  2. S Rayer2,
  3. M Schipper2,
  4. S Schmikli1,
  5. A Weir3,
  6. J L Tol3,
  7. F J G Backx1
  1. 1Rehabilitation and Sports Medicine Department, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Department of Physical Therapy, Rayer Health Care Physical Therapy, Zoetermeer, The Netherlands
  3. 3Department of Sports Medicine, Medical Center Haaglanden, Leidschendam, The Netherlands
  1. Correspondence to Dr M H Moen, Rehabilitation and Sports Medicine Department, University Medical Center Utrecht, Heidelberglaan 100, 3508 CX Utrecht, The Netherlands; m.moen{at}


Objective The purpose of this study was to describe the results of two treatment regimens for medial tibial stress syndrome (MTSS); a graded running programme and the same running programme with additional shockwave therapy (extracorporeal shockwave therapy; ESWT).

Design A prospective observational controlled trial.

Setting Two different sports medicine departments.

Participants 42 athletes with MTSS were included.

Intervention Patients from one hospital were treated with a graded running programme, while patients from the other hospital were treated with the same graded running programme and focused ESWT (five sessions in 9 weeks).

Main Outcome Measures Time to full recovery (the endpoint was being able to run 18 min consecutively without pain at a fixed intensity).

Results The time to full recovery was significantly faster in the ESWT group compared with the patients who only performed a graded running programme, respectively 59.7±25.8 and 91.6±43.0 days (p=0.008).

Conclusions This prospective observational study showed that MTSS patients may benefit from ESWT in addition to a graded running programme. ESWT as an additional treatment warrants further investigation in a prospective controlled trial with the addition of randomisation and double blinding.

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Medical Ethical Committee South West Holland.

  • Provenance and peer review Not commissioned; externally peer reviewed.