The patient came into the clinic because of experiencing pain in her shins since she started the coach to 5 k. The patient was a 2nd year drama student who said that she didn’t do much exercise and had never been in the gym. After lockdown she took up the coach to 5 k with a friend because she felt that she had put on a bit of weight in lockdown and had adopted a bad diet and habits. She said that she started running with her friend down Plymouth barbican doing around 1 mile to start off with and within a week advanced to 3 miles which involved going down hills. When assed the patient said she wore her normal trainers which were not riunning trainings and had near to no support or padding on the sole. The pain came on when the patient started her run and decrease after 10 mins in the run and the pain was described as sore in her shins on the medial side and she said the pain was around 3 cms long. On observation of the patient there was little arch in her feet. The toes and knee were cleared which produced no symtoms and the ankle was tested passily, actively and in resistance in plantar flexion, dorsi flexion and in/eversion. The was full ROM in all movements and full strength. On palpation there was pain around the medial side of the distal tibia, and this was over a 2 and half cm area. Because of the subjective assessment the patient appeared to be experiencing pain from medial tibial stress syndrome, which is an umbrella term for pain in the distal 2 thirds of the medial tibia. There was no altered sensations. It appeared that the patient had increase her running to quickly and with trainers that did not absorb any of the impact. The client was told to find trainers with more shock absorbant qualities and prescribed the following exercises:
Tibialis posterior stregtheniing
Eccentric calf raises
Banded dorsi flexion reps
The patient has been advised to reduce the running and to mix it up with less impact exercises to maintain fitness and has been booked back in in 2 weeks’ time to assess her gait.