Medial Tibial Stress Syndrome

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As you may recall from our intro post on kinesiology taping, we’re going to focus on each muscle group/joint and show you how to use kinesiology tape in three distinct ways:

  1. Immediately after injury  (for swelling and pain)
  2. During the healing process (correction techniques to restore normal position and allow for healing)
  3. Techniques to help improve strength + function

In this post, we’ re going to be talking about a taping application designed to decrease the amount of pull along the inside of the tibia (shin bone). This is perfect for recovering muscles and tendons where you want to provide support and allow for rest so that the injured muscle/tendon can heal. Medial Tibial Stress syndrome is a repetitive overuse injury that can be caused by tight calves and ankles, improper footwear, or abnormal mechanics (i.e. running/cycling form). As the calf and achilles become unable to absorb the workload, the smaller muscles (i.e. the posterior tib + inside portion of the soleus) are called on to pick up the slack. If this is too much, the muscles and the soft tissue that connects them to the bone can become injured.

This type of application is called an inhibition technique. The key for using it is to use the anatomy! Remember, the tape is specifically made to pull on itself. That is what the weird spirals and shapes are when you look at the back of the tape. When trying to inhibit the muscle, you want the tape to move from the muscle insertion to origin so that when the tape pulls on itself, it results in an eccentric pull (eccentric = lengthening of the muscle). This is ideal for trying to diminish the contraction which will allow for rest and more importantly recovery.

Anatomy

The posterior tibialis is often overlooked. It is a major source of shin splints and plantar fasciitis. The key to working on this muscle is to find it. In the picture above it is the red muscle. While it’s deep to the larger gastroc/soleus muscles, it can be easily found on the inside part of your leg where it comes out near the bone, becomes a tendon and then runs down the leg, behind your ankle bone and wraps into the arch of your foot. Start by sitting cross legged (on the floor or in a chair) with the inner ankle bone up towards the sky. With your thumbs on the tibia bone in the middle of the calf between knee and ankle, slide backwards an inch or so into the muscle. Using just your ankle, try to supinate your foot (lift your arch up towards the ceiling). You will feel the muscle move under your thumbs. You can read more about the anatomy and surrounding muscles here.

What you will need:

1) Roll of kinesiology tape

2) Sharpest scissors in the house.

Prep work:

1) Clean skin. This means no oils or lotions of any kind. You want your skin to be clean and more importantly dry. Moisture of any kind = tape will fall off or fail to stick altogether.

2) Hair care. Ideally, the less hair the better. Guys, this means that for best results you will need to trim any long leg hair or shave the calf area.

3) If clean, dry, and hairless skin still = no sticking of tape. Time to get some adhesive spray like Tuf Skin.

4) The tape should last 3-5 days. You can get it wet and shower with it on. Just towel dry it after. No hair dryer! The tape is heat activated.

Taping Techniques

1) Inhibition technique for MTSS with correction strip.

Key Points:

  • Prep the skin first. For this application you will want to put the foot and ankle on stretch by pulling the toes back towards you. If this is painful, you can do so passively (with the muscle relaxed) with a strap or belt. Only move as far as you can comfortably.
  • The primary strip will be anchored just below the inner ankle bone (medial mallelous). From here, pull the ankle/foot up into dorsiflexion and then lay the remainder of the tape down just behind the shin bone without stretch. The tape works by pulling on itself and you have already put the muscle on stretch to do the work for you. If you are unable to pull the ankle/foot back, you may add a small amount of stretch to the tape.
  • A secondary correction strip can be applied to any specific sore spots. Cut the tape so that it is long enough to cover the painful area with 1-2″ of tape on either side (these are your anchors and must be applied without stretch). Round the edges, apply 50-75% stretch and place the tape. Then remove the paper backing and lay down the ends. Don’t sweat the 50-75%. Think medium stretch versus maximum “how far can I pull this tape” kind of stretch.
  • See the video above for full details.

References

1) Capobianco, Dr. Steven and van den Dries, Greg. (2009). Power Taping, 2nd Edition, Rock Tape Inc, Los Gatos, CA.

2) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Kase, Kenzo, Wallis, Jim, and Kase, Tsuyoshi. (2003). Clinical Therapeutic Applications of the Kinesio Taping Method.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.

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