Medial Tibial Stress Syndrome Development: Common Factors, Sprint-Specific Factors and Intervention Strategies

Medial tibial stress syndrome (MTSS) is a prevalent overuse lower-extremity injury. Current research predominantly focuses on endurance runners, leaving the risk factors and pathophysiological pathways specific to sprinters poorly characterized. This narrative review aims to summarize current evidence on sprint-specific factors of MTSS development and their intervention strategies. Including 20 peer-reviewed studies published from 2020 to 2026, this paper analyzes the pathophysiological mechanisms, intrinsic factors, extrinsic factors, and sprint-specific contributors to MTSS, and evaluates the evidences for preventive and rehabilitative interventions. References show that sprinting amplifies tibial stress reaction pathways by rapid force production, abrupt eccentric-concentric muscle transitions, and high anteroposterior shear stress during acceleration. MTSS development in sprinters is driven by the interaction of intrinsic susceptibility (body composition, foot alignment, muscle function), extrinsic training variables (abrupt load progression, footwear), and sprint-specific exposures (starting block position, high-magnitude impact loading, neuromuscular capacity deficits). Supported prevention strategies include neuromuscular training, foot-core strengthening, and arch-support orthoses. For established MTSS, a staged multimodal strategy combining load modification, cryotherapy, progressive therapeutic exercise, and adjunctive interventions yields the best outcomes.