Tom Running on Treadmill

This individual came to us with complaints of being limited to running 1 mile secondary to pain. He described the pain located along the medial tibia as developing after about half a mile in and progressively worsening. Upon cessation of activity, the pain would gradually lessen. Take a look at his running form below:

One of the components that really stood out to us was the significant vertical displacement between each stride. That combined with an excessively prominent heel-strike led to our thoughts of poor foot intrinsic control. Check out the images below to see what we found upon visual inspection:

As you can see, he has some significant pes planus bilaterally. While we did not do a formal evaluation, we did find that he has limited dorsiflexion and strong tibialis posterior bilaterally. The individual was able to point to a specific spot of pain that was increased upon palpation after running. This led us to believe the possibility of stress fracture might be present. Testing with a tuning fork was negative. We believe this individual could be suffering from Medial Tibial Stress Syndrome.