The Impact of Ultrasound and Blood Flow Restriction Training on Medial Tibial Stress Syndrome: Case Study

Abstract

Background: Medial Tibial Stress Syndrome (MTSS) is one of the most common overuse injuries experienced by athletes, causing pain and lower extremity physical functional impairment. Conventional management often requires a prolonged recovery period, highlighting the need for safe, rapid, and effective intervention strategies. Objective: This study aims to evaluate the effectiveness of combining ultrasound modality therapy and Blood Flow Restriction (BFR) exercise in reducing pain levels and improving lower extremity functional capacity in MTSS patients. Methods: This study utilized a single-case study design with a pretest–posttest approach. The subject was a 21-year-old male soccer athlete diagnosed with MTSS. Interventions were administered 3 times per week for 2 consecutive weeks. The protocol consisted of continuous ultrasound modality (1 MHz, 1.5 W/cm² intensity for 8 minutes) followed by BFR exercise (80% occlusion pressure; performing Heel Raise, Toe Raise, Squat, and Single Leg Heel Raise with a 30-15-15-15 repetition scheme). Outcomes were evaluated using the Visual Analogue Scale (VAS) for pain and the MTSS Score for functional capacity. Results: After 2 weeks of intervention, pain levels decreased significantly: resting pain dropped from 5 to 0 (100% reduction), tenderness dropped from 6 to 2 (66.7% reduction), and motion pain dropped from 7 to 2 (66.7% reduction). Additionally, the MTSS Score showed functional improvement, evidenced by a score reduction from 7 at pretest to 3 at posttest. Conclusion: The combination of ultrasound therapy and BFR exercise is proven effective in reducing pain and improving lower extremity functional capacity in patients with MTSS.