Chronic Periostitis of the Anterior Tibia Treated With a Combination of Shock Wave Therapy and Gait Retraining: A Case Report

Background Tibial periostitis is a cause of exertional leg pain in athletes. Gait retraining may relieve symptoms by reducing loading rates and improving gait symmetry. Extracorporeal shock wave therapy has been used to treat overuse bone and soft tissue injuries in athletes. Case Presentation A 34-year-old female runner with chronic periostitis attempted gait retraining, but her pain returned. She subsequently completed 3 sessions of radial extracorporeal shock wave therapy and experienced improvement in leg pain that allowed her to progress through gait retraining. Outcome and Follow-Up Video analysis demonstrated conversion to a forefoot strike following gait retraining. Instrumented treadmill analysis showed improved stride symmetry and reduced vertical ground reaction forces. She continued to run pain free at 18 months following discharge. Discussion This case report illustrates the possible synergistic value of radial extracorporeal shock wave therapy with gait retraining for the management of tibial periostitis. JOSPT Cases 2022;2(1):18–23. doi:10.2519/josptcases.2022.9947