ibial bone stress injuries are one of the most frustrating injuries a runner can face. They can derail training for months, recur if managed poorly, and are often mistaken for "shin splints" in the early stages.

In this episode of The Rehab Runway, I’m joined by physiotherapist Beau Tyrrell to unpack what every runner and clinician needs to know about tibial bone stress injuries.

We discuss what is actually happening within the bone, why these injuries develop, and how to differentiate a tibial bone stress injury from medial tibial stress syndrome (MTSS). Beau also explains the role of imaging, MRI grading, and why recognising these injuries early can significantly improve outcomes.

The conversation then shifts to rehabilitation, covering relative unloading, strength training, cross-training, impact progressions, and the criteria Beau uses before returning a runner to training. We also explore common rehabilitation mistakes, recurrence risk, RED-S, training load, and practical strategies to reduce the likelihood of future bone stress injuries.

Whether you're a runner dealing with persistent shin pain or a clinician working with injured runners, this episode is packed with practical, evidence-informed advice.

In this episode, we cover:

• What a tibial bone stress injury actually is• Tibial bone stress injury vs MTSS ("shin splints")• Clinical assessment and red flags• When MRI is indicated and how useful MRI grading really is• Relative unloading vs complete rest• Strength training and bone adaptation• Cross-training during rehabilitation• Progressive impact loading• Return-to-running criteria• RED-S and low energy availability• Preventing recurrence and managing training load

🌐 ⁠Shownotes

https://www.healthhp.com.au/the-rehab-runway/episode-17-tibial-bone-stress-injuries

Guest

Beau Tyrrell, Sports Physiotherapist

Instagram: @stressfracturephysio

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🌐 https://www.healthhp.com.au/the-rehab-runway

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Tibial Bone Stress Injuries: What Every Runner and Clinician Needs to Know | Beau Tyrrell

The Rehab Runway: From the Treatment Room to the Track

Tibial Bone Stress Injuries: What Every Runner and Clinician Needs to Know | Beau Tyrrell