Stress Injuries to the Leg: Interview with Dr. Koutures

I recently had the privilege of sitting down with Dr. Chris Koutures, MD, FAAP to talk about tibial stress injuries.  Dr. Koutures is a pediatric sports medicine doctor in Anaheim Hills, CA.  He is a team physician for USA Volleyball Indoor Teams, and also works with Cal State Fullerton and Chapman University.  Dr. Koutures is one of the most thorough doctors I have met when it comes to explaining conditions and the underlying causes with patients and myself as a physical therapist.

The topic of this video interview is stress injuries to the tibia.  As you will see, this can range from shin splints to fractures of the tibia.  This is a common injury seen by runners and athletes of other sports involving a lot of loading to the lower legs.  In my experience when people get “shin splints” they chalk it up to bad luck.  If someone “always gets shin splints” it is seen as simply an unlucky occurrence.  As we will see, there are a lot of factors which will lead someone to have pain in the lower leg.  As with any stress (overuse) injury, we need to find out what are the stressors which are acting on that particular body region.  These stressors can be extrinsic factors- those coming from outside of the body.  These may include training regimen, running/playing surface, shoe wear, etc.  Stressors can also be intrinsic factors- those coming from the athlete’s body.  These may include foot structure, strength, stability, flexibility of the ankle, hip stability, core stability, and more.  The key to a successful recovery and/or prevention of this type of injury is to eliminate as many stressors as you can and increase your promoters of health.  Promoters can include rest, nutrition, proper training regimen, correct mechanics, soft tissue mobility, corrective exercises and proper equipment.