Best Practice Case Studies-Case 113 Asset 2 Distal Tibial Stress Fracture

Video Transcription

Video Summary

Tamara Brand Perez, a physical therapist and lecturer at UCSF and Stanford, explains return-to-running readiness after tibial stress injury. A key measure is the single-leg hop-for-distance test with hands behind the back, scored by “CASSS”: Control (landing quality/balance), Amount (distance), Symmetry (within 10% between legs), Speed, and Symptoms (no pain). She also emphasizes gait/biomechanics: excessive hip adduction and rearfoot eversion may contribute, so assess hip abductors and foot invertors for strength and endurance. To reduce tibial acceleration, shorten stride, increase cadence, and consider treadmill running. Encourage softer landings with more knee flexion and allow ~24 hours rest between high-load bone sessions.

Meta Tag

Concept Tibial Stress Injury

Concept Gradual Return to Running

Concept Hop Test

Concept CASSS Framework

Concept Hip Adduction

Edition 4th Edition

Related Case 4th Edition, Case 113

Topic Ankle

Keywords

4th Edition

Ankle

tibial stress injury return to running

single-leg hop-for-distance test

CASSS criteria control amount symmetry speed symptoms

gait biomechanics hip adduction rearfoot eversion

cadence increase stride shortening tibial acceleration reduction

4th Edition, Case 113

Tibial Stress Injury

Gradual Return to Running

Hop Test

CASSS Framework

Hip Adduction