Calf Strengthening With or Without Hip Strengthening for Athletes With Recurring Shin Splints

November 5, 2026 updated by: Komal Ahmed, University of Management and Technology Lahore

Effects of Progressive Loading of Soleus With and Without Hip Strengthening on Pain, Strength, Dynamic Balance and Return to Sports in Athletes With Recurrent Medial Tibial Stress Syndrome

The goal of this clinical trial is to learn whether adding hip strengthening exercises to a calf strengthening program works better than the calf program alone for athletes aged 18 to 40 who keep getting shin splints (pain along the inner edge of the shin bone during or after running). The study will find out which program better reduces shin pain, increases calf and hip muscle strength, improves balance while reaching on one leg, and helps athletes return to their sport without pain. Researchers will compare a progressive calf (soleus) strengthening program alone with the same calf program plus hip strengthening exercises. Participants will receive one of the two programs 3 times a week for 8 weeks (24 sessions), along with advice on managing training load, stretching, balance exercises and a gradual return-to-running plan. They will complete tests of pain, muscle strength, balance, daily function and return to sport at the start, at week 4 and at week 8.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
32

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • University of Management & Technology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 40 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Athletes aged 18-40 years participating in competitive or recreational sports.

    • Both male and female athletes.
    • Diagnosis of recurrent medial tibial stress syndrome according to the Yates and White criteria, characterized by exercise-induced pain along the posteromedial border of the tibia with tenderness extending over 5 cm or more.
    • Pain intensity ranging from 4 to 6 on the Numeric Pain Rating Scale (NPRS).
    • Pain occurring during running or within 24 hours following running activity.
    • History of two or more symptomatic episodes of MTSS within the previous 12 months.

Exclusion Criteria:

  • ● Confirmed chronic exertional compartment syndrome.

    • History of lower-limb surgery within the previous six months.
    • Clinically confirmed tibial stress fracture or any other bony pathology.
    • Acute lower-limb injury (sprain, strain, or fracture) within the previous six weeks.
    • Use of systemic corticosteroids, bisphosphonates, or non-steroidal anti-inflammatory drugs (NSAIDs) for more than 14 consecutive days within 30 days before enrolment.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Progressive Loading of Soleus (PLS)

Progressive soleus loading program plus basic rehabilitation, 3 supervised sessions per week for 8 weeks (24 sessions).
Other: Progressive Soleus Loading

Structured progressive soleus loading exercises to improve plantar-flexor strength, muscular endurance and tibial load tolerance. Load and intensity are progressed gradually according to each participant's tolerance and clinical response.
Experimental: Progressive Loading of Soleus Combined with Hip Strengthening

The same progressive soleus loading program and basic rehabilitation as Arm 1, plus hip strengthening, 3 supervised sessions per week for 8 weeks (24 sessions).
Other: Hip Strengthening

Strengthening exercises for the hip abductors, extensors and external rotators, performed for approximately 15 to 20 minutes per session, with individualized progression.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Pain Intensity (Numeric Pain Rating Scale)
Time Frame: Baseline (Week 0), Week 4 and Week 8.

An 11-point self-reported scale from 0 (no pain) to 10 (worst imaginable pain), rating average pain during running or sports activities. Lower scores indicate less pain.
Baseline (Week 0), Week 4 and Week 8.
Muscle Strength (Handheld Dynamometer)
Time Frame: Baseline (Week 0), Week 4 and Week 8.

Isometric strength of the plantar-flexor and hip muscles, measured with a handheld dynamometer. Higher values indicate greater strength.
Baseline (Week 0), Week 4 and Week 8.
Dynamic Balance (Y-Balance Test)
Time Frame: Baseline (Week 0), Week 4 and Week 8.

Single-leg reach in the anterior, posteromedial and posterolateral directions, normalized to limb length and reported as a composite score (% of limb length). Higher scores indicate better dynamic balance.
Baseline (Week 0), Week 4 and Week 8.
Pain-Free Return to Sport
Time Frame: Baseline (Week 0), Week 4 and Week 8.

Whether the participant completes the graded return-to-running program and resumes sport without reproduction of medial tibial stress syndrome symptoms (achieved / not achieved).
Baseline (Week 0), Week 4 and Week 8.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Management and Technology Lahore

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 5, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 10, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
January 10, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 5, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 5, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 12, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 12, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 5, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • RE-172-2026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The results data collected , de-identified individual participant data will be shared.

IPD Sharing Time Frame

6 months after the publication of the manuscript

IPD Sharing Access Criteria

The data can be requested from the corresponding author

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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