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

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

32

Phase

  • 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

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
Intervention / Treatment
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

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

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)

November 5, 2026

Primary Completion (Estimated)

January 10, 2027

Study Completion (Estimated)

January 10, 2027

Study Registration Dates

First Submitted

November 5, 2026

First Submitted That Met QC Criteria

November 5, 2026

First Posted (Actual)

November 12, 2026

Study Record Updates

Last Update Posted (Actual)

November 12, 2026

Last Update Submitted That Met QC Criteria

November 5, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID 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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