面向运动员骨髓水肿的功能性磁刺激（FMS）

实验性的：Functional Magnetic Stimulation plus standardized physiotherapy rehabilitation

Arm Description: Participants receive 12 physiotherapy rehabilitation sessions over four weeks plus eight 30-minute FMS sessions applied over the symptomatic tibial region.

其他：Standardized physiotherapy rehabilitation with FMS

Participants in this arm complete a supervised four-week rehabilitation program delivered three times per week, for a total of 12 sessions of approximately 45 minutes each. The program focuses on symptom-guided activity modification, progressive lower-limb loading, strengthening, mobility exercises, neuromuscular control, home-based exercise guidance, and gradual return to impact-related activity. In addition, participants receive Functional Magnetic Stimulation twice per week for four weeks, resulting in eight sessions in total. Each FMS session lasts 30 minutes and is applied over the symptomatic tibial region. Stimulation is delivered at 40 Hz, with repeated cycles of 3 seconds of stimulation followed by 6 seconds of rest. Intensity is increased gradually according to participant tolerance, while avoiding pain, excessive discomfort, or overly strong muscle contractions.

有源比较器：Physiotherapy rehabilitation alone

Participants in this group complete 12 supervised physiotherapy rehabilitation sessions over a four-week period and do not receive Functional Magnetic Stimulation.

其他：Standardized Physiotherapy without FMS

Participants in this group will follow the same standardized physiotherapy protocol as the first group, without the application of FMS

Change in tibial pain during a standardized walking task

Description: Pain related to loading of the affected tibia is measured with the Numeric Pain Rating Scale, an 11-point scale ranging from 0 to 10. A score of 0 indicates absence of pain, while a score of 10 indicates the highest possible pain intensity. At each assessment, participants complete a standardized treadmill walking task and report the greatest tibial pain experienced during the test. The walking speed selected at the initial assessment is kept the same for each participant at follow-up measurements, allowing pain to be evaluated under comparable loading conditions. Higher scores reflect greater symptom severity.

Changes in lower-limb functional ability with the Greek Version of the Lower Extremity Functional Scale (LEFS-GR)

Description: Lower-limb function is evaluated using the Greek version of the Lower Extremity Functional Scale. This patient-reported measure includes 20 items related to daily and sport-related activities involving the lower limb. Each item is scored from 0 to 4, and the total score ranges from 0 to 80. Lower scores indicate greater functional limitation, whereas higher scores reflect better lower-limb functional ability.

Change in MRI-derived bone marrow edema extent

Bone marrow edema is assessed using magnetic resonance imaging of the affected tibia. The extent of edema is measured on fluid-sensitive MRI sequences as the maximum visible longitudinal length of intramedullary edema. The measurement is recorded in centimeters, with lower values indicating a smaller extent of bone marrow edema.

Change in Fredericson MRI grade

Tibial bone stress injury severity is evaluated using the Fredericson MRI grading system. This classification ranges from grade 0 to grade 4, with lower grades indicating less severe MRI findings and grade 4 indicating the presence of a fracture line. Changes in Fredericson grade are assessed over time to monitor MRI-defined recovery.