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Effect of Varus-Wedged Orthoses on Medial Tibial Stresses During Running The most likely etiology for medial tibial stress syndrome (MTSS) and medial tibial stress fracture (MTSF) is excessive bending of the tibia during the support phase of running. Treatment of runners with varus-wedged orthoses, which may include a medial heel skive, a well-formed medial longitudinal arch and should include a varus forefoot extension, works exceedingly well at relieving the pain of MTSS and at preventing MTSF
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