Patient is a runner in his 40's with anterior shin pain, which is worse on rest, and better with walking and movement.

He has bilat. overpronated feet, FAROM at ankle which is pain free, but slightly decreased tib ant length, and very bulky calf's. The tib. ant. muscle belly is tender to palpate on deep palpation. Shin tap and stress tests are negative for stress fracture.

So far I have given gastro/soleus stretches, tib ant stretches, and tib post strengthening with little improvement. His is seeing podiatry and is in the process of having orthotics made up.

Any advice would be greatly appreciated!!!

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