Medial tibial stress syndrome often occurs in athletes as a result of training errors and overuse. Repetitive activity causes inflammation where the tendon attaches to the bone. Sometimes the tendon pulls away from the bone or the bone develops a tiny fracture. Although rest is the first and best treatment, there are other options.
Activity modification and specific rehabilitation can be provided by a physical therapist. The therapist can also evaluate your movement and training program to look for possible causes of your symptoms.
Surgery is performed if swelling in the area puts too much tension on the tissues along the tibia bone. Your doctor is the best one to make this recommendation.