Tibial bone stress injuries (BSIs) are common among long-distance runners. They have a high recurrence rate, and complexity emerges in the wider management and successful return to running. Following a tibial BSI, a critical component of complete rehabilitation is the successful return to running, and there is a lack of consistency or strong evidence to guide this process. The objectives of this review were to outline the criteria used in clinical decision-making prior to resuming running, and to establish evidence-based guidelines for the return to running process following a tibial BSI. Electronic databases including MEDLINE, CINAHL, Scopus, SPORTDiscus and AMED were searched for studies that stated criteria or provided guidelines on the objectives above. Fifty studies met the inclusion criteria and were included. Thirty-nine were reviews or clinical commentaries, three were retrospective cohort studies, two were randomised controlled trials, two were pilot studies, one was a prospective observational study, and three were case studies. Therefore, the recommendations that have been surmised are based on level IV evidence. Decisions on when an athlete should return to running should be shared between clinicians, coaches and the athlete. There are five important components to address prior to introducing running, which are: the resolution of bony tenderness, pain-free walking, evidence of radiological healing in high-risk BSIs, strength, functional and loading tests, and the identification of contributing factors. Effective return to running planning should address the athlete’s risk profile and manage the risk by balancing the athlete’s interests and reinjury prevention. An individualised graduated return to running programme should be initiated, often starting with walk-run intervals, progressing running distance ahead of speed and intensity, with symptom provocation a key consideration. Contributing factors to the initial injury should be addressed throughout the return to run process.

胫骨应力性损伤 (BSI) 在长跑运动员中很常见。它们的复发率很高，并且在更广泛的管理和成功恢复运行中出现了复杂性。胫骨 BSI 后，完全康复的一个关键组成部分是成功恢复跑步，但缺乏一致性或强有力的证据来指导这一过程。本次综述的目的是概述恢复跑步前临床决策中使用的标准，并为胫骨 BSI 后恢复跑步过程建立循证指南。检索了包括 MEDLINE、CINAHL、Scopus、SPORTDiscus 和 AMED 在内的电子数据库，以查找陈述标准或提供有关上述目标的指南的研究。五十项研究符合纳入标准并被纳入。三十九项是综述或临床评论，三项是回顾性队列研究，两项是随机对照试验，两项是试点研究，一项是前瞻性观察研究，三项是案例研究。因此，推测的建议是基于 IV 级证据。运动员何时应该恢复跑步的决定应由临床医生、教练和运动员共同决定。在引入跑步之前，有五个重要组成部分需要解决，它们是：骨压痛的解决、无痛行走、高风险 BSI 的放射治疗证据、力量、功能和负荷测试以及影响因素的识别。有效的恢复跑步计划应解决运动员的风险状况，并通过平衡运动员的利益和预防再次受伤来管理风险。 应启动个性化的逐步恢复跑步计划，通常从走跑间隔开始，在速度和强度之前增加跑步距离，并以症状激发为关键考虑因素。应在整个恢复跑步过程中解决造成初始伤害的因素。