Compare the lower leg muscle strength and range of motion in people with and without Medial tibia stress syndrome and its relation with leg posture

Document Type : Original article

Authors

1 Department of Corrective Exercise and Sport Injuries, School of Physical Education and Sport Sciences, University of Guilan, Iran

2 Assistant Professor, Department of Corrective Exercise and Sport Injuries, University of Guilan, Iran

Abstract

Background and Aim: Medial Tibia Stress Syndrome (MTSS) is one of the common injuries in most athletes. The purpose of the present study was to compare the lower leg muscle strength and Range of Motion (ROM) in people with or without MTSS and its relation with leg posture.
Materials and Methods: The sample were 30 students of Physical Sciences at Guilan University including 15 students with MTSS and 15 normal students. We used Foot Posture Index, to assess placement of athletes’ legs with MTSS. Also, dynamometer was used to evaluate isometric strengths of abductor and adductor thigh muscles’ dorsi and plantar flexor of the ankle. Then, we measured the active ROM for lateral and internal rotation thigh, dorsi, and plantar flexion, eversion, and inversion of ankle using universal goniometer.
Results: The results indicating the relationship between posture of leg with level of MTSS showed pronation of 46.7% (P= 0.02). Also, a significant difference was found in the strength of abductor and adductor of thigh muscle and dorsi and plantar flexor of ankle between the two groups (p≤0.05) in that muscle strength of thigh adductor (P=0.022) and ankle plantar flexor (P=0.020) with MTSS were stronger than those of the controls, but thigh abductor muscle strength (P=0.018) and ankle dorsi flextion (P=0.046) of the MTSS group were weaker than those of the control group. Other results showed significant differences in spinning ROM of thigh external and internal rotation and plantar flexor of ankle joint between the two groups (P≤0.05) as MTSS group had thigh external (P=0.011) and plantar flexor (P=0.003) ROM more than those of the other group. No significant difference was found in the internal rotation of thigh, dorsi flexion, inversion, and eversion of ankle between the two groups (P≥/05).
Conclusion: According to the findings, using appropriate exercises to improve the power and flexibility of lower limbs’ joints and muscles can prevent MTSS. Also, it was revealed that pronation of leg can be among the main causes of inside MTSS. So, it is highly recommended that the trainers correct this unnatural correction via anti-pronation tapes and special insoles.

Keywords

Main Subjects

References

  1. Yazdi NK. [Prevalence of causes of leg pain (Shin Splints) in Mashhad university female student-athlete (persian). Thesis for master of physical education. Mashhad: Faculty of Physical Education and Sports Science Ferdowsi University:1995##
  2. Brewer RB, Gregory AJM. Chronic lower leg pain in athletes a guide for the differential diagnosis, evaluation, and treatment. Sports Health 2012; 4(2): 121-127##
  3. Tweed JL, Campbell JA, Avil SJ. Biomechanical risk factors in the development of medial tibial stress syndrome in distance runners. Journal of the American Podiatric Medical Association 2008; 98(6): 436-444##
  4. Yates B, White S. The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. Am J Sports Med 2004; 32(3): 772-780 ##
  5. Almeida S, et al. Gender differences in musculoskeletal injury rates a function of symptom reporting?  Medicine and science in sports and exercise 1999; 31(12): 1807-1812##
  6. Sommer H, Vallentyne S. Effect of foot posture on the incidence of medial tibial stress syndrome. Med Sci Sports Exer 1995;27(6): 800-804##
  7. Viitasalo J, Kvist M. Some biomechanical aspects of the foot and ankle in athletes with and without shin splints. Am J Sports Med 1983; 11(3): 125-130 ##
  8. Milgrom C, Giladi M, Stein M, Kashtan H, Margulies J, Chisin R, Steinberg R, Swissa A, Aharonson Z. Medial tibial pain  A prospective study of its cause among military recruits. Clin Orthop Relat Res 1986; 213.p. 178-182
  9. Devas  MB. Stress fractures of the tibia or shin soreness. J Bone Joint Surg Br 1958; 2(20): 227- 239## 

10. Clement DB. Tibial stress syndrome in athletes. J Sports Med 1974; 2(2): 81-85##

11. Subotnik SI. The shin splints syndrome of the lower extremity. J Am Podiatry Assoc 1976; 66(1): 43-45##

12. Wen DY. Risk factors for overuse injuries in runners. Current Sports Med Rep 2007; 6(5): 307-313  ##

13. Hubbard TJ, Carpenter EM, Cordova ML. Contributing factors to medial tibial stress syndrome. Med Sci Sports Exer 2007; 41(3): 490-496##

14. Bennett JE, Reinking MF, Pluemer B, et al. Factors contributing to the development of medial tibial stress syndrome in high school runners. J Orthop Sports Phys Ther 2001; 31(9): 504–510##

15. Burne SG, Khan KM, Bandeth BP. Risk factor associated with exertional medial tibial pain. Br J Sports Med 2004; 38 (4):  441-445##

16. Yagi S, Muneta T, Sekiya I. Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners. Knee Surg Sports Traumatol Arthrosc 2013; 21(3): 556-563##

17. Moen MH, Bongers T, Bakker EW, et al. Risk factors and prognostic indicators for medial tibial stress syndrome. Scand J Med Sci Sports 2012; 22(1): 34–9##

18. Lilletvedt J, Kreighbaum E, Phillips RL. Analysis of selected alignment of the lower extremity related to the shin splint syndrome. J Am Podiatry Assoc 1979; 69(3): 211##

19. Devas MB. Stress fracture of the tibia in athletes or shin soreness. J Bone Joint Surg Br 1958; 2 (20): 22##

20. Yuksel O et al. .Inversion/eversion strength dysbalance in patients with medial tibial stress syndrome. Journal of Sports Science and Medicine 2011; 10(4): 737##

21. Michael RH, Holder LE. The soleus syndrome A cause of medial tibial stress (shin splints). American Journal of Sports Medicine 1985; 13(2): 87-94 ##

22. Sabeti V, khoshraftar yazdi N, Bizhe N, Moghimi S.  Comparison of leg muscle EMG activity in female athletice with and without leg pain. Spicific physical teraphy journal 2013; 3(1): 51-55[In Persian]##

  1. 23.  Niemuth, Paul E, et al. Hip Muscle Weakness and Overuse Injuries in Recreational Runners Clinical. Journal of Sport Medicine 2005; 15(1): 14-21##

24. Ruth Verrelst et al. The role of hip abductor and external rotator muscle strength in the development of exertional medial tibial pain. Br J Sport Med  2012; 12(2): 57-68##

25. Nicholas JA, Strizak AM, Veras G. A study of thigh muscle weakness in different pathological states of the lower extremity. J Sports Med 1976; 4(6): 241–248##

26. Souza RB, Powers CM. Differences in hip kinematics, muscle strength, and muscle activation between subjectswith and without­patellofemoral pain. J Orthop Sports Phys Ther 2009; 39 (1): 12–19##

27. Garth WP Jr, Miller ST. Evaluation of claw toe deformity, weakness of the foot intrinsics, and posteromedial shin pain. Am J Sports Med. 1989; 17(6): 821–7##

28. Messina DF, Farney WC, DeLee JC. The incidence of injury in Texas high school basketball. A prospective study among male and female athletes. Am J Sports Med . 1999; 27(3): 294-299##

29. Ireland ML, Willson JD, Ballantyne BT, and Davis IM. Hip strength in females with and without patellofemoral pain. Journal of Orthopaedic & Sports Physical Therapy 2003; 33(11): 671-676 ##

30. Evans AM, Copper AW, Scharfbilling RW, Scutter SD , Williams MT. thereliability of the foot posture index and traditional measurements of foot position. J AM Pod Med Assoc 2003; 93(3): 203-213 ##

31. Ruwe PA, Gage JR, et al. Clinical determination of femoral ante version. J of bone and joint surgery 1992 ; 74 (6):  830-  820##

32. Plisky MS, Rauh MG, Heidersheit B. Medial tibial stress syndrome in high school cross  country runners: incidence and risk factors. J Orthop Sport Phys Ther 2007; 37 (2): 40-47##

33. Reinking MF, Austin TM, Hayes AM. Exercise  related leg pain in collegiate cross  country athletes: extrinsic and intrinsic risk factors. J Orthop Sports Phys Ther 2007; 37 (11):  670-678##

34. Cote KP, Brunet ME, Gansneder BM, Shultz SJ. Effects of Pronated and Supinated Foot Postures on Static and Dynamic Postural Stability. J Athl Train 2005; 40(1): 41-6##

35. Leetun DT, Ireland ML, Willson JD, Ballantyne BT, Davis IM. Core stability measures as risk factors for lower extremity injury in athletes. Med Sci Sports Exerc 2004; 36(6): 926–934##

36. Madele LT, Munteanu SE, and Bonanno DR. Endurance of the ankle joint plantar flexor muscles in athletes

37. Clement DB. Tibial stress syndrome in athletes. J Sports Med 1974; 2(2): 81–85##

38. Cavanaugh PR, LaFortune MA. Ground reaction forces in distance running. J Biomech 1980; 13(5): 397–406##

39. Nester CJ, van der Linden ML, Bowker P. Effect of foot orthoses on the kinematics and kinetics of normal. J Gait & posture 2003; 17(2): 180–18##

 

The Scientific Journal of Rehabilitation Medicine
Volume 5, Issue 3
September and October 2016
Pages 58-67

Files

History

  • Receive Date: 29 July 2015
  • Revise Date: 25 November 2015
  • Accept Date: 30 November 2015
  • First Publish Date: 22 September 2016

Share

How to cite

Statistics