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Anatomical and Biomechanical Assessments of Medial Tibial Stress Syndrome

Katherine E. Bartosik Biokinetics Research Laboratory, Athletic Training Division, Department of Kinesiology, Temple University, Philadelphia, PA. Dr. Huxel is now with A.T. Still University, Mesa, AZ.

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Michael Sitler Biokinetics Research Laboratory, Athletic Training Division, Department of Kinesiology, Temple University, Philadelphia, PA. Dr. Huxel is now with A.T. Still University, Mesa, AZ.

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Howard J. Hillstrom Gait Study Center, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Howard Palamarchuk Foot and Ankle Institute, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Kellie Huxel Biokinetics Research Laboratory, Athletic Training Division, Department of Kinesiology, Temple University, Philadelphia, PA. Dr. Huxel is now with A.T. Still University, Mesa, AZ.

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Esther Kim Gait Study Center, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Background: Medial tibial stress syndrome is a common overuse injury in weightbearing, physically active individuals and in athletes. Most research associated with this condition is primarily based on static foot and lower-extremity measurements.

Methods: A cross-sectional design was used to assess a set of static and dynamic measurements to determine which anatomical factors (limb length, ankle dorsiflexion, first metatarsophalangeal joint extension, and arch height) and biomechanical factors (center-of-pressure excursion index, malleolar valgus index, and gait velocity) are associated with medial tibial stress syndrome.

Results: One-way analysis of variance models revealed that participants with medial tibial stress syndrome had significantly greater visual analog pain levels and slower gait velocity than noninjured controls (P = .05). No other significant differences were found between the two groups.

Conclusions: Further investigation of these and other factors can help health professionals develop better strategies for the prevention and clinical intervention of medial tibial stress syndrome. (J Am Podiatr Med Assoc 100(2): 121–132, 2010)

Corresponding author: Katherine E. Bartosik, MEd, ATC, Biokinetics Research Laboratory, Athletic Training Division, Department of Kinesiology, Temple University, 114 Pearson Hall, Broad St and Montgomery Ave, Philadelphia, PA 19122. (E-mail: ktbhoops5@hotmail.com)