• 1.

    Kortebein, PM, KR Kaufman, JR Basford, et al. :Medial tibial stress syndrome. .Med Sci Sports Exerc 32::S27. ,2000. .

  • 2.

    Plisky, MS, MJ Rauh, B Heiderscheit, et al. :Medial tibial stress syndrome in high school cross-country runners: incidence and risk factors. .J Orthop Sports Phys Ther 37::40. ,2007. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Yates, B and S White. :The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. .Am J Sports Med 32::772. ,2004. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Almeida, SA, DW Trone, DM Leone, et al. :Gender differences in musculoskeletal injury rates: a function of symptom reporting? Med Sci Sports Exerc 31.:1807. ,1999. .

    • Search Google Scholar
    • Export Citation
  • 5.

    Burne, SG, KM Khan, PB Boudville, et al. :Risk factors associated with exertional medial tibial pain: a 12 month prospective clinical study. .Br J Sports Med 38. :441.,2004. .

    • Search Google Scholar
    • Export Citation
  • 6.

    Bouche, RT and CH Johnson. :Medial tibial stress syndrome (tibial fasciitis): a proposed pathomechanical model involving fascial traction. .JAPMA 97. :31.,2007. .

    • Search Google Scholar
    • Export Citation
  • 7.

    Stickley, CD, RK Hetzler, IF Kimura, et al. :Crural fascia and muscle origins related to medial tibial stress syndrome symptom location. .Med Sci Sports Exerc 41. :1991. ,2009. .

    • Search Google Scholar
    • Export Citation
  • 8.

    Beck, BR . :Tibial stress injuries: an aetiological review for the purposes of guiding management. .Sports Med 26::265. ,1998. .

  • 9.

    Magnusson, HI, NE Westlin, F Nyqvist, et al. :Abnormally decreased regional bone density in athletes with medial tibial stress syndrome. .Am J Sports Med 29::712. ,2001. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Franklyn, M, B Oakes, B Field, et al. :Section modulus is the optimum geometric predictor for stress fractures and medial tibial stress syndrome in both male and female athletes. .Am J Sports Med 36::1179. ,2008. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Bandholm, T, L Boysen, S Haugaard, et al. :Foot medial longitudinal-arch deformation during quiet standing and gait in subjects with medial tibial stress syndrome. .J Foot Ankle Surg 47::89. ,2008. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Willems, TM, CD De, K Delbaere, et al. :A prospective study of gait related risk factors for exercise-related lower leg pain. .Gait Posture 23::91. ,2006. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

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

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Mueller, MJ and KS Maluf. :Tissue adaptation to physical stress: a proposed “Physical Stress Theory” to guide physical therapist practice, education, and research. .Phys Ther 82::383. ,2002. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Brody, DM . :Techniques in the evaluation and treatment of the injured runner. .Orthop Clin North Am 13::541. ,1982. .

  • 16.

    Mueller, MJ, JV Host, and BJ Norton. :Navicular drop as a composite measure of excessive pronation. .JAPMA 83::198. ,1993. .

  • 17.

    Redmond, AC, J Crosbie, and RA Ouvrier. :Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. .Clin Biomech (Bristol, Avon) 21::89. ,2006. .

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Cornwall, MW, TG McPoil, M Lebec, et al. :Reliability of the modified Foot Posture Index. .JAPMA 98::7. ,2008. .

  • 19.

    Jordan, K, JH Challis, and KM Newell. :Walking speed influences on gait cycle variability. .Gait Posture 26::128. ,2007. .

  • 20.

    Matsas, A, N Taylor, and H McBurney. :Knee joint kinematics from familiarised treadmill walking can be generalised to overground walking in young unimpaired subjects. .Gait Posture 11::46. ,2000. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Rathleff, MS, RG Nielsen, O Simonsen, et al. :Perspectives for clinical measures of dynamic foot function-reference data and methodological considerations. .Gait Posture 31::191. ,2010. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Bartosik, KE, M Sitler, HJ Hillstrom, et al. :Anatomical and biomechanical assessments of medial tibial stress syndrome. .JAPMA 100::121. ,2010. .

    • Search Google Scholar
    • Export Citation
  • 23.

    Hargrove, R and C Maclean. :Incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. .Am J Sports Med 33::463. ,2005. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Campbell, KM, NL Biggs, PL Blanton, et al. :Electromyographic investigation of the relative activity among four components of the triceps surae. .Am J Phys Med 52::30. ,1973. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Klein, P, S Mattys, and M Rooze. :Moment arm length variations of selected muscles acting on talocrural and subtalar joints during movement: an in vitro study. .J Biomech 29::21. ,1996. .

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Pohl, MB and JG Buckley. :Changes in foot and shank coupling due to alterations in foot strike pattern during running. .Clin Biomech (Bristol, Avon) 23::334. ,2008. .

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Nielsen, RG, MS Rathleff, OH Simonsen, et al. :Determination of normal values for navicular drop during walking: a new model correcting for foot length and gender. .J Foot Ankle Res 2::12. ,2009. .

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Nielsen, RG, MS Rathleff, UG Kersting, et al. :The predictive value of the foot posture index on dynamic function. .J Foot Ankle Res 1 ( suppl:):O37. ,2008. .

    • Search Google Scholar
    • Export Citation
  • 29.

    Hunt, AE, AJ Fahey, and RM Smith. :Static measures of calcaneal deviation and arch angle as predictors of rearfoot motion during walking. .Aust J Physiother 46. :9.,2000. .

    • Search Google Scholar
    • Export Citation
  • 30.

    Cashmere, T, R Smith, and A Hunt. :Medial longitudinal arch of the foot: stationary versus walking measures. .Foot Ankle Int 20. :112.,1999. .

    • Search Google Scholar
    • Export Citation
  • 31.

    van Ingen Schenau, GJ . :Some fundamental aspects of the biomechanics of overground versus treadmill locomotion. .Med Sci Sports Exerc 12. :257.,1980. .

    • Search Google Scholar
    • Export Citation
  • 32.

    Cornwall, MW and TG McPoil. :Relative movement of the navicular bone during normal walking. .Foot Ankle Int 20. :507.,1999. .

Dynamic Midfoot Kinematics in Subjects with Medial Tibial Stress Syndrome

Michael S. Rathleff Orthopaedic Surgery Research Unit, Aarhus University Hospital–Aalborg Hospital, Aalborg, Denmark.

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Luke A. Kelly ASPETAR–Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar.

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Finn B. Christensen Orthopaedic Department, Odense University Hospital, Odense, Denmark.

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Ole H. Simonsen Orthopaedic Surgery Research Unit, Aarhus University Hospital–Aalborg Hospital, Aalborg, Denmark.

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Søren Kaalund Kaalunds Orthopedic Clinic, Aalborg, Denmark.

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Uffe Laessoe Center for Sensory-Motor Interaction, Aalborg University, and Department of Physiotherapy, University College North Denmark, Aalborg, Denmark.

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Background:

Medial tibial stress syndrome (MTSS) is a common diagnosis. Several studies have demonstrated that excessive static navicular drop (ND) is related to the diagnosis. However, no studies have yet investigated ND and the velocity of ND during dynamic conditions. The aim of this study was to evaluate ND characteristics in patients with MTSS in dynamic and static conditions.

Methods:

In a case-control study, 14 patients diagnosed as having MTSS were included from an orthopedic outpatient clinic. A control group consisting of 14 healthy participants was matched regarding age, sex, and typical sporting activity. Navicular drop was evaluated during treadmill walking by a two-dimensional video analysis. Static foot posture, static ND, dynamic ND (dND), and velocity of dND were compared.

Results:

The two groups were comparable in relation to age, sex, height, weight, and foot size. No significant difference was found in static foot posture. Static ND showed a mean difference of 1.7 mm between the groups (P = .08). During treadmill walking, patients with MTSS had, on average, a 1.5-mm-larger dND (P =.004) and a 2.4-mm/sec-larger mean velocity of dND (P = .03).

Conclusions:

Patients with MTSS display a larger ND and a higher ND velocity during treadmill walking. Increased ND velocity may be important to this condition. Future studies should include velocity of dND to investigate the mechanisms of dND in relation to overuse injuries. (J Am Podiatr Med Assoc 102(3): 205–212, 2012)

Corresponding author: Michael S. Rathleff, BSc, PT, Orthopaedic Surgery Research Unit, Aarhus University Hospital–Aalborg Hospital, 15 Soendre Skovvej, DK-9000 Aalborg, Denmark. (E-mail: michaelrathleff@gmail.com)