Brukner P, Khan K: “Shin Pain,” in Clinical Sports Medicine, ed by P Brukner, K Khan, p 518, McGraw-Hill, Sydney, Australia. ,2001. .
Mubarak SJ, Gould RN, Lee YF, et al: The medial tibial stress syndrome: a cause of shin splints. .Am J Sports Med 10::201. ,1982. .
Yates B, Allen M, Barnes M: Outcome of surgical treatment of medial tibial stress syndrome. .J Bone Joint Surg Am 85::1974. ,2003. .
Glorioso J, Wilkins J: “Exertional Leg Pain,” Textbook of Running Medicine, ed by F O’Conner, R Wilder, p 508, McGraw-Hill, Sydney, Australia. ,2001. .
Rzonca E, Bayliss W: Common sports injuries to the foot and leg. .Clin Podiatr Med Surg 5::591. ,1988. .
James S: Injuries to runners. .Am J Sports Med 6::40. ,1978. .
Detmer D: Chronic shin splints: classification and management of medial tibial stress syndrome. .Sports Med 3::436. ,1986. .
D’Ambrosia R: Interstitial pressure measurements in the anterior and posterior compartments in athletes with shin splints. .Am J Sports Med 5::127. ,1977. .
Beck B, Osternig LR: Medial tibial stress syndrome: the location of the muscles in the leg in relation to symptoms. .J Bone Joint Surg Am 76::1057. ,1994. .
Saxena A, O’Brien T, Bunce D: Anatomic dissection of the tibialis posterior muscle and its correlation to medial tibial stress syndrome. .J Foot Surg 29::105. ,1990. .
Yates B, White S: The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. .Am J Sports Med 32::772. ,2004. .
Couture C, Karlson K: Tibial stress injuries: decisive diagnosis and treatment of “shin splints.”. Phys Sportsmed 30::29. ,2002. .
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 Ther 31::504. ,2001. .
Sommer HM, Vallentyne SW: Effect of foot posture on the incidence of medial tibial stress syndrome. .Med Sci Sports Exerc 27::800. ,1995. .
Beeson P: “Orthopaedic Assessment,” Assessment of the Lower Limb, ed by L Merriman, W Turner, Churchill Livingstone, p. 157, London. ,2002. .
Valmassey R: “Pathomechanics of Lower Extremity Function,” Clinical Biomechanics of the Lower Limb, ed by R Valmassey, p 60, Mosby, St Louis, MO. ,1996. .
DeLacerda F: A study of anatomical factors involved in shinsplints. .J Orthop Sports Ther 2::55. ,1980. .
Subotnik S: “Exercise Induced Leg Pain,” Sports Medicine of the Lower Extremity, ed by S Subotnik, p 277, Churchill Livingstone, Philadelphia. ,1999. .
Evans AM, Copper AW, Scharfbillig RW, et al: Reliability of the Foot Posture Index and traditional measures of foot position. .JAPMA 93::203. ,2003. .
Scharfbillig R, Evans AM, Copper AW, et al: Criterion validation of four criteria of the Foot Posture Index. .JAPMA 94::31. ,2004. .
Stanish WD: Overuse injuries in athletes: a perspective. .Med Sci Sports Exerc 16::1. ,1984. .
Beck BR: Tibial stress injuries: an aetiological review for the purposes of guiding management. .Sports Med 26::265. ,1998. .
Dananberg HJ: Functional hallux limitus and its relationship to gait efficiency. .JAPMA 76::648. ,1986. .
Curran SA, Dananberg HJ: Future of gait analysis: a podiatric medical perspective. .JAPMA 95::130. ,2005. .
Background: We investigated the relationship between functional and static foot posture and medial tibial stress syndrome in distance runners.
Methods: Twenty-eight runners with a clinical diagnosis of medial tibial stress syndrome and 12 asymptomatic runners were assessed with the Foot Posture Index to measure static overpronation. Range of motion was measured at the talocrural joint, with the knee extended and flexed as was range of motion at the first metatarsophalangeal joint and the angular difference between the neutral and relaxed calcaneal stance positions. Each participant was then videotaped while running on a treadmill shod and unshod. This videotape was analyzed using freeze frame to identify abnormal or mistimed pronation at each phase of gait. The results were analyzed using logistic regression to give the probability that a runner is likely to experience medial tibial stress syndrome, predicted from the static measurements and dynamic observations.
Results: Variables identified as being significant predictors of medial tibial stress syndrome were the difference between the neutral and relaxed calcaneal stance positions, range of motion of the talocrural joint with the knee extended, early heel lift and abductory twist during gait, and apropulsive gait.
Conclusion: Runners with suspected symptoms of medial tibial stress syndrome should be assessed dynamically and statically for abnormal or mistimed pronation. (J Am Podiatr Med Assoc 98(6): 436–444, 2008)