Factors Contributing to Medial Tibial Stress Syndrome in Runners: A Prospective Study

Purpose Medial tibial stress syndrome (MTSS) is one of the most common overuse injuries sustained by runners. Despite the prevalence of this injury, risk factors for developing MTSS remain unclear. The purpose of this study was to prospectively evaluate differences in passive range of motion, muscle strength, plantar pressure distributions, and running kinematics between runners who developed MTSS and those who did not. Methods 24 NCAA Division 1 cross country runners participated in this study. Participants underwent a clinical exam documenting passive range of motion and muscle strength at the hips and ankles. Plantar pressure analysis was used to quantify mediolateral pressure balances while walking and 3D motion capture was used to quantify running kinematics. Participants were followed for a two year period during which time any runners who developed MTSS were identified by the team's certified athletic trainer. Results Runners who developed MTSS demonstrated tighter iliotibial bands (p=.046, ES=1.07), weaker hip abductors (p=.008, ES=1.51), more pressure under the medial aspect of their foot at initial foot contact(p=.001, ES=1.97), foot flat(p<.001 es="3.25)," and heel off greater contralateral pelvic drop peak amounts durations of rearfoot eversion during stance phase. a logistic regression p indicated that every increase in duration increased odds developing mtss by conclusions these findings demonstrate the development is multifactorial with passive range motion muscle strength plantar pressure distributions both proximal distal kinematics all playing role. we suggest coaches or sports medicine professionals screening runners for injury risk consider adopting comprehensive evaluation which includes areas. corresponding author: dr. james becker department health human hoseaus fitness center montana state university bozeman mt james.becker4 no funding was received this work. authors have conflicts interest to declare. results study are presented clearly honestly without fabrication falsification inappropriate data manipulation. present do not constitute endorsement american college medicine. accepted publication: may>

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