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Mattock J, Steele JR, Mickle KJ. A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners. BMC Sports Sci Med Rehabil. 2018;10:20doi: 10.1186/s13102-018-0109-1.
Mattock, J., Steele, J. R., & Mickle, K. J. (2018). A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners. BMC sports science, medicine & rehabilitation, 1020. https://doi.org/10.1186/s13102-018-0109-1
Mattock, Joshua, et al. "A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners." BMC sports science, medicine & rehabilitation vol. 10 (2018): 20. doi: https://doi.org/10.1186/s13102-018-0109-1
Mattock J, Steele JR, Mickle KJ. A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners. BMC Sports Sci Med Rehabil. 2018 Nov 22;10:20. doi: 10.1186/s13102-018-0109-1. eCollection 2018. PMID: 30479774; PMCID: PMC6251115.
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BMC Sports Sci Med Rehabil. 2018 Nov 22;10:20. doi: 10.1186/s13102-018-0109-1. eCollection 2018.

A protocol to prospectively assess risk factors for medial tibial stress syndrome in distance runners.

BMC sports science, medicine & rehabilitation

Joshua Mattock, Julie R Steele, Karen J Mickle

Affiliations

  1. 1Biomechanics Research Laboratory, University of Wollongong, Wollongong, NSW Australia.
  2. 2Institute of Health and Sport, Victoria University, Melbourne, VIC Australia.

PMID: 30479774 PMCID: PMC6251115 DOI: 10.1186/s13102-018-0109-1

Abstract

BACKGROUND: Medial tibial stress syndrome (MTSS) is a lower leg injury with a reported incidence rate of up to 35% in active individuals. Although numerous prospective studies have tried to identify risk factors for developing MTSS, managing the syndrome remains difficult. One risk factor yet to be extensively explored in MTSS development is reduced lower leg girth. Further investigation of reduced lower leg girth is required due to the important role lower leg musculature plays in attenuating ground reaction forces during the gait cycle. Therefore, the primary aim of this study is to ascertain whether lower leg muscle morphology and function contribute to the development of MTSS. Our ultimate aim is to identify potential risk factors for MTSS that can be targeted in future studies to better manage the injury or, preferably, prevent individuals developing MTSS.

METHODS: This study will be prospective in design and will recruit asymptomatic distance runners. All participants will be tested at base line and participants will have their training data longitudinally tracked over the following 12 months to assess any individuals who develop MTSS symptoms. At base line, outcome measures will include bilateral measures of lower limb anthropometry; cross sectional area (CSA) and thickness of the tibialis anterior, peroneals, flexor digitorum longus, flexor hallucis longus and thickness of soleus, medial and lateral head of gastrocnemius. Tibial bone speed of sound, ankle dorsiflexion range of motion, strength of the six previously described muscles, foot alignment and ankle plantar flexor endurance will also be assessed. Participants will also complete a treadmill running protocol where three-dimensional kinematics, plantar pressure distribution and electromyography data will be collected.

DISCUSSION: This study will aim to identify characteristics of individuals who develop MTSS and, in turn, identify modifiable risk factors that can be targeted to prevent individuals developing this injury.

Keywords: Injury prevention; Medial tibial stress syndrome; Protocols; Running injuries

Conflict of interest statement

Ethical clearance for this study, including the participant recruitment strategy and all procedures, was obtained from the University of Wollongong Human Research Ethics Committee (HE15/012). All part

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