PainSci summary of Becker 2018: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible.
The researchers measured hip strength in a couple of dozen athletes and then waited (two years) to see who would develop medial tibial stress syndrome (a prospective study, which is the right way to do it). The runners who developed medial tibial stress syndrome originally had weaker hip abductors (that’s the muscles on the sides of the hips). It wasn’t a dramatic difference, but it was detectable and clinically significant… if it’s real.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
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: Twenty-four National Collegiate Athletic Association Division 1 cross-country runners participated in this study. Participants underwent a clinical examination 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 up for a 2-yr 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 = 0.046; effect size [ES] = 1.07), weaker hip abductors (P = 0.008, ES = 1.51), more pressure under the medial aspect of their foot at initial foot contact (P = 0.001, ES = 1.97), foot flat (P < 0.001, ES = 3.25), and heel off (P = 0.034, ES = 1.30), greater contralateral pelvic drop (P = 0.021, ES = 1.06), and greater peak amounts (P = 0.017, ES = 1.42) and durations (P < 0.001, ES = 2.52) of rearfoot eversion during stance phase. A logistic regression (χ = 21.31, P < 0.001) indicated that every 1% increase in eversion duration increased odds of developing MTSS by 1.38 (P = 0.015).
CONCLUSIONS: These findings demonstrate that the development of MTSS is multifactorial, with passive range of motion, muscle strength, plantar pressure distributions, and both proximal and distal kinematics all playing a role. We suggest that coaches or sports medicine professionals screening runners for injury risk consider adopting a comprehensive evaluation which includes all these areas.
- “Association of Isometric Strength of Hip and Knee Muscles With Injury Risk in High School Cross Country Runners,” Lace E Luedke, Bryan C Heiderscheit, D S Blaise Williams, and Mitchell J Rauh, International Journal of Sports Physical Therapy, 2015.
- “Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners,” Shigenori Yagi, Takeshi Muneta, and Ichiro Sekiya, Knee Surgery, Sports Traumatology, Arthroscopy, 2013.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.
- Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Zhou 2020 Sci Rep.
- Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Nakale 2018 Foot Ankle Int.
- No Added Benefit of Combining Dry Needling With Guideline-Based Physical Therapy When Managing Chronic Neck Pain: A Randomized Controlled Trial. Stieven 2020 J Orthop Sports Phys Ther.
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.