Ankle isokinetic muscle strength and navicular drop in athletes with medial tibial stress syndrome

Year 2019, Volume: 44 Issue: 3, 898 - 903, 30.09.2019

Sabriye Ercan

https://doi.org/10.17826/cumj.459411

Cited By: 1

Abstract

Purpose: The purpose of this study is to compare some anatomical features and ankle isokinetic muscle strength of adolescent athletes with medial tibial stress syndrome (MTSS) and healthy control group and to examine the adequacy of ‘tibial facial traction theory in the development of MTSS.

Materials and Methods: Adolescent athletes who had been diagnosed with MTSS during the season and healthy control group participants were included in the study. Demographic data and training details of the athletes were recorded. The MTSS score was used to determine the severity of the injury. The navicular drop test, lower extremity length measurement, and isokinetic muscle strength measurement were performed. 

Results: The complaint duration of the patients with MTSS (n:21) was 1.8 ± 1.8 months and the MTSS score was 3.9 ± 2.2. The control group (n:12) and the athletes diagnosed with MTSS had similar demographic characteristics and training details. There was no difference between the groups in terms of navicular drop and lower extremity length. There was no ‘lower extremity difference’ for right and left extremities. According to the results of the isokinetic muscle strength test in plantarflexion and dorsiflexion direction, there was no difference between the groups in terms of muscle strength at both low and high angular speeds. 

Conclusion: ‘The tibial traction theory’ does not sufficiently explain the pathogenesis of MTSS. Studies which evaluate isokinetic muscle strength and perform real-time dynamic analysis on the track are required to make recommendations for ideal protection and rehabilitation in cases of MTSS. 

Keywords

Medial tibial stress syndrome, muscle strength, navicular drop

Medial tibial stres sendromlu sporcularda ayak bileği izokinetik kas kuvveti ve naviküler çökme miktarı

Abstract

Amaç: Bu çalışmanın amacı, medial tibial stres sendromu (MTSS) gelişen adolesan sporcular ile sağlıklı kontrol grubunun bazı anatomik özelliklerini ve ayak bileği izokinetik kas kuvvetini karşılaştırmaktır. MTSS gelişiminde ‘Tibial fasial-traksiyon teorisi’nin yeterliliğini incelemektir. 

Gereç ve Yöntem: Bir sezonluk süre içerisinde MTSS tanısı alan adolesan sporcular ve sağlıklı kontrol grubu araştırmaya alındı. Sporculara ait demografik veriler ve antrenman detayları kaydedildi. Hastalık şiddetini belirlemek için MTSS şiddet skoru kullanıldı. Sporculara naviküler çökme testi, alt ekstremite uzunluk ölçümü ve izokinetik kas kuvvet ölçümü yapıldı. 

Bulgular: MTSS tanısı alan (n:21) hastaların şikayet süresi 1.8 ± 1.8 ay, MTSS şiddet skoru 3.9 ± 2.2 puandı. Kontrol grubu (n:12) ile MTSS tanısı alan sporcuların demografik verileri ve antrenman detayları benzerdi. Naviküler çökme miktarı ve alt ekstremite uzunluğu gruplar arasında fark oluşturmadı. Sağ ve sol ekstremite için ‘alt ekstremite uzunluk farkı’ yoktu. Plantarfleksiyon ve dorsifleksiyon yönündeki izokinetik kas kuvvet testinin sonuçlarına göre hem düşük açısal hızda hem de yüksek açısal hızda gruplar arasında kas kuvveti açısından fark belirlenmedi. 

Sonuç: ‘Tibial fasial-traksiyon teorisi’ MTSS patogenezini açıklamakta yetersizdir. MTSS vakalarında, ideal düzeyde koruma ve rehabilitasyon önerilerde bulunmak için izokinetik kas kuvvetinin değerlendirildiği ve koşu alanında gerçek zamanlı dinamik analizlerin yapıldığı çalışmalara ihtiyaç vardır. 

Keywords

Medial tibial stress sendromu, kas kuvveti, naviküler çökme

References

• 1. Reinking MF, Austin TM, Richter RR, Krieger MM. Medial Tibial Stress Syndrome in Active Individuals: A Systematic Review and Meta-analysis of Risk Factors. Sports Health. 2017;9(3):252-61.
• 2. Hubbard TJ, Carpenter EM, Cordova ML. Contributing factors to medial tibial stress syndrome: a prospective investigation. Med Sci Sports Exerc. 2009;41(3):490-6.
• 3. Thacker SB, Gilchrist J, Stroup DF, Kimsey CD. The prevention of shin splints in sports: a systematic review of literature. Med Sci Sports Exerc. 2002;34(1):32-40.
• 4. Bartosik KE, Sitler M, Hillstrom HJ, Palamarchuk H, Huxel K, Kim E. Anatomical and biomechanical assessments of medial tibial stress syndrome. J Am Podiatr Med Assoc. 2010;100(2):121-32.
• 5. Saeki J, Nakamura M, Nakao S, Fujita K, Yanase K, Morishita K, et al. Ankle and toe muscle strength characteristics in runners with a history of medial tibial stress syndrome. J Foot Ankle Res. 2017;10(1):16.
• 6. Rauh MJ. Leg-length inequality and running-related injury among high school runners. Int J Sports Phys Ther. 2018;13(4):643-51.
• 7. Noh B. Medial tibial stress syndrome: focused on tibial fascial-traction theory and prevention strategies. Asian J Kinesiol. 2018; 20(2):38-42.
• 8. Bouche RT, Johnson CH. Medial tibial stress syndrome (Tibial fasciitis) A proposed pathomechanical model involving fascial traction. J Am Podiatr Med Assoc. 2007;97(1):31-6.
• 9. Luedke LE, Heiderscheit BC, Williams DB, Rauh MJ. Association of isometric strength of hip and knee muscles with injury risk in high school cross country runners. Int J Sports Phys Ther. 2015;10(6):868.
• 10. Lachniet PB, Taylor-Haas JA, Paterno MV, DiCesare CA, Ford KR. Altered sagittal plane hip biomechanics in adolescent male distance runners with a history of lower extremity injury. Int J Sports Phys Ther. 2018;13(3):441.
• 11. Yüksel O, Özgürbüz C, Ergün M, İşlegen Ç, Taskiran E, Denerel N, et al. Inversion/Eversion strength dysbalance in patients with medial tibial stress syndrome. J Sports Sci Med. 2011;10(4):737.
• 12. Fourchet F, Kelly L, Horobeanu C, Loepelt H, Taiar R, Millet G. High-intensity running and plantar-flexor fatigability and plantar-pressure distribution in adolescent runners. J Athl Train. 2015;50(2):117-25.
• 13. Verrelst R, Willems TM, De Clercq D, Roosen P, Goossens L, Witvrouw E. The role of hip abductor and external rotator muscle strength in the development of exertional medial tibial pain: a prospective study. Br J Sports Med. 2014;48(21):1564-9.
• 14. Winters M, Moen MH, Zimmermann WO, Lindeboom R, Weir A, Backx FJ, et al. The medial tibial stress syndrome score: a new patient-reported outcome measure. Br J Sports Med. 2016;50(19):1192–9.
• 15. Burne SG, Khan KM, Boudville PB, Mallet RJ, Newman PM, Steinman LJ, et al. Risk factors associated with exertional medial tibial pain: a 12 month prospective clinical study. Br J Sports Med. 2004;38(4):441-5.
• 16. Nielsen RG, Rathleff MS, Simonsen OH, Langberg H. Determination of normal values for navicular drop during walking: a new model correcting for foot length and gender. J Foot Ankle Res. 2009;2(1):12.
• 17. Garnock C, Witchalls J, Newman P. Predicting individual risk for medial tibial stress syndrome in navy recruits. J Sci Med Sport. 2018;21(6):586-90.
• 18. Bennett JE, Reinking MF, Rauh MJ. The relationship between isotonic plantar flexor endurance, navicular drop, and exercise-related leg pain in a cohort of collegiate cross-country runners. Int J Sports Phys Ther. 2012;7(3):267-78.
• 19. Madeley LT, Munteanu SE, Bonanno DR. Endurance of the ankle joint plantar flexor muscles in athletes with medial tibial stress syndrome: a case-control study. J Sci Med Sport. 2007;10(6):356-62.
• 20. Gehlsen GM, Seger A. Selected measures of angular displacement, strength, and flexibility in subjects with and without shin splints. Res Q Exerc Sport. 1980;51(3):478-85.