Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees
Abstract
Purpose: The aim of this study was to investigate potential risk factors associated with a history of medial tibial stress syndrome (MTSS) in football referees.
Methods: A total of 39 referees participated in this cross-sectional study. Based on the definition criteria for MTSS reported in the literature, participants were divided into two groups: those with a history of MTSS (n=14) and those without (n=25). All assessments were conducted in a blinded manner, with examiners unaware of group allocation. The navicular drop test, Craig's test, and heel elevation endurance test were administered to evaluate lower extremity function. Hip internal and external rotation, knee flexion, and ankle dorsiflexion and plantarflexion ROM were measured using a standard goniometer. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Additionally, participants were asked about their athletic history and the comfort of the footwear they used during training and competition. Perceived running condition was evaluated using the Visual Analog Scale (VAS).
Results: MTSS history was determined in 14 of the referees participating in the study. Statistically significant differences were found between groups regarding height length (p = 0.006), condition (p = 0.045), left knee flexion angle (p = 0.007) and right knee flexion angle (p = 0.046). According to the regression analysis result, MTSS history (right) and left knee flexion angle were found to be significantly related (p = 0.015). There was no significant difference or relationship between other variables (p> 0.05).
Conclusion: According to our results, individuals with a history of MTSS had significantly greater height, while their running condition and knee flexion angle were significantly lower compared to those without a history of MTSS. These variables showed statistically significant differences between the two groups.
Keywords
References
- 1. Ohya S, Nakamura M, Aoki T, Suzuki D, Kikumoto T, Nakamura E, et al. The effect of a running task on muscle shear elastic modulus of posterior lower leg. J Foot Ankle Res. 2017; 10: 56.
- 2. Yates B, White S. The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. Am J Sports Med. 2004; 32(3): 772-780.
- 3. Newman P, Adams R, Waddington G. Two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test. Br J Sports Med. 2012; 46(12): 861-864.
- 4. Hubbard TJ, Carpenter EM, Cordova ML. Contributing factors to medial tibial stress syndrome: a prospective investigation. Med Sci Sports Exerc. 2009; 41(3): 490-496.
- 5. Menéndez C, Batalla L, Prieto A, Rodríguez MÁ, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. Int J Environ Res Public Health. 2020; 17(20): 7457.
- 6. 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): 252-261.
- 7. Fernández-Ruiz V, López-Samanes Á, Del Coso J, Pino-Ortega J, Sánchez-Sánchez J, Terrón-Manrique P, et al. Influence of Football Match-Play on Isometric Knee Flexion Strength and Passive Hip Flexion ROM in Football Referees and Assistant Referees. Int J Environ Res Public Health. 2021; 18(22): 11941.
- 8. Weston M. Match performances of soccer referees: the role of sports science. Movement Sport SciencesScience and Motricite. 2015; 87: 113-117.
Details
Primary Language
English
Subjects
Physiotherapy
Journal Section
Research Article
Publication Date
June 30, 2025
Submission Date
March 20, 2025
Acceptance Date
June 2, 2025
Published in Issue
Year 2025 Volume: 1 Number: 1
APA
Ünver, F., & Tekin, E. (2025). Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees. Clinical Physiotherapy and Related Research, 1(1), 1-9. https://izlik.org/JA62AF72PW
AMA
1.Ünver F, Tekin E. Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees. PT. 2025;1(1):1-9. https://izlik.org/JA62AF72PW
Chicago
Ünver, Fatma, and Ebru Tekin. 2025. “Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees”. Clinical Physiotherapy and Related Research 1 (1): 1-9. https://izlik.org/JA62AF72PW.
EndNote
Ünver F, Tekin E (June 1, 2025) Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees. Clinical Physiotherapy and Related Research 1 1 1–9.
IEEE
[1]F. Ünver and E. Tekin, “Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees”, PT, vol. 1, no. 1, pp. 1–9, June 2025, [Online]. Available: https://izlik.org/JA62AF72PW
ISNAD
Ünver, Fatma - Tekin, Ebru. “Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees”. Clinical Physiotherapy and Related Research 1/1 (June 1, 2025): 1-9. https://izlik.org/JA62AF72PW.
JAMA
1.Ünver F, Tekin E. Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees. PT. 2025;1:1–9.
MLA
Ünver, Fatma, and Ebru Tekin. “Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees”. Clinical Physiotherapy and Related Research, vol. 1, no. 1, June 2025, pp. 1-9, https://izlik.org/JA62AF72PW.
Vancouver
1.Fatma Ünver, Ebru Tekin. Investigation of Risk Factors for History of Medial Tibial Stress Syndrome in Referees. PT [Internet]. 2025 Jun. 1;1(1):1-9. Available from: https://izlik.org/JA62AF72PW