The role of hip abductor and external rotator muscle strength in the development of exertional medial tibial pain: a prospective study
- Ruth Verrelst1,
- Tine Marieke Willems1,
- Dirk De Clercq2,
- Philip Roosen1,
- Lennert Goossens2,
- Erik Witvrouw1
- 1Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- 2Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Correspondence to Ruth Verrelst, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185 3B3, Ghent 9000, Belgium;
- Received 24 August 2012
- Revised 17 December 2012
- Accepted 16 January 2013
- Published Online First 8 February 2013
Objective To prospectively identify proximal risk factors contributing to the development of exertional medial tibial pain (EMTP).
Methods Data were prospectively collected on healthy female students in physical education, who were freshmen in 2010–2011 and 2011–2012. 95 female students, aged 18.15±0.84, were tested at the beginning of their first academic year. Testing included isokinetic hip strength measurements of the abductors, adductors, internal rotators and external rotators. The follow-up of the individulas was assessed using a weekly online questionnaire and a 3-monthly retrospective control questionnaire. EMTP was diagnosed by an experienced MD (Doctor of Medicine). Cox regression analysis was used to identify the potential risk factors for the development of EMTP.
Results 21 individuals were diagnosed with EMTP during follow-up. The results of this study identified that decreased hip abductor concentric strength is a predictive parameter for the development of EMTP in females. More specifically, total work (p=0.010) and average power (p=0.045) for concentric abduction strength were found to be significant predictors for this lower leg overuse injury.
Conclusions Hip abductor weakness is a significant predictor for EMTP in women. Preventive screening methods for EMTP should therefore include this proximal contributing factor.