Original research
Foot Medial Longitudinal-Arch Deformation During Quiet Standing and Gait in Subjects with Medial Tibial Stress Syndrome

https://doi.org/10.1053/j.jfas.2007.10.015Get rights and content

The objective of this study was to investigate (1) if subjects with medial tibial stress syndrome demonstrate increased navicular drop and medial longitudinal-arch deformation during quiet standing and gait compared with healthy subjects, and (2) the relationship between medial longitudinal-arch deformation during quiet standing and gait. Thirty subjects aged 20 to 32 years were included (15 with medial tibial stress syndrome and 15 controls). Navicular drop and medial longitudinal-arch deformation were measured during quiet standing with neutral and loaded foot using a ruler and digital photography. Medial longitudinal-arch deformation was measured during walking gait using 3-dimensional gait analysis. Subjects with medial tibial stress syndrome demonstrated a significantly larger navicular drop (mean ± 1 SD, 7.7 ± 3.1 mm) and medial longitudinal-arch deformation (5.9 ± 3.2 degrees) during quiet standing compared with controls (5.0 ± 2.2 mm and 3.5 ± 2.6 degrees, P < .05). Subjects with medial tibial stress syndrome also demonstrated significantly larger medial longitudinal-arch deformation (8.8 ± 1.8 degrees) during gait compared with controls (7.1 ± 1.7 degrees, P = .015). There was no correlation between medial longitudinal-arch deformation during quiet standing and gait in either of the 2 groups (r < 0.127, P > .653). The subjects with medial tibial stress syndrome in this study demonstrated increased navicular drop and medial longitudinal-arch deformation during quiet standing and increased medial longitudinal-arch deformation during gait compared to healthy subjects. Medial longitudinal-arch deformation during quiet standing did not correlate with medial longitudinal-arch deformation during gait in either of the 2 groups. ACFAS Level of Clinical Evidence: 5.

Section snippets

Subjects

Fifteen subjects with MTSS (mean ± 1 SD, 26.1 ± 3.8 years; range, 20 to 32 years, 9 women) and 15 healthy (control) subjects (26.4 ± 3.1 years; range, 21 to 32 years, 9 women) were included in the present study. The subjects with MTSS were sequentially included. All included subjects were recreational athletes. Eleven subjects participated in running in combination with other sports such as European team handball, cycling, volleyball, soccer, or badminton (6 subjects with MTSS and 4 controls).

Between-group Comparisons

Self-selected walking speed was not significantly different between groups (P = 0.793). Navicular height and drop, and MLA-angles and deformation during quiet standing and gait are shown in Table 1. During quiet standing, there were no significant between-group differences in navicular height or MLA-angles with the foot in the neutral or loaded position (P > .05). The subjects with MTSS, however, demonstrated a significantly larger ND (7.7 ± 3.1 mm) and MLA-deformation (5.9 ± 3.2 degrees)

Discussion

The main findings of the present study were (1) the included subjects with MTSS demonstrated increased MLA-deformation and ND during quiet standing, and increased MLA-deformation during gait compared to healthy subjects and (2) MLA-deformation during quiet standing did not correlate with MLA-deformation during gait in either of the 2 groups.

Acknowledgments

The authors thank Stig Sonne-Holm, MD, DSc, and Derek Curtis, RPT, for comments on the manuscript.

References (37)

  • S.J. Mubarak et al.

    The medial tibial stress syndromeA cause of shin splints

    Am J Sports Med

    (1982)
  • M.E. Batt et al.

    A prospective controlled study of diagnostic imaging for acute shin splints

    Med Sci Sports Exerc

    (1998)
  • O. Johnell et al.

    Morphological bone changes in shin splints

    Clin Orthop Relat Res

    (1982)
  • M.B. Devas

    Stress fractures of the tibia in athletes or shin soreness

    J Bone Joint Surg Br

    (1958)
  • J. Puranen et al.

    Intracompartmental pressure increase on exertion in patients with chronic compartment syndrome in the leg

    J Bone Joint Surg Am

    (1981)
  • R.H. Michael et al.

    The soleus syndromeA cause of medial tibial stress (shin splints)

    Am J Sports Med

    (1985)
  • B.R. Beck et al.

    Medial tibial stress syndromeThe location of muscles in the leg in relation to symptoms

    J Bone Joint Surg Am

    (1994)
  • B.R. Beck

    Tibial stress injuriesAn aetiological review for the purposes of guiding management

    Sports Med

    (1998)
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