BackgroundThe only three randomized trials on the treatment of MTSS were all performed in military populations. The treatment options investigated in this study were not previously examined in athletes. This study investigated if functional outcome of three common treatment options for medial tibial stress syndrome (MTSS) in athletes in a non-military setting was the same.MethodsThe study design was randomized and multi-centered. Physical therapists and sports physicians referred athletes with MTSS to the hospital for inclusion. 81 athletes were assessed for eligibility of which 74 athletes were included and randomized to three treatment groups. Group one performed a graded running program, group two performed a graded running program with additional stretching and strengthening exercises for the calves, while group three performed a graded running program with an additional sports compression stocking. The primary outcome measure was: time to complete a running program (able to run 18 minutes with high intensity) and secondary outcome was: general satisfaction with treatment.Results74 Athletes were randomized and included of which 14 did not complete the study due a lack of progress (18.9%). The data was analyzed on an intention-to-treat basis. Time to complete a running program and general satisfaction with the treatment were not significantly different between the three treatment groups.ConclusionThis was the first randomized trial on the treatment of MTSS in athletes in a non-military setting. No differences were found between the groups for the time to complete a running program.Trial registrationCCMO; NL23471.098.08

Our findings show that MTSS can be reliably diagnosed clinically using history and physical examination, in clinical practice and research settings. We also found that concurrent lower leg injuries are common in athletes with MTSS.

To identify primary target groups for injury prevention in physical education teacher education (PETE) students, risk differences between subgroups by sex and curriculum years were compared in a retrospective cohort study (2000‐2014). Injuries recorded by healthcare professionals at the medical facility of a Dutch PETE college were used to calculate overall, intra‐ and extracurricular injury prevalence per sex, curriculum years, and semesters and to compare these by logistic regression analyses. Of 1083 PETE students, 599 (55.3%) reported at least one injury during their curriculum (60.0% intracurricular). Female students had a higher risk for overall (OR 2.29, 95%CI 1.77‐2.96) and for intracurricular injuries (OR 3.12, 95%CI 2.41‐4.03), but not for extracurricular injuries. Compared to the freshman year, injury risk dropped during the consecutive years (OR 0.56, 95%CI 0.46‐0.67; OR 0.33, 95%CI 0.27‐0.41; OR 0.04, 95%CI 0.03‐0.07, respectively). The first semesters of the freshman and second year showed higher injury prevalence compared to two out of three consecutive semesters (P < .006). Primary target groups for injury preventive measures are freshman and female PETE students. Factors contributing to the predominantly higher intracurricular injury risks, most notably in female students, need to be investigated in prospective cohort studies, regardless of sex.

ObjectivesTo investigate the influence of sports/activity types and their distribution over the curriculum years on intracurricular injury risk differences between curriculum years and sexes in Physical Education Teacher Education (PETE) studies.MethodsIn a cohort study over 14 years (2000–2014), injuries reported at the medical facility of a Dutch vocational institute by PETE students who completed their full curriculum were registered. Intracurricular injury rates (IR) per 1000 hours and 95% CIs were calculated per sport, sex and curriculum year and compared with injury rate ratios (RR) and 95% CI. Exposure times per sports category per curriculum year were compared with the χ2 test.ResultsIntracurricular IR was highest for gymnastics, team ball sports and track and field (0.76–1.23, 95% CI 0.65 to 1.45). IRs were higher for female compared with male students (RR 2.38, 95% CI 1.97 to 2.87). Comparisons for all individual sports and for all three curriculum years showed the same pattern. IR for the first year was higher than for the second (RR 1.79, 95% CI 1.45 to 2.21) and third year (RR 2.74, 95% CI 2.13 to 3.54) with similar patterns for all sports categories. Over the curriculum years, exposure time distributions per sport showed small differences (p<0.001, Cramer’s V=0.07).ConclusionCurriculum year, sex and sports types are risk factors to be independently targeted for preventive and rehabilitative measures in PETE studies. The nature and aetiology of injuries in mixed sports, and the adaption to increased loads in first-year and female PETE students, need further investigation.

Background. Injury risk is high in Physical Education Teacher Education (PETE) students. Insights into specific injury locations per sex, setting, sports, and curriculum year are needed to develop preventive measures. Purpose. To compare injury distributions by body locations in PETE students and how these distributions differ by sex, type, onset, curriculum year, settings, or sports. Methods. In a historical cohort study over 14 years, data from 2899 students (male 76.2%, n = 1947) enlisted in the first three years of a PETE curriculum were analysed. Injuries reported at the institution’s medical facility were categorised per sex, body location, onset, type, setting, sports, and curriculum year. Results. Forty-three percent (n = 1247) of all students (female 54.9%, n = 523, male 37.2%, and n = 429) reported a total of 2129 injuries (freshmen 56.4%; 2nd year 28.2%; 3rd year 15.5%). The most prevalent sudden onset injury locations (63.4% of all injuries) were the ankle (32.5%) and knee (16.6). The most prevalent gradual onset injuries were the lower leg (27.8%) and knee (25.2%). Joint/ligament injuries (45.8%) and muscle/tendon injuries (23.4%) were the most prevalent injury types. Proportions for injury locations and injury types differed significantly between curriculum years. Injury prevalence per setting and sport differed significantly between the sexes. Injury locations differed significantly between sports and between the sexes per sport. Conclusion. A differential approach per injury location, onset, type, sex, setting, sports, and curriculum year is needed to develop adequate preventive measures in PETE studies. The engagement of precurricular, intracurricular, and extracurricular stakeholders is needed in the development of these measures.