Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners

Yagi, Shigenori; Muneta, Takeshi; Sekiya, Ichiro

doi:10.1007/s00167-012-2160-x

Cited by 85 publications

(92 citation statements)

References 33 publications

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“…Second, the ASLR test was also found to be related to running injuries; it assesses active hamstring and gastric-soleus flexibility while maintaining a stable pelvis. This finding agreed with the study by Yagi et al (24), who also reported that limited SLR ability increased the injury risk in high school runners. Additionally, Lysholm and Wiklander (13) reported that flexibility of the hamstrings was a risk factor for injury.…”

Section: Discussionsupporting

confidence: 93%

“…Unfortunately, some runners are forced to retire from running because of serious running injuries. Previous studies reported some risk factors for running injuries, such as inadequate flexibility (24), muscle weakness and imbalance (16), and deficits in neuromuscular coordination (19). Cook et al (6,7) stated that these factors also caused poor movement patterns, which were reflected in the lower score of the FMS.…”

Section: Introductionmentioning

confidence: 99%

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Functional Movement Screen for Predicting Running Injuries in 18- to 24-Year-Old Competitive Male Runners

Hotta

Nishiguchi

Fukutani

et al. 2015

Journal of Strength and Conditioning Research

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The purpose of this study was to investigate whether the functional movement screen (FMS) could predict running injuries in competitive runners. Eighty-four competitive male runners (average age = 20.0 ± 1.1 years) participated. Each subject performed the FMS, which consisted of 7 movement tests (each score range: 0-3, total score range: 0-21), during the preseason. The incidence of running injuries (time lost because of injury ≤ 4 weeks) was investigated through a follow-up survey during the 6-month season. Mann-Whitney U-tests were used to investigate which movement tests were significantly associated with running injuries. The receiver-operator characteristic (ROC) analysis was used to determine the cutoff. The mean FMS composite score was 14.1 ± 2.3. The ROC analysis determined the cutoff at 14/15 (sensitivity = 0.73, specificity = 0.54), suggesting that the composite score had a low predictability for running injuries. However, the total scores (0-6) from the deep squat (DS) and active straight leg raise (ASLR) tests (DS and ASLR), which were significant with the U-test, had relatively high predictability at the cutoff of 3/4 (sensitivity = 0.73, specificity = 0.74). Furthermore, the multivariate logistic regression analysis revealed that the DS and ASLR scores of ≤3 significantly influenced the incidence of running injuries after adjusting for subjects' characteristics (odds ratio = 9.7, 95% confidence interval = 2.1-44.4). Thus, the current study identified the DS and ASLR score as a more effective method than the composite score to screen the risk of running injuries in competitive male runners.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Functional Movement Screen for Predicting Running Injuries in 18- to 24-Year-Old Competitive Male Runners

Hotta

Nishiguchi

Fukutani

et al. 2015

Journal of Strength and Conditioning Research

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“…Risk factors for MTSS have been studied in numerous individual studies. Researchers have examined many variables as potential risk factors for MTSS such as body mass index (BMI),4 7–9 bone geometry,10 gait kinematics,[11–14 leg length differences,12 navicular drop,9 15–20 range of motion (ROM),4 8 9 11 12 14 16 18 21 training history4 18 19 22 and others. Although the results of these individual studies can inform clinical practice, the reported findings are often based on small sample sizes with conflicting results.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis

2014

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Medial tibial stress syndrome (MTSS) is a common injury in runners and military personnel. There is a lack of agreement on the aetiological factors contributing to MTSS, making treatment challenging and highlighting the importance of preventive efforts. Understanding the risk factors for MTSS is critical for developing preventive measures. The purpose of this systematic review and meta-analysis was to assess what factors put physically active individuals at risk to develop MTSS. Selected electronic databases were searched. Studies were included if they contained original research that investigated risk factors associated with MTSS, compared physically active individuals with MTSS and physically active individuals without MTSS, were in the English language and were full papers in peer-reviewed journals. Data on research design, study duration, participant selection, population, groups, MTSS diagnosis, investigated risk factors and risk factor definitions were extracted. The methodological quality of the studies was assessed. When the means and SDs of a particular risk factor were reported three or more times, that risk factor was included in the meta-analysis. There were 21 studies included in the systematic review and nine risk factors qualified for inclusion in the meta-analysis. Increased BMI (weighted mean difference (MD)=0.79, 95% CI 0.38 to 1.20, p<0.001), navicular drop (MD=1.19 mm, 95% CI 0.54 to 1.84, p<0.001), ankle plantarflexion range of motion (ROM; MD=5.94°, 95% CI 3.65 to 8.24, p<0.001) and hip external rotation ROM (MD=3.95°, 95% CI 1.78 to 6.13, p<0.001) were risk factors for MTSS. Dorsiflexion and quadriceps-angle were clearly not risk factors for MTSS. There is a need for high-quality, prospective studies using consistent methodology evaluating MTSS risk factors. Our findings suggest that interventions focused on addressing increased BMI, navicular drop, ankle plantarflexion ROM and hip external rotation ROM may be a good starting point for preventing and treating MTSS in physically active individuals such as runners and military personnel.

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“…A recent study followed 230 high school runners over 3 yr and found that nearly half developed MTSS at some point. 51 Patients complain of tenderness localized to the medial aspect of the distal third of the tibia that is often bilateral. A number of possible biomechanical factors have been identified as risk factors, including excessive foot pronation and calf weakness.…”

Section: Medial Tibial Stress Syndromementioning

confidence: 99%

Lower extremity overuse injuries in the skeletally immature athlete

Williams

Valasek

Wilckens

2014

Current Orthopaedic Practice

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Sport participation is a leading cause of injury in children and adolescents. Although the focus often is on acute injuries, overuse injuries are extremely common and can cause lasting damage when not recognized early and treated appropriately. Overuse injuries result from the combination of repetitive microtrauma and inadequate healing time. Children are especially susceptible for many reasons, including muscle-tendon imbalance, improper technique, and difficulty identifying early signs of injury. In the last decades, not only have more children been participating in sporting activities, but the intensity of their participation has increased, with many participating year-round on multiple teams, often with professional or scholarship aspirations. As a consequence, overuse injuries have become even more prevalent. Bone, cartilage, tendon, physis, or apophysis may be affected, and the diagnosis can be challenging. In an effort to promote prevention, early recognition, and treatment of overuse injuries in children and adolescents, this article provides an overview of these injuries, describes vulnerabilities of the immature skeleton, and provides guidance and talking points for physicians, parents, and coaches.

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Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners

Abstract: Prospective cohort study, Level II.

Cited by 85 publications

References 33 publications

Functional Movement Screen for Predicting Running Injuries in 18- to 24-Year-Old Competitive Male Runners

Functional Movement Screen for Predicting Running Injuries in 18- to 24-Year-Old Competitive Male Runners

Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis

Lower extremity overuse injuries in the skeletally immature athlete

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