Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review

Abstract

This systematic review evaluates the existing literature about medial tibial stress syndrome (MTSS) in novice and recreational runners. PubMed/MEDLINE, EMBASE, Web of Science, Scopus, SPORTDiscus and CINAHL databases were searched until July 2020. Studies covering risk factors, diagnostic procedures, treatment methods and time to recovery of MTSS in novice and recreational runners were selected. Eleven studies met the inclusion criteria and were included. The risk factors of MTSS are mainly intrinsic and include higher pelvic tilt in the frontal plane, peak internal rotation of the hip, navicular drop and foot pronation, among others. Computed tomography (CT) and pressure algometry may be valid instruments to corroborate the presence of this injury and confirm the diagnosis. Regarding treatment procedures, arch-support foot orthoses are able to increase contact time, normalize foot pressure distribution and similarly to shockwave therapy, reduce pain. However, it is important to take into account the biases and poor methodological quality of the included studies, more research is needed to confirm these results.

Clinical Measures of Pelvic Tilt in Physical Therapy

“…9 In research, 'pelvic tilt' is usually de-scribing the position or movement of the pelvis in the sagittal plane, but is occasionally referred to as movement of the pelvis in the frontal plane. 10,11 In the physical therapy setting, pelvic tilt typically refers to the angle formed from a horizontal line and a line bifurcating the anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS) in the sagittal plane. 8,12 It is commonly assessed in a static manner, such as the pelvic tilt of an individual in a relaxed standing position.…”

Custom-Made Foot Orthoses as Non-Specific Chronic Low Back Pain and Pronated Foot Treatment

“…CLBP is considered a risk factor in sports-specific pathologies such as patellofemoral pain, medial tibial stress syndrome, etc. [ 15 ]. There is a wide variety of treatments for CLBP, and excessive pronation of the foot has been linked to CLBP [ 4 , 5 , 7 ].…”

“…Foot pronation is evaluated with the foot posture index (FPI) [ 16 ] in relation to being a condition that causes kinematics changes in the lower extremity and increases the pelvic tilt, tension of the back muscles and lumbar hyperlordosis [ 17 , 18 , 19 , 20 , 21 , 22 ]. There is a lack of evidence on the effect of the custom-made foot orthoses in subjects suffering from CLBP and pronated foot to improve this syndrome by normalizing the foot posture [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Causes and Prevention of Running-Related Injury: An Engineering Perspective

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The absence of a systematic reduction in Injury frequency, despite decades of research has led to suggestions that the scientific method has been unsuccessful in resolving the problem of running injuries [3][4][5][6].

The Problem: Running Injury Statistics in the Past 40 Years are UnchangedRunning for recreation first became very popular in the1970s [7] and was followed soon after by studies on the prevalence of injuries in runners. Results of these studies varied, with injury incidence ranging between 15% and 85% [8-27] (Figure 1).

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“…The absence of a systematic reduction in Injury frequency, despite decades of research has led to suggestions that the scientific method has been unsuccessful in resolving the problem of running injuries [3][4][5][6].…”