Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces

Zimmermann, W; Helmhout, Pieter H.; Beutler, Anthony I.

doi:10.1136/jramc-2016-000635

Cited by 37 publications

(49 citation statements)

References 113 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is of note that no athlete was clinically suspected of having a tibial stress fracture, one of the more important differential diagnoses when assessing overuse injuries along the medial aspects of the tibia. However, tibial stress fractures are extremely rare in The Netherlands, even in the Dutch Royal Army 30. We acknowledge that in other geographical areas (eg, Australia,31 Great Britain,32 Israel33 and the USA34) the prevalence of tibial stress fractures seems much higher, and, possibly this may affect the ease to distinguish between MTSS and tibial stress fracture.…”

Section: Discussionmentioning

confidence: 95%

Medial tibial stress syndrome can be diagnosed reliably using history and physical examination

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 95%

Medial tibial stress syndrome can be diagnosed reliably using history and physical examination

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In the Dutch Armed forces, as in the British and American forces, ERLP is a major cause of decreased readiness to continue with training. [1] Continued effort is warranted in both the primary prevention and treatment of these injuries. In previous studies, positive results were reported with gait retraining in the treatment of soldiers diagnosed with CECS.…”

Section: Discussionmentioning

confidence: 99%

Gait retraining as part of the treatment programme for soldiers with exercise-related leg pain: preliminary clinical experiences and retention

Zimmermann

Linschoten²,

Beutler³

2017

S. Afr. j. sports med

Self Cite

View full text Add to dashboard Cite

Background: Gait retraining as part of a treatment programme for exercise-related leg pain (ERLP) was introduced in the sports medicine department of the Royal Netherlands Army in 2013.Objectives: To describe clinical experiences and retention of gait retraining in a military setting.Methods: Sixty-one cases from the year 2015 were available for analysis of gait and gait retraining. In 2016, 32 of these patients were available for a follow-up survey, 28 of them also for the follow-up measurement of running biomechanics in running shoes.Results: Soldiers received an outpatient treatment programme that lasted on average 129 days (SD 76). On average they received 2.4 gait retraining sessions, leading to significant and lasting changes in running biomechanics; in particular, reduction in maximal force (N) and maximal pressure (N/cm2) on the heels at 317 days follow-up (average, SD 108). Most soldiers were satisfied with gait retraining. At follow-up, 27 soldiers (84%) contributed some, the majority or all reduction of symptoms to it. Seventy percent reported that they had mastered the new running technique within two months. The Single Assessment Numeric Evaluation score increased from 55% to 78% for males and from 44% to 75% for females.Discussion: This is the first study to report on gait retraining for Medial Tibial Stress Syndrome. In future, prospective studies in the military running in shoes and running in boots respectively should be investigated.Conclusion: Soldiers with exercise-related leg pain (ERLP), among them patients with Medial Tibial Stress Syndrome, respond well to a treatment programme that included gait retraining. Ten months post-gait retraining, their running biomechanics still showed these positive changes from their time of intake.

show abstract

“…11,12 Surgical intervention entails opening of the enveloping fascia via a fasciotomy using an open, a minimally invasive, or an endoscopic technique. [12][13][14] Traditionally, management of CECS starts with conservative measures, followed by surgical intervention in case of treatment failure or severely disabling symptoms. 11 This sequence is merely based on clinical experience; a surgery first approach, or a combination of surgery and conservative measures, might also be beneficial.…”

mentioning

confidence: 99%

Systematic review of outcome parameters following treatment of chronic exertional compartment syndrome in the lower leg

Vogels

Ritchie

Dongen

et al. 2020

Scandinavian Med Sci Sports

View full text Add to dashboard Cite

Objective Surgery is the gold standard in the management of chronic exertional compartment syndrome (CECS) of the lower extremity, although recent studies also reported success following gait retraining. Outcome parameters are diverse, and reporting is not standardized. The aim of this systematic review was to analyze the current evidence regarding treatment outcome of CECS in the lower leg. Material and Methods A literature search and systematic analysis were performed according to the PRISMA criteria. Studies reporting on outcome following treatment of lower leg CECS were included. Results A total of 68 reports fulfilled study criteria (n =; 3783; age range 12‐70 year; 7:4 male‐to‐female ratio). Conservative interventions such as gait retraining (n =; 2) and botulinum injection (n =; 1) decreased ICP (truex- =; 68 mm Hg totruex- =; 32 mm Hg) and resulted in a 47% (±42%) rate of satisfaction and a 50% (±45%) rate of return to physical activity. Fasciotomy significantly decreased ICP (truex- =; 76 mm Hg to truex- =; 24 mm Hg) and was associated with an 85% (±13%) rate of satisfaction and an 80% (±17%) rate of return to activity. Return to activity was significantly more often achieved (P < .01) in surgically treated patients, except in one study favoring gait retraining in army personnel. Conclusion Surgical treatment of CECS in the lower leg results in higher rates of satisfaction and return to activity, compared to conservative treatment. However, the number of studies is limited and the level of evidence is low. Randomized controlled trials with multiple treatment arms and standardized outcome parameters are needed.

show abstract

Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces

Cited by 37 publications

References 113 publications

Medial tibial stress syndrome can be diagnosed reliably using history and physical examination

Medial tibial stress syndrome can be diagnosed reliably using history and physical examination

Gait retraining as part of the treatment programme for soldiers with exercise-related leg pain: preliminary clinical experiences and retention

Systematic review of outcome parameters following treatment of chronic exertional compartment syndrome in the lower leg

Contact Info

Product

Resources

About