Studying the Relation Between Medial Tibial Stress Syndrome and Anatomic and Anthropometric Characteristics of Military Male Personnel

Abstract

Background:Medial Tibial Stress Syndrome (MTSS) is common among military recruits and to our knowledge; the factors that might put the military recruits at higher risk of incidence of MTSS are not well known.Objectives:This study was done to investigate the association between some anthropometric and anatomical factors and the prevalence of MTSS among military recruits.Patients and Methods:One hundred and eighty one randomly selected military recruits were included in this cross sectional study. Using history taking and physical examinations they were tested for MTSS. Accordingly the subjects were assigned to the case (those with MTSS) and control groups (normal healthy subjects). Using standard guidelines, the anthropometric and anatomical criteria of the subjects were measured. The correlation between the measurements and the prevalence of MTSS was tested using statistical analysis.Results:Data of all the 181 subjects with the mean age of 30.7 ± 4.68 years were Included in the final analysis. The prevalence of MTSS was found to be 16.6% (30 people). Internal and external rotation range of motion, iliospinale height, the score of navicular drop test, and the trochanteric tibial lateral length were significantly different between healthy subjects and patients with MTSS (P < 0.05).Discussion:The prevalence of MTSS was relatively lower in this study comparing to other studies on military personnel. It was not probably due to type of military shoes or exercise area surface (none of them were standardized); it could be due to low intensity trainings and the long intervals between training sessions.

Risk Factors for Medial Tibial Stress Syndrome Associated with the Kinetics of the Countermovement Jump in Cadets Undergoing Training

“…and White also found no significant differences for the BMI between the groups with and without MTSS (p = 0.917) in a sample of Australian navy recruits (52). Another two studies evidenced that the BMI is not associated significantly with the pathology reported in the military personnel (p >0.05) (54,55). One of the reasons for the differences found is that the systematic reviews with meta-analysis showed heterogeneity in the samples evaluated (athletes, civilian or military population).…”

Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review

“…3 In military personnel, the incidence of MTSS was 7.2% to 35%. [5][6][7] For many military recruits, the nature and volume of the physical load on the lower legs increase as they adjust to basic training. 7 The lower extremity injuries military recruits sustain have negative effects on morbidity, training time, financial resources, and staffing.…”

“…[5][6][7] For many military recruits, the nature and volume of the physical load on the lower legs increase as they adjust to basic training. 7 The lower extremity injuries military recruits sustain have negative effects on morbidity, training time, financial resources, and staffing. 2,8,9 Based on research findings and practitioners' beliefs, experiences, biases, and paradigms, multiple risk factors are theorized for MTSS.…”

“…12 In their systematic review, Yates and White 7 hypothesized that extensibility of the tibialis anterior muscle and greater plantar flexion could affect navicular drop. Thus, the risk factor of greater plantar flexion may be the cause of the navicular-drop risk factor.…”

“…5 The method used to assess hip external-rotation ROM varied in the studies, yet we agree that ROM changes, both deficits and laxity, could increase tibial loading during activity or alter the angle of the femoral neck at the hip joint, thereby increasing torque on the lower leg. 7 This would predispose the active individual to injuries such as exertional medial tibial pain, tibial stress fractures, and MTSS. 6 Even though we do not fully understand the role of hip external-rotation ROM in MTSS, clinicians should continue to assess this factor to develop appropriate prevention and treatment programs.…”