title: Effect of foot posture on the incidence of medial tibial stress syndrome.
abstract: This study reviewed the assessment of medial tibial stress syndrome (MTSS), a common lower limb overuse injury among athletes and dancers. The purpose of the study was twofold: 1) to determine whether abnormal foot alignment is positively correlated with a previous diagnosis of MTSS and 2) to assess the interrater reliability of the proposed methods. We therefore studied foot alignment retrospectively both qualitatively and quantitatively in both a closed and open kinetic chain manner. The specific measures evaluated were: 1) standing foot angle (SFA), 2) nonweight-bearing hindfoot angle, and 3) nonweight-bearing forefoot angle. Qualitative parameters were used for the non weight-bearing measures along the continuum: varus-neutral-valgus. The authors made their measurements independently and were blinded to the previous authors results. Case limbs (as defined as the symptomatic limb in a subject with the diagnosis of MTSS) were found to have a SFA < controls (P = 0.0001). Case limbs also tended towards having a higher incidence of hindfoot (P = 0.017) as well as forefoot (P = 0.08) varus alignment. We found that a SFA of < 140 degrees and a varus alignment of the hindfoot and/or forefoot, were predictive of a previous history of MTSS. These methods were found to be reliable and can be performed in an office setting without any special equipment.
authors.affiliation: Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: H M
authors.initials: HM
authors.lastname: Sommer
authors.forename: S W
authors.initials: SW
authors.lastname: Vallentyne
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D012090:Cumulative Trauma Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain; D011187:Posture; D011403:Pronation; D013312:Stress, Physiological; D013484:Supination; D013577:Syndrome; D013977:Tibia