title: Biomechanical risk factors in the development of medial tibial stress syndrome in distance runners.
abstract: BACKGROUND
  We investigated the relationship between functional and static foot posture and medial tibial stress syndrome in distance runners.
  
  
  METHODS
  Twenty-eight runners with a clinical diagnosis of medial tibial stress syndrome and 12 asymptomatic runners were assessed with the Foot Posture Index to measure static overpronation. Range of motion was measured at the talocrural joint, with the knee extended and flexed as was range of motion at the first metatarsophalangeal joint and the angular difference between the neutral and relaxed calcaneal stance positions. Each participant was then videotaped while running on a treadmill shod and unshod. This videotape was analyzed using freeze frame to identify abnormal or mistimed pronation at each phase of gait. The results were analyzed using logistic regression to give the probability that a runner is likely to experience medial tibial stress syndrome, predicted from the static measurements and dynamic observations.
  
  
  RESULTS
  Variables identified as being significant predictors of medial tibial stress syndrome were the difference between the neutral and relaxed calcaneal stance positions, range of motion of the talocrural joint with the knee extended, early heel lift and abductory twist during gait, and apropulsive gait.
  
  
  CONCLUSIONS
  Runners with suspected symptoms of medial tibial stress syndrome should be assessed dynamically and statically for abnormal or mistimed pronation.
authors.affiliation: Kensington and Chelsea PCT, Podiatry Department, St. Charles Hospital, London, England. jo.tweed@northampton.ac.uk
authors.forename: Jo L
authors.initials: JL
authors.lastname: Tweed
authors.forename: Jackie A
authors.initials: JA
authors.lastname: Campbell
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Avil
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology; D016022:Case-Control Studies; D012090:Cumulative Trauma Disorders / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007869:Leg Injuries / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology; D012307:Risk Factors; D012420:Running / Q000293:injuries*; D013577:Syndrome; D016474:Weight-Bearing / Q000502:physiology; D055815:Young Adult