title: A neuromuscular intervention for exercise-related medial leg pain.
abstract: BACKGROUND
  Exercise-related medial leg pain (ERMLP) is a common complaint among athletes, and efforts toward rehabilitation are often unsuccessful.
  
  
  OBJECTIVE
  To evaluate the efficacy of a therapeutic intervention in ERMLP localized to soft tissue.
  
  
  METHODS
  A quasi-experimental, nonequivalent control-group study.
  
  
  METHODS
  Athletic training facility.
  
  
  METHODS
  20 volunteer male and female athletes (18-22 y old) with ERMLP. Complete data were available for 13 participants.
  
  
  METHODS
  Treatment group (TRE, n = 7) received therapeutic intervention focused on relieving muscle hypertonicity in the deep compartment of the lower leg and restoring balance of the toe flexors and extensors. Control group (CON, n = 6) received no intervention.
  
  
  METHODS
  Self-reported pain intensity, pain threshold, and extensor hallucis longus to extensor digitorum brevis (EHL:EDB) electromyography ratio.
  
  
  RESULTS
  There were no significant differences in age, duration of symptoms, or pain measures between the 2 groups at baseline. CON demonstrated no significant changes in any of the outcome measures in posttreatment testing, but significant between-groups differences were identified for pain during activity (CON mean = 6.5, 95% CI 5.05, 7.95; TRE mean = 3.5, 95% CI 1.67, 5.33; P = .01), change scores for pain during activity (CON mean = 0.33, 95% CI -1.25, 1.91; TRE mean = -3.43, 95% CI:-4.6, -2.25; P < .001), change scores in pressure threshold (CON mean = -0.25, 95% CI -0.74, 0.23; TRE mean = 0.72, 95% CI 0.22, 1.37; P = .006), and change in EHL:EDB ratios (CON mean = 0.05, 95% CI -0.22, 0.33; TRE mean = 1.07, 95% CI 0.75, 2.07; P < .046).
  
  
  CONCLUSIONS
  Therapeutic interventions focused on restoring muscle balance appear to be effective in resolving ERMLP.
authors: Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO, USA.
authors: Katherine R
authors: KR
authors: Newsham
authors: Matthew D
authors: MD
authors: Beekley
authors: Christine A
authors: CA
authors: Lauber
mesh_terms: D000293:Adolescent; D004576:Electromyography; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D009122:Muscle Hypertonia / Q000503:physiopathology / Q000628:therapy; D052580:Muscle Stretching Exercises / Q000379:methods*; D018482:Muscle, Skeletal / Q000503:physiopathology; D059352:Musculoskeletal Pain / Q000503:physiopathology* / Q000628:therapy*; D017288:Pain Threshold / Q000502:physiology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult