title: Contralateral risk factors associated with exertional medial tibial pain in women.
abstract: OBJECTIVE
  This study aimed to prospectively analyze the role of factors on the contralateral side of the kinetic chain in the development of exertional medial tibial pain (EMTP).
  
  
  METHODS
  Eighty-one female physical education students were tested at the beginning of their first academic year. Within the testing protocol, contralateral isokinetic hip muscle strength and full-body kinematic parameters during a single-leg drop jump were evaluated. Online questionnaires were administered weekly, and personal interviews were conducted every 3 months to assess injury follow-up. EMTP was diagnosed by an experienced medical doctor. Cox regression analysis was used to identify the potential risk factors for the development of EMTP.
  
  
  RESULTS
  After exclusion of subjects with diagnosed bilateral EMTP, 11 subjects were included in the EMTP group. Fifty-three subjects did not develop any lower extremity overuse injury and were included in the control group. The leg not at risk within subjects who developed EMTP was compared with an uninjured leg of those in the control group. Increased transverse plane motion for the contralateral lower leg segment during landing phase was found to be a significant predictor (P = 0.012) for EMTP. Analysis of the isokinetic data did not reveal altered hip muscle strength parameters for the leg not at risk within the EMTP group.
  
  
  CONCLUSIONS
  Impaired dynamic joint stability or accessory movements were found in the transverse plane of the contralateral lower leg segment of EMTP subjects. This contralateral instability might have contributed to altered movement patterns within the kinetic chain function of EMTP subjects. No contralateral hip muscle strength parameters were found to predict EMTP in this study.
authors: 1Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, BELGIUM; 2Department of Movement and Sports Sciences, Ghent University, Ghent, BELGIUM; 3Department of Physical Medicine and Orthopaedic Surgery, Ghent University, Ghent, BELGIUM; and 4Department of Physiotherapy, Aspetar, Doha, QATAR.
authors: Ruth
authors: R
authors: Verrelst
authors: Dirk
authors: D
authors: De Clercq
authors: Tine Marieke
authors: TM
authors: Willems
authors: Philip
authors: P
authors: Roosen
authors: Erik
authors: E
authors: Witrouw
mesh_terms: D001265:Athletic Injuries / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D012090:Cumulative Trauma Disorders / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006615:Hip / Q000502:physiology; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology; D007866:Leg / Q000503:physiopathology*; D053580:Muscle Strength / Q000502:physiology; D010146:Pain / Q000503:physiopathology*; D011446:Prospective Studies; D012307:Risk Factors; D013977:Tibia / Q000503:physiopathology*