Related Experiment Video
Updated: May 11, 2026
Subject-specific Musculoskeletal Model for Studying Bone Strain During Dynamic Motion
Published on: April 11, 2018
Regional bone geometry of the tibia in triathletes and stress reactions--an observational study
Richard J Newsham-West1, Brett Lyons2, Peter D Milburn1
1Centre for Musculoskeletal Research, School of Physiotherapy and Exercise Science, Griffith Health Institute, Griffith University, Australia.
Objectives:
The association between tibial morphology and tibial stress fractures or tibial stress syndrome was examined in triathletes with an unusually high incidence of these injuries.
Design:
A cross-sectional study design examined associations between tibial geometry from MRI images and training and injury data between male and female triathletes and between stress fracture (SF) and non-stress fracture (NSF) groups.
Methods:
Fifteen athletes (7 females, 8 males) aged 17-23 years who were currently able to train and race were recruited from the New Zealand Triathlete Elite Development Squad. Geometric measurements were taken at 5 zones along the tibia using MRI and compared between symptomatic and asymptomatic tibiae subjects.
Results:
SF tibiae displayed either oedema within the cancellous bone and/or stress fracture on MRI. When collapsed across levels, symptomatic tibiae had thicker medial cortices (F1,140=9.285, p=0.003), thicker lateral cortices (F1,140=10.129, p=0.002) and thinner anterior cortices (F1,140=14.517, p=0.000) than NSF tibiae. Only medial cortex thickness in SF tibia was significantly different (F4,140=3.358, p=0.012) at different levels. Follow-up analysis showed that athletes showing oedema within the cancellous bone and/or stress fracture on MRI had, within 2 years of analysis, subsequently taken time off training and racing due a tibial stress fracture.
Conclusions:
The thinner anterior cortex in SF tibiae is associated with a stress reaction in these triathletes.
