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[Medial tibial pain in runners]
P Sepulchre1, P Blaimont, J L Pasteels
1Département d'Orthopédie et de Traumatologie IMC d'Ixelles, Belgique.
International Orthopaedics
|January 1, 1988
Summary
Young athletes may experience tibial pain from flexor digitorum longus and soleus strain due to excessive training. Treatment involves biomechanical correction, training modification, orthotics, and potentially surgery for persistent symptoms.
Area of Science:
- Sports Medicine
- Orthopedic Surgery
- Biomechanics
Background:
- Pain at the tibial insertion of the flexor digitorum longus and soleus is common in young athletes starting intense training.
- Associated factors include heel valgus, mid-foot pronation, and tibial torsion.
- Symptoms arise from excessive training, leading to strain at muscle attachments.
Purpose of the Study:
- To investigate the cause and effective treatment for pain at the tibial insertion of the flexor digitorum longus and soleus in young athletes.
- To correlate clinical findings with imaging and histological results.
- To establish a treatment protocol based on biomechanics and surgical intervention.
Main Methods:
- Clinical examination identifying pain at the medial tibial border.
- Radiographic and bone scan imaging to detect cortical thickening and increased isotope uptake.
- Histological examination of flexor digitorum longus specimens for ischemic changes.
- Assessment of deep posterior compartment pressure.
Main Results:
- Radiographs showed cortical thickening; bone scans indicated mild isotope uptake increase.
- Histology revealed ischemic changes in the flexor digitorum longus.
- Deep posterior compartment pressure was normal.
- Pain linked to strain of flexor digitorum longus and soleus aponeurotic insertion.
Conclusions:
- Tibial insertion pain in young athletes is likely due to overuse strain of the flexor digitorum longus and soleus.
- Conservative treatment includes biomechanical correction, training modification, and orthotics.
- Surgical intervention, such as partial division of the soleus attachment and freeing the flexor digitorum longus insertion, is effective for refractory cases.