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[Internal tibial pain in runners]
P Sepulchre1, P Blaimont, J L Pasteels
1Département d'Orthopédie et de Traumatologie IMC d'Ixelles, Overijse, Belgique.
Medial tibial stress syndrome, often seen in late-starting young athletes, involves pain at the flexor digitorum longus and soleus muscle insertions. Treatment includes orthotics and gradual training, with surgery as a last resort.
Area of Science:
- Orthopedics
- Sports Medicine
- Biomechanics
Context:
- Medial tibial pain in young athletes, particularly those starting racing later.
- Pain is exacerbated by intensive training and tiptoe propulsion exercises.
- Associated symptoms include tarsal pronation, hindfoot valgisation, and lower limb torsion disorders.
Purpose:
- To describe the clinical presentation, diagnostic findings, and treatment of a specific tibial pain syndrome in athletes.
- To investigate the underlying biomechanical and pathological factors contributing to the pain.
- To evaluate the effectiveness of conservative and surgical interventions.
Summary:
- This condition presents with pain along the internal tibia, specifically at the insertions of the flexor digitorum longus and soleus muscles.
- Radiography may reveal moniliform cortical adaptations, while bone scintigraphy shows longitudinal hypercaptation.
- Pathological findings suggest an ischemic phenomenon, potentially due to excessive use of the flexor digitorum longus and partial soleus aponeurosis rupture.
Impact:
- Highlights the importance of understanding foot pressure mechanics in racing athletes.
- Emphasizes the role of corrective footwear and gradual training in management.
- Suggests surgical intervention (aponeurotomy with partial disinsertion) for refractory cases.
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