Do Plantar-Flexor Muscle Structure and Function Contribute to Medial Tibial Stress Syndrome in Long-Distance Runners?
Joshua P M Mattock1, Julie R Steele1, Karen J Mickle2
1Biomechanics Research Laboratory, School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine & Health, University of Wollongong, Australia.
Journal of Athletic Training
|April 17, 2024
Summary
Runners with reduced plantar-flexor strength and endurance capacity may be at higher risk for developing medial tibial stress syndrome (MTSS). Assessing these factors could help identify at-risk athletes.
Area of Science:
- Sports Medicine
- Biomechanics
- Exercise Physiology
Background:
- Medial tibial stress syndrome (MTSS) is a common injury in runners.
- The underlying biomechanical and neuromuscular factors contributing to MTSS are not fully understood.
- Plantar-flexor muscle function and structure may play a role in MTSS development.
Purpose of the Study:
- To investigate the relationship between plantar-flexor muscle structure and function, running biomechanics, and the development of MTSS in long-distance runners.
- To identify potential risk factors for MTSS development.
Main Methods:
- Two long-distance runners who developed MTSS were assessed at baseline.
- Plantar-flexor muscle structure was evaluated using B-mode ultrasound and lean leg girth.
- Plantar-flexor muscle function was assessed via handheld dynamometry and a single-leg heel raise-to-failure test.
- Spatiotemporal running variables were measured during a treadmill protocol.
Main Results:
- The runners who developed MTSS exhibited reduced plantar-flexor strength and endurance capacity compared to normative data.
- Marked variability in plantar-flexor muscle structure was observed in the MTSS group.
- These deficits suggest an impaired ability to resist tibial-bending moments due to premature muscle fatigue.
Conclusions:
- Reduced plantar-flexor strength and endurance may contribute to MTSS development by increasing tibial-bending moments during running.
- Assessing plantar-flexor muscle strength and endurance could be a valuable tool for identifying athletes at risk of MTSS.
- Further research with larger cohorts is warranted to confirm these findings.
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