MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all...

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Medial Tibial Stress Syndrome MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries

Transcript of MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all...

Page 1: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Medial Tibial Stress Syndrome

MEDIAL TIBIAL STRESS SYNDROME

Most common lower leg injury in sportsAccounts for 6-16% of all running injuries and 50%

of all lower leg injuries

Page 2: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Cause1. CAUSE: Related to training

volume, training surface, physical conditi0n of the athlete,

Page 3: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Risk factors Increased pronation• Increased muscular strength of the foot

planter flexors• Increased varus of the forefoot or hindfoot• Abrupt increase in training intensity• Inadequate calcium intake• Hard or inclined surfaces• Shoes• Previous injuries

Page 4: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Involvement of the soleus muscleDisruption of the fibers of sharpeyRepeditive stress eccentrically that fatigue

the soleus which creates tibial bending or bowing over loading the bone-remodeling capabilities of the tibia

Page 5: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Role of pronationIncreased pronation signifigantMaximum velosity of pronation showed

greater correlation that pronation alone.

Page 6: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

PreventionInsoles most promising in controlled trials,

shock absorbing-pronation controlledWeak or fatigues muscles cannot absorb the

shock it is transferred to the bone. Increase muscular strength.

Shoes should be replaced every 600 milesGraduated running programsDecrease volume, increase intensityStretching

Page 7: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

TreatmentReduce inflammationPromote healing with HF24 and laserKinesiontapingOrthoticsNavicular, cuboid, talar and adjustments to

the kinetic chain. Adjust head of fibulaCheck the SI joint Look for imbalance in the external rotators,

iliopsoas, and adductors.

Page 8: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Navicular DropCorrelates with increase incidence of MTSS

Page 9: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Differential DiagnosisShin Splints: tenoperiostial tearing with

inflammation and pain. Usually along a diffuse area of the tibia and involving the posterior tibial muscle origin

Stress Fractures: Usually point tenderness. Very localized.

Page 10: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Imageing: X-ray

Page 11: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Imaging: X-ray

Page 12: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Imaging X-ray

Page 13: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.
Page 14: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.
Page 15: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Bone Scan

Page 16: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.

Treatment

Page 17: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.
Page 18: MEDIAL TIBIAL STRESS SYNDROME Most common lower leg injury in sports Accounts for 6-16% of all running injuries and 50% of all lower leg injuries.