Comparison of Hip and Knee Anatomical Alignment in Elite Male Runners with and without Medial Tibial Stress Syndrome

Document Type : Original Article

Authors

1 Department of Health & Sport Medicine, Faculty of Physical Education & Sport Sciences, University of Tehran, Tehran, Iran

2 Department of Health & Sport Medicine, Faculty of Physical Education & Sport Sciences, University of Tehran, Tehran, Ira

Abstract

Purpose:
The aim of the study is to evaluate the anatomical alignment difference of the hip and knee in elite male runners with and without medial tibial stress syndrome.
Methods:
The study population comprised 70 elite male runners, who were divided into two groups with medial tibial stress syndrome and control group. Variables including genu varum and genu valgum (IM-IC index), knee hyper extension, Q angle, femoral anteversion, hip internal rotation and hip external rotation of the runners were measured. Data was analyzed by independent t test by SPSS statistical software version 18.
Results:
Results showed significant differences between mean knee hyper extension (3/51± 2.33) (6.0± 2.62), femoral anteversion (14.38± 2.52) (16.7± 2.87) and hip external rotation (33.15±6.25) (30/50 6/23) between two groups (p<0.05). Therefore, amount of knee hyperextension and femoral anteversion in the group of MTSS is more and runners with MTSS are limited ROM hip external rotation. Additionally, there is no significant differences in the means of index IM-IC (1.98± 3.30) (1/90± 2.94), Q angle (10.7± 3.90) (11.6± 3.20) and hip internal rotation (31.8± 5/6) (32.3± 5.98) between two groups (p>0.05).
Conclusion:
According to the results of the present study probably genu recurvatum, increased femoral anteversion and decreased hip external rotation is effective and considered risk factors in the occurrence of medial tibia stress syndrome, which can be the timely detection of abnormalities and early intervention may prevent the occurrence of the damage.

Keywords

References

  1. Yates B, White S. The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. The American journal of sports medicine 2004; 32(3): 80-772.
  2. Fredericson M, Bergman AG, Hoffman KL, Dillingham MS. Tibial stress reaction in runners correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system. The American journal of sports medicine 1995; 23(4): 81-472.
  3. Sommer HM, Vallentyne SW. Effect of foot posture on the incidence of medial tibial stress syndrome. Medicine and science in sports and exercise. 1995; 27(6): 4-800.
  4. Sobhani V, Shakibaee A, Aghda AK, Meybodi MKE, Delavari A, Jahandideh D. Studying the Relation Between Medial Tibial Stress Syndrome and Anatomic and Anthropometric Characteristics of Military Male Personnel. Asian Journal of Sports Medicine 2015; 6(2): e23811.
  5. O'Connor FG, Wilder RP, Nirschl R. Textbook of running medicine: McGraw-Hill 2001; 38(3): 55-79
  6. Milgrom C, Giladi M, Stein M, Kashtan H, Margulies J, Chisin R, et al. Medial Tibial Pain: A Prospective Study of Its Cause Among Military Recruits. Clinical orthopaedics and related research 1986; 213: 167-71.
  7. Yagi S, Muneta T, Sekiya I. Incidence and risk factors for medial tibial stress syndrome and tibial stress fracture in high school runners. Knee Surgery, Sports Traumatology, Arthroscopy 2013; 21(3) :63-556.
  8. Prentic W. Rehabilitation techniques for sports medicine and athletic training. Boston: WCB McGraw Hill 2003; chapter 22: 597.
  9. Beck BR, Osternig LR. Medial tibial stress syndrome. The location of muscles in the leg in relation to symptoms. The Journal of Bone & Joint Surgery 1994; 76(7): 1057-61.
  10. Bandholm T, Boysen L, Haugaard S, Zebis MK, Bencke J. Foot medial longitudinal-arch deformation during quiet standing and gait in subjects with medial tibial stress syndrome. The Journal of foot and ankle surgery 2008; 47(2): 95-89.
  11. Raissi GR, Cherati AD, Mansoori KD, Razi MD. The relationship between lower extremity alignment and Medial Tibial Stress Syndrome among non-professional athletes. BMC Sports Science, Medicine and Rehabilitation 2009; 1(1): 11. [Persian]
  12. Moen M, Bongers T, Bakker E, Zimmermann W, Weir A, Tol J, et al. Risk factors and prognostic indicators for medial tibial stress syndrome. Scandinavian journal of medicine & science in sports 2012; 22(1): 9-34.
  13. Plisky MS, Rauh MJ, Heiderscheit B, Underwood FB, Tank RT. Medial tibial stress syndrome in high school cross-country runners: incidence and risk factors. journal of orthopaedic & sports physical therapy 2007; 37(2): 5-441.
  14. Burne S, Khan K, Boudville P, Mallet R, Newman P, Steinman L, et al. Risk factors associated with exertional medial tibial pain: a 12 month prospective clinical study. British journal of sports medicine 2004; 38(4): 5-441.
  15. Balochi, R. Naderi, E. Ghiasi, A. A survey of lower extremity alignment in the athletes affected by shin splint. Journal of exercise physiology applied 2010; 6 (12): 31-44 [Persian]
  16. Newman P, Witchalls J, Waddington G, Adams R. Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Open access journal of sports medicine 2013; 4: 229.
  17. Jabal Ameli M, Yeganeh A, Nojomi M. Axial Alignment of Lower Extremity in Adults. Razi Journal of Medical Sciences 2009; 16(63): 52-60 .[Persian]
  18. Nguyen A-D, Shultz SJ. Sex differences in clinical measures of lower extremity alignment. journal of orthopaedic & sports physical therapy 2007; 37(7): 98-389.
  19. Cain LE, Nicholson LL, Adams RD, Burns J. Foot morphology and foot/ankle injury in indoor football. Journal of Science and Medicine in Sport 2007; 10(5): 9-311.
  20. Emami M-J, Ghahramani M-H, Abdinejad F, Namazi H. Q-angle: an invaluable parameter for evaluation of anterior knee pain. Arch Iran Med 2007; 10(1): 6-24. [Persian]
  21. Amraee D, Alizadeh M, Razi M, Yazdi H, Minoonejad H. Risk factors associated with noncontact injuries of the anterior cruciate ligament in male athletes. Minerva Ortopedica e Traumatologica 2013; 64(4): 44-435.[Persian]
  22. Piva SR, Fitzgerald K, Irrgang JJ, Jones S, Hando BR, Browder DA, et al. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC musculoskeletal disorders 2006; 7(1): 33.
  23. Solberg G, Gur V, Adar E. Postural disorders and musculoskeletal dysfunction: diagnosis, prevention and treatment: Elsevier Health Sciences 2007; chapter7: 700-712.
  24. Cote KP, Brunet ME, II BMG, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. Journal of athletic training 2005; 40(1): 41.
  25. Rothbart BA. Medial column foot systems: an innovative tool for improving posture. Journal of bodywork and movement therapies 2002; 6(1): 37-46.
  26. Page P, Frank C, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach: Human Kinetics 2010; chapter15: 229.
  27. Magee DJ. Orthopedic physical assessment: Elsevier Health Sciences 2014; chapter7: 700-712.
  28. Bonci CM. Assessment and evaluation of predisposing factors to anterior cruciate ligament injury. Journal of athletic training 1999; 34(2): 155.
  29. Kaneko M, Sakuraba K. Association between femoral anteversion and lower extremity posture upon single-leg landing: implications for anterior cruciate ligament injury. Journal of physical therapy science 2013; 25(10): 12-13.
  30. Krivickas LS. Anatomical factors associated with overuse sports injuries. Sports Medicine 1997; 24(2): 46-132.
  31. Maul D. The Role of lower extremity biomechanics & etiology of medial tibial stress syndrome: Thesis Paper; faculty advisor: daniel haun, DC, DACBER 2011.
  32. Wilder RP, Sethi S. Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints. Clinics in sports medicine. 2004; 23(1): 55-81.
  33. Tönnis D, Heinecke A. Current Concepts Review-Acetabular and Femoral Anteversion: Relationship with Osteoarthritis of the Hip*. The Journal of Bone & Joint Surgery 1999; 81(12): 70-1747.
  34. Rajabi reza, zandi shahrzad, index lower extremity alignment (genu varum and genu valgum) Iranian male and female. Projection research. Physical education and sport science. 2011[Projection research]
  35. Sahrmann, S., Movement system impairment syndromes of the extremities, cervical and thoracic spines. Elsevier Health Sciences 2010; chapter7: 360-362.
  36. Jerry Thomas, Jack Nelson, Stephen Silverman. Research Methods in Physical Activity. human kinetics publication. 7th Edition 2015; chapter16.
  37. Cowan, D. N. , B. H. Jones, P. N. Frykman, D. W. Polly Jr, E. A. Harman, R. M. Rosenstein, et al. , Lower limb morphology and risk of overuse injury among male infantry trainees. Medicine and science in sports and exercise, 1996. 28(8): 945-952.

Journal of Paramedical Sciences & Rehabilitation
Volume 6, Issue 3
September 2017
Pages 51-59

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