Medial Tibial Stress Syndrome: Muscles Located at the Site of Pain

Ato Ampomah Brown, Ato Ampomah Brown

Abstract

Objective. The purpose of this study was to examine the relationship between the location of the MTSS pain (posteromedial border of tibia) and the muscles that originate from that site. Method. The study was conducted in the Department of Anatomy of the School of Medical Sciences, University of Cape Coast, and involved the use of 22 cadaveric legs (9 paired and 4 unpaired) from 11 males and 2 females. Findings. The structures that were thus observed to attach directly to the posteromedial border of the tibia were the soleus, the flexor digitorum longus, and the deep crural fascia. The soleus and flexor digitorum longus muscles were observed to attach directly to the posteromedial border of the tibia. The tibialis posterior muscle had no attachment to this site. Conclusion. The findings of this study suggest that if traction is the cause of MTSS then soleus and the flexor digitorum muscles and not the tibialis posterior muscle are the likely cause of MTSS.

Figures

Figure 1
Figure 1
Site of muscle attachment on posterior aspect of the left tibia bone.

References

    1. Yates B., White S. The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. American Journal of Sports Medicine. 2004;32(3):772–780. doi: 10.1177/0095399703258776.
    1. Newman P., Adams R., Waddington G. Two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test. British Journal of Sports Medicine. 2012;46(12):861–864. doi: 10.1136/bjsports-2011-090409.
    1. Moen M. H., Tol J. L., Weir A., Steunebrink M., Winter T. C. D. Medial tibial stress syndrome: a critical review. Sports Medicine. 2009;39(7):523–546. doi: 10.2165/00007256-200939070-00002.
    1. Brukner P., Khan K. Clinical Sports Medicine. 3rd. McGraw-Hill Professional; 2006.
    1. Goodship A. E., Lanyon L. E., McFie H. Functional adaptation of bone to increased stress. The Journal of Bone & Joint Surgery—American Volume. 1979;61(4):539–546.
    1. Devas M. B. Stress fracture of the tibia in athletes or ‘shin soreness’. The Journal of Bone & Joint Surgery—British Volume. 1958;40:227–239.
    1. Judex S., Gross T. S., Zernicke R. F. Strain gradients correlate with sites of exercise-induced bone-forming surfaces in the adult skeleton. Journal of Bone and Mineral Research. 1997;12(10):1737–1745. doi: 10.1359/jbmr.1997.12.10.1737.
    1. Gross T. S., Edwards J. L., Mcleod K. J., Rubin C. T. Strain gradients correlate with sites of periosteal bone formation. Journal of Bone and Mineral Research. 1997;12(6):982–988. doi: 10.1359/jbmr.1997.12.6.982.
    1. Beck B. R., Osternig L. R. Medial tibial stress syndrome: the location of muscles in the leg in relation to symptoms. The Journal of Bone & Joint Surgery—American Volume. 1994;76(7):1057–1061.
    1. Wallensten R. Results of fasciotomy in patients with medical tibial syndrome or chronic anterior-compartment syndrome. The Journal of Bone & Joint Surgery—American Volume. 1983;65(9):1252–1255.
    1. Bouché R. T., Johnson C. H. Medial tibial stress syndrome (tibial fasciitis): a proposed pathomechanical model involving fascial traction. Journal of the American Podiatric Medical Association. 2007;97(1):31–36. doi: 10.7547/0970031.
    1. Michael R. H., Holder L. E. The soleus syndrome. A cause of medial tibial stress (shin splints) American Journal of Sports Medicine. 1985;13(2):87–94. doi: 10.1177/036354658501300202.
    1. Detmer D. E. Chronic shin splints. Classification and management of medial tibial stress syndrome. Sports Medicine. 1986;3(6):436–446. doi: 10.2165/00007256-198603060-00005.
    1. Garth W. P., Jr., Miller S. T. Evaluation of claw toe deformity, weakness of the foot intrinsics, and posteromedial shin pain. American Journal of Sports Medicine. 1989;17(6):821–827. doi: 10.1177/036354658901700617.
    1. Edama M., Onishi H., Kubo M., et al. Gender differences of muscle and crural fascia origins in relation to the occurrence of medial tibial stress syndrome. Scandinavian Journal of Medicine & Science in Sports. 2015 doi: 10.1111/sms.12639.
    1. Saxena A., O'Brien T., Bunce D. Anatomic dissection of the tibialis posterior muscle and its correlation to medial tibial stress syndrome. Journal of Foot Surgery. 1990;29(2):105–108.
    1. Murley G. S., Landorf K. B., Menz H. B., Bird A. R. Effect of foot posture, foot orthoses and footwear on lower limb muscle activity during walking and running: a systematic review. Gait and Posture. 2009;29(2):172–187. doi: 10.1016/j.gaitpost.2008.08.015.
    1. DeLacerda F. G. A study of anatomical factors involved in shinsplints. Journal of Orthopaedic and Sports Physical Therapy. 1980;2(2):55–59. doi: 10.2519/jospt.1980.2.2.55.
    1. Bennett J. E., Reinking M. F., Pluemer B., Pentel A., Seaton M., Killian C. Factors contributing to the development of medial tibial stress syndrome in high school runners. Journal of Orthopaedic and Sports Physical Therapy. 2001;31(9):504–510. doi: 10.2519/jospt.2001.31.9.504.
    1. Neal S B., Griffiths B I., Dowling J G., et al. Foot posture as a risk factor for lower limb overuse injury: a systematics and meta-analysis. Journal of Foot and Ankle Research. 2014;7(1):55–68.
    1. Hamstra-Wright K. L., Bliven K. C. H., Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. British Journal of Sports Medicine. 2014;49:362–369. doi: 10.1136/bjsports-2014-093462.
    1. Frost H. M. Wolff's law and bone's structural adaptations to mechanical usage: an overview for clinicians. The Angle Orthodontist. 1994;64(3):175–188.
    1. Downey P. A., Siegel M. I. Bone biology and the clinical implications for osteoporosis. Physical Therapy. 2006;86(1):77–91.

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