Forefoot flexibility and medial tibial stress syndrome

NewsBot · Dec 31, 2015

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Forefoot flexibility and medial tibial stress syndrome.
Kudo S, Hatanaka Y
J Orthop Surg (Hong Kong). 2015 Dec;23(3):357-60.

PURPOSE:
To investigate the association between medial tibial stress syndrome (MTSS) and morphology and flexibility of the foot arches.
METHODS:
131 feet from 74 healthy subjects and 31 feet from 27 patients with MTSS were classified as normal feet (n=78 in 40 subjects), flat feet (n=53 in 34 subjects), or MTSS feet (n=31 in 27 patients). The medial longitudinal arch (MLA) ratio and the transverse arch length (TAL) were measured in both rearfoot and forefoot loading positions. The difference between the 2 positions indicated the flexibility of the MLA (diff-MLA ratio) and the transverse arch (diff- TAL).
RESULTS:
The MLA ratio was higher in normal feet than MTSS feet or flat feet (15.1% vs. 12.8% vs. 12.3%, p<0.001). The diff-TAL was lower in MTSS feet than normal feet or flat feet (0.4% vs. 0.8% vs. 0.9%, p<0.001]). The 3 groups were comparable in terms of the diff-MLA ratio and the TAL. Respectively for the MLA ratio and the diff-TAL, the cut-off value was 11.9% and 0.61% based on the Youden index. The sensitivity, specificity, and odds ratio of the cut-off value were 0.4, 0.9, and 4.8 for the MLA ratio, and 0.6, 0.7, and 9.8 for the diff-TAL, respectively.
CONCLUSION:
Decreased flexibility of the transverse arch and decreased MLA ratio are risk factors for MTSS. In contrast, the flexibility of the MLA and the height of the transverse arch were not risk factors for MTSS.
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Admin2 · Dec 31, 2015

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NewsBot · Jun 17, 2020

Difference in the Foot Intersegmental Coordination Pattern Between Female Lacrosse Players With and Without a History of Medial Tibial Stress Syndrome: a Cross-sectional Study
Hiroshi Akuzawa, Tomoki Oshikawa, Koji Nakamura, Ren Kubota, Norifumi Takaki, Naoto Matsunaga, Koji Kaneoka
Research Square

Background
Medial tibial stress syndrome is a common sports related injury. Altered foot kinematics can be a risk factor for the injury. Since foot segments can move independently, intersegment coordination is important for proper foot function. This study aimed to compare the foot intersegmental coordination pattern and single segment kinematics between women lacrosse players with and without a history of medial tibial stress syndrome during drop jump.

Methods
Nine players with a medial tibial stress syndrome history and 12 players with no history were enrolled. Foot kinematics, including angle at landing and peak angle and excursion at the rearfoot, midfoot, and forefoot during single-leg drop jumps were analyzed. Each segment motion data from landing to leaping was time-scaled to 100% to analyze the intersegmental coordination with a modified vector coding technique. Instant intersegmental coordination of every 1% was classified into four patterns (in-phase, two segments rotate in the same direction with similar amplitudes; anti-phase, two segments rotate in opposite directions; proximal phase, proximal segment dominantly rotates in the same direction compared to the distal segment; and distal phase, distal segment dominantly rotates in the same direction compared to the proximal segment). The percentage of intersegmental coordination pattern and kinematics in each segment were compared between the groups using the Student’s t test.

Results
Groups with a history of medial stress syndrome showed a significantly higher percentage of proximal phase between the rearfoot and midfoot in the sagittal (Mean ± SD; history, 52.0 ± 18.5%, no history, 29.3 ± 16.7%; p = 0.005) and coronal planes (history, 43.0 ± 26.1%, no history, 15.9 ± 9.1%; p = 0.008). Dorsiflexion excursion (history, 34.8 ± 4.7°, no history, 29.6 ± 2.1°; p = 0.002) were significantly larger in a history of medial tibial stress syndrome group compared to no history group.

Conclusions
Rearfoot dominant motion pattern relative to the midfoot may be related to medial tibial stress syndrome. Intersegmental coordination analysis may be useful for detecting abnormal foot coordination patterns.
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