Stiffness of the Lower Leg Muscles in Patients with Medial Tibial Stress Syndrome

NewsBot · Apr 30, 2016

Members do not see these Ads. Sign Up.
Shear Modulus of the Lower Leg Muscles in Patients with Medial Tibial Stress Syndrome
Kei Akiyam et al
Ultrasound in Medicine & Biology; 26 April 2016

This study aimed to investigate the in vivo kinematics of shear modulus of the lower leg muscles in patients with medial tibial stress syndrome (MTSS). The study population included 46 limbs with MTSS and 40 healthy limbs. The shear modulus of the medial head of the gastrocnemius, lateral head of the gastrocnemius, soleus, peroneus longus and tibialis anterior muscles were measured using shear wave ultrasound elastography. As a result, the shear modulus of the lower leg muscles was significantly greater in patients with MTSS than in healthy patients (p < 0.01). Based on the differences in shear modulus of lower leg muscles between the patients with MTSS and healthy patients, the measurements obtained via shear wave ultrasound elastography could be used to evaluate risk factors of MTSS
Click to expand...

Admin2 · Apr 30, 2016

Related Threads:
Medial tibial stress syndrome and bone marrow edmea
Muscles at the site of pain for medial tibial stress syndrome
Risk factors for exercise-related lower leg pain
Forefoot flexibility and medial tibial stress syndrome
Medial tibial stress syndrome
Medial tibial stress syndrome score
Proximal influences in medial tibial stress syndrome
Deformation of the longitudinal arches in medial tibial stress syndrome
Muscle activation in medial tibial stress syndrome
Fascial Distortion Model approach to Medial Tibial Stress Syndrome
Use a wider base of gait for medial tibial stress syndrome
Gait Retraining and Medial Tibial Stress Syndrome

NewsBot · Feb 17, 2017

Muscle stiffness of posterior lower leg in runners with a history of medial tibial stress syndrome
Junya Seaki, et al
Scandinavian Journal of Medicine & Science in Sports: 16 February 2017

Previous history of medial tibial stress syndrome (MTSS) is a risk factor for MTSS relapse, which suggests that there might be some physical factors that are related to MTSS development in runners with a history of MTSS. The relationship between MTSS and muscle stiffness can be assessed in a cross-sectional study that measures muscle stiffness in subjects with a history of MTSS, who do not have pain at the time of measurement, and in those without a history of MTSS. The purpose of this study was to compare the shear elastic modulus, which is an index of muscle stiffness, of all posterior lower leg muscles of subjects with a history of MTSS and those with no history and investigate which muscles could be related to MTSS. Twenty-four male collegiate runners (age, 20.0 ± 1.7 years; height, 172.7 ± 4.8 cm; weight, 57.3 ± 3.7 kg) participated in this study; 14 had a history of MTSS, and 10 did not. The shear elastic moduli of the lateral gastrocnemius, medial gastrocnemius, soleus, peroneus longus, peroneus brevis, flexor hallucis longus, flexor digitorum longus, and tibialis posterior were measured using shear wave elastography. The shear elastic moduli of the flexor digitorum longus and tibialis posterior were significantly higher in subjects with a history of MTSS than in those with no history. However, there was no significant difference in the shear elastic moduli of other muscles. The results of this study suggest that flexor digitorum longus and tibialis posterior stiffness could be related to MTSS.
Click to expand...

NewsBot · Mar 7, 2017

Stiffness mapping of lower leg muscles during passive dorsiflexion
Guillaume Le Sant, et al
Jornal of Anatomy February 2017

It is challenging to differentiate the mechanical properties of synergist muscles in vivo. Shear wave elastography can be used to quantify the shear modulus (i.e. an index of stiffness) of a specific muscle. This study assessed the passive behavior of lower leg muscles during passive dorsiflexion performed with the knee fully extended (experiment 1, n = 22) or with the knee flexed at 90° (experiment 2, n = 20). The shear modulus measurements were repeated twice during experiment 1 to assess the inter-day reliability. During both experiments, the shear modulus of the following plantar flexors was randomly measured: gastrocnemii medialis (GM) and lateralis (GL), soleus (SOL), peroneus longus (PL), and the deep muscles flexor digitorum longus (FDL), flexor hallucis longus (FHL), tibialis posterior (TP). Two antagonist muscles tibialis anterior (TA), and extensor digitorum longus (EDL) were also recorded. Measurements were performed in different proximo-distal regions for GM, GL and SOL. Inter-day reliability was adequate for all muscles (coefficient of variation < 15%), except for TP. In experiment 1, GM exhibited the highest shear modulus at 80% of the maximal range of motion (128.5 ± 27.3 kPa) and was followed by GL (67.1 ± 24.1 kPa). In experiment 2, SOL exhibited the highest shear modulus (55.1 ± 18.0 kPa). The highest values of shear modulus were found for the distal locations of both the GM (80% of participants in experiment 1) and the SOL (100% of participants in experiment 2). For both experiments, deep muscles and PL exhibited low levels of stiffness during the stretch in young asymptomatic adults, which was unknown until now. These results provide a deeper understanding of passive mechanical properties and the distribution of stiffness between and within the plantar flexor muscles during stretching between them and thus could be relevant to study the effects of aging, disease progression, and rehabilitation on stiffness.
Click to expand...

NewsBot · Dec 13, 2017

The effect of a running task on muscle shear elastic modulus of posterior lower leg
Shuhei Ohya, Masatoshi Nakamura et al
Journal of Foot and Ankle Research201710:56

Background
Medial tibial stress syndrome (MTSS) is one of the most common causes of exercise-related leg pain in runners. Because stopping training due to pain from MTSS could decrease the athlete’s competitiveness, it is necessary to construct MTSS prevention and treatment programs. However, the effect of running, which is believed to cause MTSS, on shear elastic modulus of the posterior lower leg is unclear. Therefore, the purpose of this study was to investigate the effect of 30 min of running on shear elastic modulus of the posterior lower leg in healthy subjects.

Methods
Twenty healthy males volunteered to participate in this study (age, 20.9 ± 0.6 y; height, 169.6 ± 4.5 cm; weight, 62.6 ± 5.2 kg). The shear elastic modulus of the posterior lower leg was measured using ultrasonic shear wave elastography before and immediately after a 30-min running task.

Results
Shear elastic moduli of the flexor digitorum longus and tibialis posterior were significantly increased after 30 min running task. However, there were no significant changes in shear elastic moduli of the lateral gastrocnemius, medial gastrocnemius, peroneus longus and peroneus brevis.

Conclusion
The results suggested that the increases in shear elastic moduli of flexor digitorum longus and tibialis posterior after running could be a risk factor for running-related MTSS development.
Click to expand...

NewsBot · Dec 3, 2020

Running Characteristics of Plantar Flexor Forces Based
on Different Foot Strike Patterns in Medial Tibial Stress
Syndrome
Byungjoo Noh et al
Asian J Kinesiol 2020; 22(4): 48-54 ·

OBJECTIVES The purpose of this study was to compare plantar flexor force due to different foot strike patterns
during running in barefoot and shod condition with and without medial tibial stress syndrome (MTSS).
METHODS Fifteen collegiate soccer players who volunteered to participate were divided into MTSS group
and controls. Participants’ running at 3.3 m/s with and without shoes were recorded with a 12-camera
system at a sampling frequency of 250 Hz. Each subject completed different foot strike patterns of running
as the forefoot strike pattern (FFS) and rearfoot strike pattern (RFS) were collected. Plantar flexor forces were
investigated by software for interactive musculoskeletal modeling.
RESULTS Normalized plantar flexor forces in barefoot running with the FFS pattern had greater soleus and
peroneus brevis muscle forces in the MTSS group than in controls during the first half of stance, although
there were no statistically significant differences for other plantar flexor muscle forces between groups
and shod running. In plantar flexor forces due to foot strike pattern, the FFS pattern showed higher plantar
flexor forces than the RFS pattern.
CONCLUSIONS The results of musculoskeletal modeling suggest that subjects with MTSS have greater muscle
forces of the plantar flexor during running, especially barefoot running with the FFS pattern. It also suggests
increased forces in some plantar flexors generated great traction force by repetitively landing on connective
tissues in the deep crural fascia causing inflammation at the posteromedial site of the tibia in MTSS.
Click to expand...

NewsBot · Oct 15, 2021

Are Leg Muscle, Tendon and Functional Characteristics Associated with Medial Tibial Stress Syndrome? A Systematic Review
Joshua P. M. Mattock, Julie R. Steele & Karen J. Mickle
Sports Medicine - Open volume 7, Article number: 71 (2021)

Background
Medial tibial stress syndrome (MTSS) is a common overuse injury that lacks effective evidence-based treatment options. Reduced leg girth has been associated with MTSS development because it is hypothesised to impair the ability of the leg to modulate tibial loading generated during foot–ground contact. Measuring total leg girth, however, does not provide specific information about the structural composition or functional capacity of individual leg muscles. Consequently, uncertainty remains as to which specific muscles are compromised and contribute to MTSS development. Therefore, this paper aimed to systematically review the body of literature pertaining to how the structure and function of the leg muscles are thought to be associated with MTSS injury.

Methods
The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). Medline, PubMed, SCOPUS, SPORTDiscus with Full-texts and Web of Science were searched until March 2021 to identify articles in which lower limb muscle structural or functional variables associated with MTSS injury were investigated.

Results
Seventeen studies, which were predominately case–control in design and captured data from 332 individuals with MTSS symptoms and 694 control participants, were deemed appropriate for review. The average Downs and Black Quality Assessment score was 71.7 ± 16.4%, with these articles focussing on leg girth, tendon abnormalities, muscle strength and endurance, shear modulus and neuromuscular control. Of the risk factors assessed in the 17 studies, decreased lean leg girth and higher peak soleus muscle activity during propulsion were most strongly correlated with MTSS development. Individuals with MTSS also displayed deficits in ankle plantar flexor endurance, greater isokinetic concentric eversion strength, increased muscle shear modulus and altered neuromuscular recruitment strategies compared to asymptomatic controls.

Conclusions
Future prospective studies are required to confirm whether decreased lean leg girth and higher peak soleus muscle activity during propulsion are associated with MTSS development and to elucidate whether these structural and functional differences in the leg muscles between MTSS symptomatic and asymptomatic controls are a cause or effect of MTSS.

Key Points
Decreased lean leg girth is a likely risk factor associated with developing MTSS, although this reduction in muscle girth is not related to the capacity of the leg muscles to produce maximal force.

Higher peak soleus muscle activity during propulsion is likely associated with MTSS development.

The small number of prospective studies deemed appropriate to include in this review resulted in large knowledge gaps as to how leg muscle structure and function are associated with MTSS. Therefore, future prospective studies are necessary to assess leg muscle structural and functional characteristics in populations at risk of MTSS development.
Click to expand...

NewsBot · Oct 17, 2021

Lower Leg Muscle Stiffness on Two-Dimensional Shear Wave Elastography in Subjects With Medial Tibial Stress Syndrome.
Zhang H et al.
Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, 07 Oct 2021,

Objectives
We aimed to explore, which muscle stiffness changes may be related to medial tibial stress syndrome (MTSS) and the correlation between the medial tibial periosteal thickness and lower leg muscle stiffness.
Methods
This study included 63 subjects distributed into 3 groups: the symptomless group, the MTSS group, and the control group. The lower leg muscle stiffness of the tibialis anterior (TA), extensor digitorum longus (EDL), peroneus longus (PL), soleus (SOL), lateral gastrocnemius (LG), medial gastrocnemius (MG), tibialis posterior (TP), and flexor digitorum longus (FDL) in the 3 groups was obtained by two-dimensional shear wave elastography. Differences in the muscle stiffness and medial tibial periosteal thickness in the 3 groups were determined by one-way analysis of variance (ANOVA) and least significant difference tests. The relationships between the periosteal thickness and the muscle stiffness were assessed using Pearson correlations.
Results
The shear wave velocity (SWV) of all lower leg muscles except the EDL was higher in the symptomless and MTSS groups than in the control group (TA, P = .001; PL, P = .006; SOL, P < .001; LG, P < .001; MG, P < .001; TP, P < .001; FDL, P = .013; and ANOVA). A significant difference was found in the SWV of the SOL, TP, and FDL between the control and symptomless groups (P = .041, P < .001, and P = .013, respectively). Moreover, the medial tibial periosteum was thickened after running training, and its thickness was positively correlated with muscle stiffness.
Conclusion
The medial tibia periosteal thickness is positively correlated with the lower leg muscles stiffness. Changes in SOL, TP, and FDL stiffness may be related to the occurrence of MTSS.
Click to expand...

NewsBot · Feb 22, 2023

Tibialis posterior muscle stiffness assessment in flat foot subjects by ultrasound based Shear-Wave Elastography
Joel Marouvo et al
Foot (Edinb). 2023 Feb 9;54:101975

Background: Few methodologies are used to assess Tibialis Posterior muscle stiffness. Those present limitations leading to a lack of evidence. Muscle stiffness assessment can help in the injuries risk factors identification while coupling with Ultrasound based Shear-Wave Elastography for its management. However, a precise and reliable methodology needs to be utilized to increase stiffness accuracy among the entire Tibialis Posterior muscle. Therefore, this study aims to investigate the stiffness association between Tibialis posterior deep and superficial layer and between flat and neutral footed subjects.

Methods: The sample consisted of 18 participants, where 9 subjects represent the flatfoot group and 9 the neutral foot group. Only the subjects who presented a Navicular Drop Test value of > 9 mm were included in the flatfooted group. All participants were submitted to the Tibialis posterior stiffness assessment with the help of Ultrasound base Shear-Wave Elastography in a lying supine position. Association between Tibialis Posterior deep and superficial layers were determined by Pearson's correlation analysis and group differences were assessed using the U-Mann Whitney test in the comparison between flat foot and neutral foot group (p < 0.05).

Results: No significant correlations between Tibialis Posterior layers stiffness were found (p = 0.194), nor in the comparison between both neutral and flat foot groups (p = 0.424/p = 0.258).

Conclusion: Among participants, no associations between tibialis posterior layers stiffness were found. Also, we did not find any differences in the stiffness between flat and neutral foot groups. In this study, the stiffness did not differentiate flat-footed subjects from neutral subjects.
Click to expand...

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Impact attenuation properties of jazz shoes alter lower limb joint stiffness

Lower extremity joint stiffness characteristics during running with different footfall patterns

Lower extremity joint stiffness in runners with low back pain

Diabetic neuropathy and lower limb stiffness

Stiffness of plantar fascia in plantar fasciopathy

The foot as a lever :Factors influencing stiffness and efficiency

Frontal plane ankle stiffness increases with weight-bearing

Share This Page