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BMC Sports Science, Medicine and Rehabilitation
Published in: BMC Sports Science, Medicine and Rehabilitation 1/2012

Open Access 01-12-2012 | Research

The treatment of medial tibial stress syndrome in athletes; a randomized clinical trial

Published in: BMC Sports Science, Medicine and Rehabilitation | Issue 1/2012

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Abstract

Background

The only three randomized trials on the treatment of MTSS were all performed in military populations. The treatment options investigated in this study were not previously examined in athletes. This study investigated if functional outcome of three common treatment options for medial tibial stress syndrome (MTSS) in athletes in a non-military setting was the same.

Methods

The study design was randomized and multi-centered. Physical therapists and sports physicians referred athletes with MTSS to the hospital for inclusion. 81 athletes were assessed for eligibility of which 74 athletes were included and randomized to three treatment groups. Group one performed a graded running program, group two performed a graded running program with additional stretching and strengthening exercises for the calves, while group three performed a graded running program with an additional sports compression stocking. The primary outcome measure was: time to complete a running program (able to run 18 minutes with high intensity) and secondary outcome was: general satisfaction with treatment.

Results

74 Athletes were randomized and included of which 14 did not complete the study due a lack of progress (18.9%). The data was analyzed on an intention-to-treat basis. Time to complete a running program and general satisfaction with the treatment were not significantly different between the three treatment groups.

Conclusion

This was the first randomized trial on the treatment of MTSS in athletes in a non-military setting. No differences were found between the groups for the time to complete a running program.

Trial registration

CCMO; NL23471.098.08
Appendix
Available only for authorised users
Literature
1.
Andrish JT, Bergfeld JA, Walheim J: A prospective study on the management of shin splints. J Bone Joint Surg Am. 1974, 56A (8): 1697-1700.
2.
Bennett JE, Reinking MF, Pluemer B, Pentel A, Seaton M, Killian C: Factors contributing to the development of medial tibial stress syndrome in high school runners. J Orthop Sports Phys Ther. 2001, 31 (9): 504-510.CrossRefPubMed
3.
Clanton TO, Solcher BW: Chronic leg pain in the athlete. Clin Sports Med. 1994, 13 (4): 743-759.PubMed
4.
Beck BR, Osternig LR, Oregon E: Medial tibial stress syndrome: the location of muscles in the leg in relation to symptoms. J Bone Joint Surg Am. 1994, 76-A (7): 1057-1061.
5.
Detmer DE: Chronic shin splints: classification and management of medial tibial stress syndrome. Sports Med. 1986, 3 (6): 436-446. 10.2165/00007256-198603060-00005.CrossRefPubMed
6.
Magnusson HI, Westlin NE, Nyqvist F, Gardsell P, Seeman E, Karlsson MK: Abnormally decreased regional bone density in athletes with medial tibial stress syndrome. Am J Sports Med. 2001, 29 (6): 712-715.PubMed
7.
Gaeta M, Minutoli F, Scribano E, et al: CT and MRI imaging findings in athletes with early tibial stress injuries: comparison of bone scintigraphy findings and emphasis on cortical abnormalities. Radiology. 2005, 235 (2): 553-561. 10.1148/radiol.2352040406.CrossRefPubMed
8.
Moen MH, Tol JL, Weir A, Steunebrink M, de ThC W: Medial tibial stress syndrome, a critical review. Sports Med. 2009, 39 (7): 523-546. 10.2165/00007256-200939070-00002.CrossRefPubMed
9.
Nissen LR, Astvad K, Madsen L: Low-energy laser treatment of medial tibial stress syndrome. Ugeskr Laeger. 1994, 156 (49): 7329-7331.PubMed
10.
Johnston E, Flynn T, Bean M, et al: A randomised controlled trial of a leg orthosis versus traditional treatment for soldiers with shin splints: a pilot study. Mil Med. 2006, 171 (1): 40-44.CrossRefPubMed
11.
Callisson M: Acupuncture and tibial stress syndrome. J Chinese Med. 2002, 70: 24-27.
12.
Rompe JD, Cacchio A, Furia JP, Maffulli N: Low energy extracorporeal shock wave therapy as a treatment for medial tibial stress syndrome. Am J Sports Med. 2010, 38 (1): 125-132. 10.1177/0363546509343804.CrossRefPubMed
13.
Eickhoff CA, Hossain SA, Slawski DP: Effects of prescribed foot orthoses on medial tibial stress syndrome in collegiate cross country runners. Clin Kinesiol. 2000, 54 (4): 76-80.
14.
Loudon JK, Dolphino MR: Use of foot orthoses and calf stretching for individuals with medial tibial stress syndrome. Foot Ankle Spec. 2010, 3 (1): 15-20. 10.1177/1938640009355659.CrossRefPubMed
15.
Moen MH, Ratnayake A, Weir A, Suraweera HJ, Backx FJG: The treatment of medial tibial stress syndrome with bisphosphonates; a report of two cases. Dutch J Sports Medicine. 2011, 1: 1-4.
16.
Morris RH: Medial tibial syndrome: a treatment protocol using electric current. Chiropractic Sports Med. 1991, 5 (1): 5-8.
17.
Schulman RA: Tibial shin splints treated with a single acupuncture session: case report and review of the literature. J Am Med Acupuncture. 2002, 13 (1): 7-9.
18.
Andrish JT: The shin splint syndrome. Orthopaedic sports medicine chapter 29. Edited by: DeLee JC, Drez D. 2003, Amsterdam: Elsevier, 2155-2158. 2
19.
Kortebein PM, Kaufman KR, Basford JR, Stuart MJ: Medial tibial stress syndrome. Med Sci Sports Exerc. 2000, 32 (Suppl. 3): S27-S33.PubMed
20.
Kaspar D, Seidl W, Neidlinger-Wilke C, Claes L: In vitro effect of dynamic strain on the proliferative and metabolic activity of human osteoblasts. J Musculoskel Neuron Interact. 2000, 1 (2): 161-164.
21.
Lozupone E, Palumbo C, Favia A, Ferretti M, Palazzini F, Cantatore FP: Intermittent compressive load stimulates osteogenesis and improves osteocytes viability in bones cultured in vitro. Clin Rheumatol. 1996, 15 (6): 563-572. 10.1007/BF02238545.CrossRefPubMed
22.
Waldorff EI, Christenson KB, Cooney LA, Goldstein SA: Microdamage repair and remodeling requires mechanical loading. J Bone Miner Res. 2010, 25 (4): 734-745.PubMed
23.
Hill DB: Production and absorption of work by muscle. Science. 1960, 131 (3404): 897-903. 10.1126/science.131.3404.897.CrossRefPubMed
24.
Paul IL, Murno MB, Abernethy PJ, Simon SR, Radin EL, Rose RM: Musculo-skeletal shock absorption: relative contribution of bone and soft tissues at various frequencies. J Biomech. 1978, 11 (5): 237-239. 10.1016/0021-9290(78)90049-0.CrossRefPubMed
25.
Radin EL: Role of muscles in protecting athletes from injury. Acta Med Scand Suppl. 1986, 711: 143-147.PubMed
26.
Winter DA: Moments of force and mechanical power in jogging. J Biomech. 1983, 16 (1): 91-97. 10.1016/0021-9290(83)90050-7.CrossRefPubMed
27.
Milgrom C, Radeva-Petrova DR, Finestone A: The effect of muscle fatigue on in vivo tibial strains. J Biomech. 2007, 40 (4): 845-850. 10.1016/j.jbiomech.2006.03.006.CrossRefPubMed
28.
Zimmermann WO, Paantjes MA: Sport compression stockings: user satisfaction 50 military personnel. Dutch J Mil Med. 2009, 62: 209-213.
29.
Roelofsen J, Klein-Nulend J, Burger EH: Mechanical stimulation by intermittent hydrostatic compression promotes bone-specific gene expression in vitro. J Biomech. 1995, 33 (12): 1493-1503.CrossRef
30.
Yates B, White S: The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. Am J Sports Med. 2004, 32 (3): 772-80. 10.1177/0095399703258776.CrossRefPubMed
31.
Edwards PH, Wright ML, Hartman JF: A practical approach to the differential diagnosis of chronic leg pain in athletes. Am J Sports Med. 2005, 33 (8): 1241-1249. 10.1177/0363546505278305.CrossRefPubMed
32.
Moen MH, Bongers T, Bakker EW, et al: The additional value of a pneumatic leg brace in the treatment of medial tibial stress syndrome. J Royal Army Med Corps. 2010, 156 (4): 236-240.CrossRef
33.
Moen MH, Rayer S, Schipper M, Schmikli S, Weir A, Tol JL, Backx FJG: Shockwave treatment for medial tibial stress syndrome in athletes; a prospective controlled study. Br J Sports Med. 2011.
34.
Kallings L, Leijon M, Kowalski J, Hellenius ML, Stahle A: Self-reported adherence - a method for evaluating prescribed physical activity in primary health care athletes. J Phys Act Health. 2009, 6: 483-492.PubMed
35.
Leijon ME, Bendten P, Stahle A, Ekberg K, Festin K, Nilsen P: Factors associated with athletes self-reported adherence to prescribed physical activity in routine primary health care. BMC Fam Pract. 2010, 11: 38-47. 10.1186/1471-2296-11-38.CrossRefPubMedPubMedCentral
36.
Likert R: A simple a reliable method of scoring the Thurstone attitude scales. J Soc Psychol. 1934, 5 (2): 228-237. 10.1080/00224545.1934.9919450.CrossRef
37.
World Health Organisation: Adherence to long-term therapies: evidence from action. Geneva. 2003
Metadata
Title
The treatment of medial tibial stress syndrome in athletes; a randomized clinical trial
Publication date
01-12-2012
Published in
BMC Sports Science, Medicine and Rehabilitation / Issue 1/2012
Electronic ISSN: 2052-1847
DOI
https://doi.org/10.1186/1758-2555-4-12

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