The role of proximal dynamic joint stability in the development of exertional medial tibial pain: a prospective study.
Exertional medial tibial pain (EMPT) is amongst the most common overuse injuries seen in athletes. The term EMPT encompasses a number of separate diagnostic entities including medial tibial stress syndrome, tibial stress fracture, and chronic exertional compartment syndrome. In essence, EMPT is caused by local tissue damage resulting from repetitive microtrauma. The aim of the current study was to investigate the risk factors contributing to the onset of EMTP.
Kinematic parameters in the frontal and transverse planes were measured a single-leg drop jump (SLDJ) for 86 female pain-free students. Injury follow-up was assessed via a weekly online questionnaire and a 3-month respective control questionnaire.
22 females were diagnosed with EMTP over the course of the two-year investigation. The kinematic variables that were associated with EMPT were increased range-of-motion in the transverse plane of the hip and thorax during the landing component of the SLDJ, along with the push-off phase of the same task.
It may concluded that an impaired ability to maintain dynamic joint stability - as suggested by increased range-of-motion of the hip and thorax in the transverse plane - are potential precursors to the aetiology of EMTP; by virtue of increased accessory movements. Consequently, proximal stability appears to be an important factor for the prevention and rehabilitation of EMTP > From Verrelst et al., Brit J Sport Med (2013) (Epub ahead of print). All rights reserved to BMJ Journals.
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