Do Plantar-Flexor Muscle Structure and Function Contribute to Medial Tibial Stress Syndrome in Long-Distance Runners? A Case Report

J Athl Train. 2024 Nov 1;59(11):1095-1099. doi: 10.4085/1062-6050-0459.23.

Abstract

Two long-distance runners developed medial tibial stress syndrome (MTSS; male age = 26.3 years, female age = 47.5 years) after baseline assessment of plantar-flexor muscle structure and function and spatiotemporal running variables. B-mode ultrasound and lean leg girth characterized plantar-flexor muscle structure. Handheld dynamometry and a single-leg heel raise-to-failure protocol characterized plantar-flexor muscle function. Finally, spatiotemporal running variables were determined during a treadmill protocol. The 2 runners who developed MTSS demonstrated less plantar-flexor strength and endurance capacity than published comparative control data and marked variability in muscle structure. Reduced plantar-flexor strength and endurance capacity were thought to contribute to an impaired ability to resist tibial-bending moments during midstance due to earlier muscle fatigue. Earlier muscle fatigue could, in turn, contribute to increased tibial-bending moments and MTSS development. Therefore, assessing plantar-flexor muscle strength and endurance might help to identify athletes at risk of developing MTSS.

Keywords: injury prevention; shin splints.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Exercise Test
  • Female
  • Foot / physiology
  • Foot / physiopathology
  • Humans
  • Male
  • Medial Tibial Stress Syndrome*
  • Middle Aged
  • Muscle Fatigue / physiology
  • Muscle Strength* / physiology
  • Muscle, Skeletal* / physiology
  • Muscle, Skeletal* / physiopathology
  • Physical Endurance / physiology
  • Running* / physiology
  • Tibia / diagnostic imaging
  • Tibia / physiology
  • Ultrasonography