The Incidence and Risk Factors in the Development of Medial Tibial Stress Syndrome among Naval Recruits

Yates, Ben; White, Shaun

doi:10.1177/0095399703258776

Cited by 310 publications

(358 citation statements)

References 50 publications

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“…The loading is also likely to be highest at regions of peak compressive forces and, to a lesser extent, tensile forces [24] but no investigations have performed a prospective detailed examination of the tibia in response to an arduous training programme. This is clinically important because the tibia is susceptible to stress injuries early in military training [32], which typically present at the posterior border of the distal third [32][33][34]. The primary purpose of this study was to examine site-and regional-specific adaptations of the tibia to arduous training in a cohort of male infantry recruits to better understand how bone responds in vivo to mechanical loading.…”

Section: Introductionmentioning

confidence: 99%

Increased density and periosteal expansion of the tibia in young adult men following short-term arduous training

Izard¹,

Fraser

Negus³

et al. 2016

Bone

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2 AbstractPurpose: Few human studies have reported early structural adaptations of bone to weightbearing exercise, which provide a greater contribution to improved bone strength than increased density. This prospective study examined site-and regional-specific adaptations of the tibia during arduous training in a cohort of male military (infantry) recruits to better understand how bone responds in vivo to mechanical loading.Methods: Tibial bone density and geometry were measured in 90 British Army male recruits (ages 21 + 3 y, height 1.78 ± 0.06 m, body mass 73.9 + 9.8 kg) in weeks 1 (Baseline) and 10 of initial military training. Scans were performed at the 4%, 14%, 38% and 66% sites, measured from the distal end plate, using pQCT (XCT2000L, Stratec Pforzheim, Germany).Customised software (BAMPack, L-3 ATI) was used to examine whole bone cross-section and regional sectors. T-tests determined significant differences between time points (P<0.05).Results: Bone density of trabecular and cortical compartments increased significantly at all measured sites. Bone geometry (cortical area and thickness) and bone strength (i, MM i and BSI) at the diaphyseal sites (38 and 66%) were also significantly higher in week 10. Regional changes in density and geometry were largely observed in the anterior, medial-anterior and anterior-posterior sectors. Calf muscle density and area (66% site) increased significantly at week 10 (P<0.01). Conclusions:In vivo mechanical loading improves bone strength of the human tibia by increased density and periosteal expansion, which varies by site and region of the bone.These changes may occur in response to the nature and distribution of forces originating from bending, torsional and shear stresses of military training. These improvements are observed early in training when the osteogenic stimulus is sufficient, which may be close to the fracture threshold in some individuals.3

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Section: Introductionmentioning

confidence: 99%

Increased density and periosteal expansion of the tibia in young adult men following short-term arduous training

Izard¹,

Fraser

Negus³

et al. 2016

Bone

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“…Prospective studies have found that variations in weightbearing foot posture are associated with an increased risk of medial tibial stress syndrome in military recruits [1] and overuse leg injuries in triathletes [2]. These findings suggest that pes cavus (high medial longitudinal arch) and pes planus (low medial longitudinal arch) may display abnormal biomechanical parameters that predispose an individual to injury.…”

Section: Introductionmentioning

confidence: 99%

Foot posture is associated with kinematics of the foot during gait: A comparison of normal, planus and cavus feet

et al. 2015

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“…This finding demonstrated the FPI-6 being simple to use and reliable. Some studies have used the FPI to identify risk factors for sports-related injuries (Cain, Nicholson, Adams, & Burns, 2007;Yates & White, 2004). Yates and White (2004) found a positive correlation between pronated feet and medial tibial stress syndrome in naval recruits.…”

Section: Discussionmentioning

confidence: 99%

The foot posture index between elite athletic and sedentary college students

Kuo

Liu²

2017

Kinesiology (Zagreb, Online)

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Abstract:Sports participation may lead to musculoskeletal adaptation and alter foot posture; however, the effect of high impact sports on foot posture has not fully been understood yet. The purpose of this study was to investigate the difference in foot posture between elite collegiate athletes participating in high impact sports and sedentary college students using the Foot Posture Index (FPI). Foot postures of 30 elite collegiate athletes of high impact sports and 30 sedentary controls were observed in standing and evaluated using the 6-item FPI. The FPI-6 score for the athletic group was statistically significantly higher than that for the sedentary group (z=−2.282, p=.022). Participation in high impact sports can be associated with a more pronated foot posture; however, most college students, whether athletic or sedentary, had normal feet as categorized by the FPI-6.

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The Incidence and Risk Factors in the Development of Medial Tibial Stress Syndrome among Naval Recruits

Abstract: Identifying a pronated foot type prior to training may help reduce the incidence of medial tibial stress syndrome by early intervention to control abnormal pronation. Findings of a higher incidence of medial tibial stress syndrome among female recruits require further investigation.

Cited by 310 publications

References 50 publications

Increased density and periosteal expansion of the tibia in young adult men following short-term arduous training

Increased density and periosteal expansion of the tibia in young adult men following short-term arduous training

Foot posture is associated with kinematics of the foot during gait: A comparison of normal, planus and cavus feet

The foot posture index between elite athletic and sedentary college students

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