Abstract

BackgroundA high proportion of flexor digitorum longus attachment is found at the posteromedial border of the tibia, which is the most common location of medial tibial stress syndrome (MTSS). Therefore, plantar flexion strength of the lesser toes could be related to MTSS; however, the relationship between MTSS and muscle strength of the hallux and lesser toes is not yet evaluated due to the lack of quantitative methods. This study investigated the muscle strength characteristics in runners with a history of MTSS by using a newly developed device to measure the muscle strength of the hallux, lesser toes, and ankle.MethodsThis study comprised 27 collegiate male runner participants (20.0 ± 1.6 years, 172.1 ± 5.1 cm, 57.5 ± 4.0 kg). Maximal voluntary isometric contraction (MVIC) torque of the plantar flexion, dorsiflexion, inversion, and eversion of the ankle were measured by using an electric dynamometer. MVIC torque of the 1st metatarsophalangeal joint (MTPJ) and 2nd–5th MTPJ were measured by using a custom-made torque-measuring device. MVIC torques were compared between runners with and without a history of MTSS.ResultsMVIC torque of the 1st MTPJ plantar flexion was significantly higher in runners with a history of MTSS than in those without it. In contrast, there were no significant differences in the MVIC torque values of the 2nd–5th MTPJ plantar flexion and each MVIC torque of the ankle between runners with and without a history of MTSS.ConclusionA history of MTSS increased the isometric FHL strength.

Highlights

  • A high proportion of flexor digitorum longus attachment is found at the posteromedial border of the tibia, which is the most common location of medial tibial stress syndrome (MTSS)

  • Because the flexor digitorum longus (FDL) had a higher proportion of attachment to the posteromedial border of the tibia, which is the most common location of MTSS [12], plantar flexion strength of the lesser toes could be related to MTSS

  • For the Maximal voluntary isometric contraction (MVIC) torque of the ankle, there was no significant difference between participants with and without a history of MTSS (p = 0.45 for plantar flexion, 0.75 for dorsi flexion, 0.66 for eversion and 0.90 for inversion)

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Summary

Introduction

A high proportion of flexor digitorum longus attachment is found at the posteromedial border of the tibia, which is the most common location of medial tibial stress syndrome (MTSS). Previous studies have reported that 15.2% of high school runners developed MTSS during the 13 weeks of cross-country season [3] and 43.6% of high school runners developed MTSS during the 3 years of the follow-up period [4], and took 44–78 days to resume their original athletic level [5]. These studies indicated that prevention or treatment for MTSS is important; there is. FDL had a higher proportion of attachment to the posteromedial border of the tibia, which is a more common location of MTSS than is the soleus (SOL) (FDL, 97%; SOL, 49%) [12], which suggested that MTSS could be developed by elongational stress of the FDL

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