Evaluation of Static and Dynamic Plantar Pressure Distribution along with Other Musculoskeletal Parameters in Athletes with and without Medial Tibial Stress Syndrome

Abstract

ABSTRACT Background: Medial tibial stress syndrome is one of the most common overuse injuries in all running-related activities. Despite the high prevalence, various controversy exist in the literature regarding the risk factors for MTSS. Purpose: The main purpose of the present study was to evaluate and compare the risk factors for MTSS such as passive ankle range of motion, static and dynamic plantar pressure distribution, navicular drop, hip flexors, and hamstring flexibility as well as the foot posture between the athletes with MTSS and normal athletes. Materials and Methods: Fourty-eight participants after detailed assessment were recruited in the present study and were divided into two groups, Group A (subjects with MTSS) and Group B (subjects without MTSS). They all went through a musculoskeletal examination for quantifying the navicular drop, foot posture, hamstring and hip flexor’s flexibility, ankle plantarflexion and dorsiflexion range of motion. Plantar pressure analysis was used to quantify plantar pressure while standing and running. Results: Independent t-test was used. Subjects with MTSS demonstrated deficit in hamstring flexibility (P = 0.0006), dorsiflexion range of motion (P = 0.0039), a greater navicular drop (P < 0.0001), and a more pronated foot posture (P = 0.0245) when compared with the normal athletes. MTSS subjects also showed more total force and pressure under the forefoot region in both static and dynamic measurement of plantar pressure. Conclusion: The findings demonstrated that MTSS is multifactorial syndrome with passive ankle range of motion, foot posture and navicular drop, plantar pressure distributions, as well as flexibility playing a major role.