Prevalence of Medial Tibial Stress Syndrome among Non-Athletic Treadmill Users. A cross-sectional study

Main Article Content

Fatima Mazhar
Amna faisal
Uzma Irshad
Fatima Aymen
Rimsha Tariq
Aneeqa Aqdas
Erum Ghaffar


Background: Medial tibial stress syndrome (MTSS) is a common injury affecting athletes, runners, and individuals engaged in high-impact activities. Non-athletic treadmill users are also at high risk due to increased exercise volume, load, and impact. MTSS is characterized by unrepaired microdamage in the cortical bone of the tibia, often resulting from repetitive muscle contractions.

Objective: To determine the prevalence of medial tibial stress syndrome among non-athletic treadmill users.

Methods: This cross-sectional study was conducted over six months following the approval of the synopsis. A convenience sampling technique was used to recruit 96 participants from two gym centers in Lahore. Participants, aged 18 to 30 years, with no history of physical or mental illness, were included. Exclusion criteria included those involved in structured sports, competitive programs, athletes, individuals under training, those with joint stiffness, obvious deformities, or comorbid conditions such as fractures, osteoarthritis, bone carcinoma, or recent surgical procedures of the lower limbs. Data were collected using a Delphi-study-developed, cross-culturally translated English questionnaire. Ethical approval was obtained, and the study adhered to the principles of the Declaration of Helsinki. Data were analyzed using SPSS version 25, employing descriptive statistics, frequencies, and percentages.

Results: The mean age of the participants was 24.09 ± 2.970 years. Among the 96 participants, 45 were male (46.9%) and 51 were female (53.1%). MTSS severity was classified as follows: 20% minimal, 23.9% moderate, 29.1% severe, 14.5% crippling, and 11.4% bed-bound.

Conclusion: Medial tibial stress syndrome was found to be prevalent among non-athletic treadmill users, with a significant portion experiencing moderate to severe symptoms. This highlights the need for targeted interventions and preventive measures for this demographic.

Article Details

How to Cite
Mazhar, F., Amna faisal, Irshad, U., Fatima Aymen, Rimsha Tariq, Aneeqa Aqdas, & Ghaffar, E. (2024). Prevalence of Medial Tibial Stress Syndrome among Non-Athletic Treadmill Users. A cross-sectional study. Journal of Health and Rehabilitation Research, 4(2), 1744–1748.
Author Biographies

Fatima Mazhar, Hajvery University Pakistan.

Hajvery University Pakistan.

Amna faisal, Hajvery University Pakistan.

Hajvery University Pakistan.

Uzma Irshad, Hajvery University Pakistan.

Hajvery University Pakistan.

Fatima Aymen, Hajvery University Pakistan.

Hajvery University Pakistan.

Rimsha Tariq, Hajvery University Pakistan.

Hajvery University Pakistan.

Aneeqa Aqdas, Hajvery University Pakistan.

Hajvery University Pakistan.

Erum Ghaffar, Hajvery University Pakistan.

Hajvery University Pakistan.


Sobhani V, Shakibaee A, Aghda AK, Meybodi MKE, Delavari A, Jahandideh D. Studying the Relation Between Medial Tibial Stress Syndrome and Anatomic and Anthropometric Characteristics of Military Male Personnel. Asian J Sports Med. 2015;6(2):1–5.

Fatima et al. Lower Limb Pain Among Gym-Goers: A Cross-Sectional Study. [Study Year].

Winters M, Bakker EWP, Moen MH, Barten CC, Teeuwen R, Weir A. Medial Tibial Stress Syndrome Can Be Diagnosed Reliably Using History and Physical Examination. Br J Sports Med. 2018;52(19):1267–72.

Lohrer H, Malliaropoulos N, Korakakis V, Padhiar N. Exercise-Induced Leg Pain in Athletes: Diagnostic, Assessment, and Management Strategies. Phys Sportsmed. 2019;47(1):47–59.

Shaw A, Newman P, Witchalls J, Hedger T. Externally Validated Machine Learning Algorithm Accurately Predicts Medial Tibial Stress Syndrome in Military Trainees: A Multicohort Study. BMJ Open Sport Exerc Med. 2023;9(2):1–8.

Bliekendaal S, Moen M, Fokker Y, Stubbe JH, Twisk J, Verhagen E. Incidence and Risk Factors of Medial Tibial Stress Syndrome: A Prospective Study in Physical Education Teacher Education Students. BMJ Open Sport Exerc Med. 2018;4(1):1–7.

Deshmukh NS, Phansopkar P. Medial Tibial Stress Syndrome: A Review Article. Cureus. 2022;14(7):1–5.

Newman P, Witchalls J, Waddington G, Adams R. Risk Factors Associated With Medial Tibial Stress Syndrome in Runners: A Systematic Review and Meta-Analysis. Open Access J Sport Med. 2021;229.

Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, et al. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-Based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018;2(3).

Kiel J, Kaiser K. Stress Reaction and Fractures. Treasure Island (FL): StatPearls Publishing; 2023.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91.

Beck BR, Osternig LR. Medial tibial stress syndrome. The location of muscles in the leg in relation to symptoms. The Journal of bone and joint surgery American volume. 1994;76(7):1057-61.

Craig DI. Medial tibial stress syndrome: evidence-based prevention. Journal of athletic training. 2008;43(3):316-8.

Meardon SA, Willson JD, Gries SR, Kernozek TW, Derrick TR. Bone stress in runners with tibial stress fracture. Clinical biomechanics (Bristol, Avon). 2015;30(9):895-902.

Martin JR, Watts CD, Levy DL, Kim RH. Medial Tibial Stress Shielding: A Limitation of Cobalt Chromium Tibial Baseplates. The Journal of arthroplasty. 2017;32(2):558-62.

Ghasemi SH, Kalantari H, Abdollahikho SS, Nowak AS. Fatigue reliability analysis for medial tibial stress syndrome. Materials science & engineering C, Materials for biological applications. 2019;99:387-93.

Nakamura M, Ohya S, Aoki T, Suzuki D, Hirabayashi R, Kikumoto T, et al. Differences in muscle attachment proportion within the most common location of medial tibial stress syndrome in vivo. Orthopaedics & traumatology, surgery & research : OTSR. 2019;105(7):1419-22.

Sato D, Kondo E, Yabuuchi K, Onodera J, Onodera T, Yagi T, et al. Assessment of valgus laxity after release of the medial structure in medial open-wedge high tibial osteotomy: an in vivo biomechanical study using quantitative valgus stress radiography. BMC musculoskeletal disorders. 2019;20(1):481.

Rice HM, Kenny M, Ellison MA, Fulford J, Meardon SA, Derrick TR, et al. Tibial stress during running following a repeated calf-raise protocol. Scandinavian journal of medicine & science in sports. 2020;30(12):2382-9.

Winters M. The diagnosis and management of medial tibial stress syndrome : An evidence update. Der Unfallchirurg. 2020;123(Suppl 1):15-9.

Cho BW, Kwon HM, Hong YJ, Park KK, Yang IH, Lee WS. Anatomical tibial component is related to more medial tibial stress shielding after total knee arthroplasty in Korean patients. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2021;29(3):710-7.