Frequency of Unilateral Versus Bilateral Medial Tibial Stress Syndrome in Novice Footballers

Main Article Content

Ayesha Kousar
Khizra Hamid
Rafia Mannan
Samreen Sadiq
Hafiz Muhammad Asim
Rabia Amjad

Abstract

Background: Medial tibial stress syndrome (MTSS) is a common overuse injury characterized by pain along the distal two-thirds of the medial tibial border. It predominantly affects athletes engaged in weight-bearing activities, including football players. Despite its prevalence, there is limited research focusing on MTSS specifically within the context of football, particularly in relation to unilateral versus bilateral occurrences and the implications of limb dominance.


Objective: The study aimed to measure the frequency of unilateral versus bilateral MTSS in footballers and to provide insights into the relationship between MTSS and limb dominance.


Methods: This comparative cross-sectional study was conducted over six months from July 2021 to December 2021 across various football clubs in Lahore, Pakistan. Ethical approval was obtained from the Lahore College of Physical Therapy, and permissions were secured from club administrations. The sample comprised 140 recreational footballers aged 20-29 years, selected using non-probability convenience sampling. Participants were diagnosed using the MTSS criteria established by Marinus Winters in 2017, which included history taking and physical examination. Data collection involved a detailed questionnaire covering demographics, medical history, and sporting history. The study excluded individuals with previous surgical history, systemic diseases, or tumors. Data analysis was performed using SPSS version 25, employing descriptive and inferential statistics to examine relationships between variables.


Results: The mean age of participants was 21.3 years (SD = 2.97), with a mean weight of 62.2 kg (SD = 8.1) and mean height of 5.5 feet (SD = 0.39). The sample included 97 males (69.3%) and 43 females (30.7%). MTSS was reported unilaterally in 82.2% of participants, with 67.9% (n = 95) experiencing symptoms in the right leg and 14.3% (n = 20) in the left leg. Bilateral MTSS was observed in 17.9% (n = 25) of participants.


Conclusion: The majority of athletes reported unilateral MTSS, with the right leg being more commonly affected than the left. These findings suggest the need for comprehensive bilateral assessment in the diagnosis and treatment of MTSS in footballers to optimize performance and prevent recurrence.

Article Details

How to Cite
Kousar , A., Hamid, K., Mannan, R., Sadiq, S., Asim, H. M., & Amjad, R. (2024). Frequency of Unilateral Versus Bilateral Medial Tibial Stress Syndrome in Novice Footballers. Journal of Health and Rehabilitation Research, 4(2), 1062–1066. https://doi.org/10.61919/jhrr.v4i2.946
Section
Articles
Author Biographies

Ayesha Kousar , University of Biological & Applied Sciences Lahore Pakistan.

Demonstrator, Department of Physical Therapy & Rehabilitation Sciences, University of Biological & Applied Sciences, Lahore Pakistan.

Khizra Hamid, University of Biological & Applied Sciences Lahore Pakistan.

Lecturer, Department of Physical Therapy & Rehabilitation Sciences, University of Biological & Applied Sciences, Lahore Pakistan.

Rafia Mannan, University of Biological & Applied Sciences Lahore Pakistan.

Lecturer, Department of Physical Therapy & Rehabilitation Sciences, University of Biological & Applied Sciences, Lahore Pakistan.

Samreen Sadiq, University of Biological & Applied Sciences Lahore Pakistan.

Associate Professor, Department of Physical Therapy & Rehabilitation Sciences, University of Biological & Applied Sciences, Lahore Pakistan.

Hafiz Muhammad Asim, University of Biological & Applied Sciences Lahore Pakistan.

Chairman, Department of Physical Therapy & Rehabilitation Sciences, University of Biological & Applied Sciences, Lahore Pakistan.

Rabia Amjad, Fiaz-Ul-Haq Family Clinic Lahore Pakistan.

Physical Therapist, Fiaz-Ul-Haq Family Clinic, Lahore Pakistan.

References

Winters M, Bakker E, Moen M, Barten C, 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.

Yates B, White S. The Incidence and Risk Factors in the Development of Medial Tibial Stress Syndrome Among Naval Recruits. Am J Sports Med. 2004;32(3):772-80.

Winters M, Bon P, Bijvoet S, Bakker EW, Moen MH. Are Ultrasonographic Findings Like Periosteal and Tendinous Edema Associated With Medial Tibial Stress Syndrome? A Case-Control Study. J Sci Med Sport. 2017;20(2):128-33.

Lopes AD, Hespanhol LC, Yeung SS, Costa LOP. What Are the Main Running-Related Musculoskeletal Injuries? Sports Med. 2012;42(10):891-905.

Couture CJ, Karlson KA. Tibial Stress Injuries: Decisive Diagnosis and Treatment of ‘Shin Splints’. Physician Sportsmed. 2002;30(6):29-36.

Kilic O, Kemler E, Gouttebarge V. The "Sequence of Prevention" for Musculoskeletal Injuries Among Adult Recreational Footballers: A Systematic Review of the Scientific Literature. Phys Ther Sport. 2018;32:308-22.

Bouché RT, Johnson CH. Medial Tibial Stress Syndrome (Tibial Fasciitis): A Proposed Pathomechanical Model Involving Fascial Traction. J Am Podiatr Med Assoc. 2007;97(1):31-6.

Tweed JL, Avil SJ, Campbell J. Aetiological Factors in the Development of MTSS. 2007.

Naderi A, Baloochi R, Rostami KD, Fourchet F, Degens H. Obesity and Foot Muscle Strength Are Associated With High Dynamic Plantar Pressure During Running. Foot. 2020;44:101683.

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 Sports Med. 2013;4:229.

Naderi A, Degens H, Sakinepoor A. Arch-Support Foot-Orthoses Normalize Dynamic In-Shoe Foot Pressure Distribution in Medial Tibial Stress Syndrome. Eur J Sport Sci. 2019;19(2):247-57.

Murley GS, Landorf KB, Menz HB, Bird AR. Effect of Foot Posture, Foot Orthoses and Footwear on Lower Limb Muscle Activity During Walking and Running: A Systematic Review. Gait Posture. 2009;29(2):172-87.

Menéndez C, Batalla L, Prieto A, Rodríguez MÁ, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. Int J Environ Res Public Health. 2020;17(20):7457.

Winters M. Medial Tibial Stress Syndrome: Diagnosis, Treatment and Outcome Assessment. Utrecht University; 2017.

Naderi A, Moen MH, Degens H. Is High Soleus Muscle Activity During the Stance Phase of the Running Cycle a Potential Risk Factor for the Development of Medial Tibial Stress Syndrome? A Prospective Study. J Sports Sci. 2020;38(20):2350-8.

DeLang MD, Rouissi M, Bragazzi NL, Chamari K, Salamh PA. Soccer Footedness and Between-Limbs Muscle Strength: Systematic Review and Meta-Analysis. Int J Sports Physiol Perform. 2019;14(5):551-62.

Hägglund M, Waldén M, Ekstrand J. Previous Injury as a Risk Factor for Injury in Elite Football: A Prospective Study Over Two Consecutive Seasons. Br J Sports Med. 2006;40(9):767-72.

Serner A, Tol JL, Jomaah N, Weir A, Whiteley R, Thorborg K, et al. Diagnosis of Acute Groin Injuries: A Prospective Study of 110 Athletes. Am J Sports Med. 2015;43(8):1857-64.

DeLang MD, Salamh PA, Farooq A, Tabben M, Whiteley R, van Dyk N, et al. The Dominant Leg Is More Likely to Get Injured in Soccer Players: Systematic Review and Meta-Analysis. Biol Sport. 2021;38(3).

Winters M. Medial Tibial Stress Syndrome: Diagnosis, Treatment and Outcome Assessment (PhD Academy Award). Br J Sports Med. 2018.

Most read articles by the same author(s)