Biomechanical Risk Factors in the Development of Medial Tibial Stress Syndrome in Distance Runners

2008 ◽  
Vol 98 (6) ◽  
pp. 436-444 ◽  
Author(s):  
Jo L. Tweed ◽  
Jackie A. Campbell ◽  
Steven J. Avil
Keyword(s):  
Range Of Motion ◽  
Metatarsophalangeal Joint ◽  
Medial Tibial Stress Syndrome ◽  
Distance Runners ◽  
Talocrural Joint ◽  
First Metatarsophalangeal Joint ◽  
Stress Syndrome ◽  
Foot Posture ◽  
The Difference ◽  
The Relationship

Background: We investigated the relationship between functional and static foot posture and medial tibial stress syndrome in distance runners. Methods: Twenty-eight runners with a clinical diagnosis of medial tibial stress syndrome and 12 asymptomatic runners were assessed with the Foot Posture Index to measure static overpronation. Range of motion was measured at the talocrural joint, with the knee extended and flexed as was range of motion at the first metatarsophalangeal joint and the angular difference between the neutral and relaxed calcaneal stance positions. Each participant was then videotaped while running on a treadmill shod and unshod. This videotape was analyzed using freeze frame to identify abnormal or mistimed pronation at each phase of gait. The results were analyzed using logistic regression to give the probability that a runner is likely to experience medial tibial stress syndrome, predicted from the static measurements and dynamic observations. Results: Variables identified as being significant predictors of medial tibial stress syndrome were the difference between the neutral and relaxed calcaneal stance positions, range of motion of the talocrural joint with the knee extended, early heel lift and abductory twist during gait, and apropulsive gait. Conclusion: Runners with suspected symptoms of medial tibial stress syndrome should be assessed dynamically and statically for abnormal or mistimed pronation. (J Am Podiatr Med Assoc 98(6): 436–444, 2008)

Chevron (Austin) Distal Metatarsal Osteotomy for Hallux Valgus: Comparison of Pre- and Post-Surgical Characteristics

2002 ◽  
Vol 23 (6) ◽  
pp. 503-508 ◽  
Author(s):  
Thomas W. Kernozek ◽  
Steven A. Sterriker
Keyword(s):  
Range Of Motion ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Pain Scale ◽  
Metatarsal Osteotomy ◽  
Talocrural Joint ◽  
First Metatarsophalangeal Joint ◽  
Perceived Pain ◽  
Distal Metatarsal Osteotomy ◽  
Joint Range

The purpose of the study was to compare the range of motion, perceived pain and plantar loading characteristics of the Chevron (Austin) corrective procedures in treating hallux valgus (HV) 12 months postsurgically. Twenty-five female participants with the diagnosis of mild to moderate HV deformity were studied. All participants had a distal metatarsal osteotomy (Chevron (Austin)) to correct their deformity. First metatarsophalangeal and talocrural joint range of motion (ROM) and a 10-point analog pain scale were measured presurgically and 12 months post-surgically on each participant. Radiographic measures of hallux valgus and intermetatarsal (IM) angles were taken preoperatively and six weeks postoperatively for comparison. Five pressure distribution measurements were recorded of barefoot walking using the EMED-SF presurgically and 12 months postsurgically. Statistical analyses revealed that plantar loading is still altered 12 months postsurgically despite a decrease in perceived pain and adequate first metatarsophalangeal joint ROM. Greater loading occurred in the central forefoot (CFF) region with decreases in some of the loading parameters in the medial toe (MT) region postsurgically. Loading parameters in the lateral forefoot (LFF), heel (HL), midfoot (MF), and lateral toe (LT) were unchanged 12 months postsurgery compared to presurgery.

An Assessment of Hallux Limitus in University Basketball Players Compared with Noncompetitive Individuals

2014 ◽  
Vol 104 (5) ◽  
pp. 468-472 ◽  
Author(s):  
Paul Trégouët
Keyword(s):  
Range Of Motion ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Artificial Turf ◽  
Basketball Players ◽  
First Metatarsophalangeal Joint ◽  
Hallux Limitus ◽  
Significant Difference ◽  
Turf Toe ◽  
The Difference

BackgroundInjuries of the first metatarsophalangeal joint have lately been receiving attention from researchers owing to the important functions of this joint. However, most of the studies of turf toe injuries have focused on sports played on artificial turf.MethodsThis study compared the range of motion of the first metatarsophalangeal joint in collegiate basketball players (n = 123) and noncompetitive individuals (n = 123).ResultsA statistically significant difference (P < .001) in range of motion was found between the two groups. The difference between the two sample means was 21.35°.ConclusionsWith hallux rigidus being a potential sequela of repeated turf toe injuries, it seems likely that subacute turf toe injuries occur in basketball players, leading to degenerative changes that result in hallux limitus.

Anatomical and Biomechanical Assessments of Medial Tibial Stress Syndrome

2010 ◽  
Vol 100 (2) ◽  
pp. 121-132 ◽  
Author(s):  
Katherine E. Bartosik ◽  
Michael Sitler ◽  
Howard J. Hillstrom ◽  
Howard Palamarchuk ◽  
Kellie Huxel ◽  
...  
Keyword(s):  
Center Of Pressure ◽  
Metatarsophalangeal Joint ◽  
Clinical Intervention ◽  
Gait Velocity ◽  
Medial Tibial Stress Syndrome ◽  
Cross Sectional ◽  
Physically Active ◽  
First Metatarsophalangeal Joint ◽  
Stress Syndrome ◽  
Cross Sectional Design

Background: Medial tibial stress syndrome is a common overuse injury in weightbearing, physically active individuals and in athletes. Most research associated with this condition is primarily based on static foot and lower-extremity measurements. Methods: A cross-sectional design was used to assess a set of static and dynamic measurements to determine which anatomical factors (limb length, ankle dorsiflexion, first metatarsophalangeal joint extension, and arch height) and biomechanical factors (center-of-pressure excursion index, malleolar valgus index, and gait velocity) are associated with medial tibial stress syndrome. Results: One-way analysis of variance models revealed that participants with medial tibial stress syndrome had significantly greater visual analog pain levels and slower gait velocity than noninjured controls (P = .05). No other significant differences were found between the two groups. Conclusions: Further investigation of these and other factors can help health professionals develop better strategies for the prevention and clinical intervention of medial tibial stress syndrome. (J Am Podiatr Med Assoc 100(2): 121–132, 2010)

Effect of Foot Posture and Inverted Foot Orthoses on Hallux Dorsiflexion

2006 ◽  
Vol 96 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Shannon E. Munteanu ◽  
Adam D. Bassed
Keyword(s):  
Negative Correlation ◽  
Metatarsophalangeal Joint ◽  
Significant Negative Correlation ◽  
Foot Orthoses ◽  
First Metatarsophalangeal Joint ◽  
Foot Posture Index ◽  
Posture Index ◽  
Foot Posture ◽  
The Right ◽  
The Relationship

A pronated foot posture is considered to be a factor in limitation of dorsiflexion at the first metatarsophalangeal joint during weightbearing. Customized foot orthoses are widely used to increase dorsiflexion at the first metatarsophalangeal joint in people with pronated feet. However, the effect of foot posture and customized foot orthoses on maximum first metatarsophalangeal joint dorsiflexion has not been widely investigated. This study sought to determine 1) the relationship between foot posture and static maximum first metatarsophalangeal joint dorsiflexion and 2) the effect of customized foot orthoses on static maximum first metatarsophalangeal joint dorsiflexion in people with pronated feet. Foot posture was assessed using the Foot Posture Index. Static maximum first metatarsophalangeal joint dorsiflexion of the right foot was determined using a goniometer while participants stood relaxed with and without Blake-style inverted (30°) foot orthoses positioned under their feet. There was a significant negative correlation between Foot Posture Index and static maximum first metatarsophalangeal joint dorsiflexion (r = −0.587). Inverted (30°) foot orthoses increased the magnitude of static maximum first metatarsophalangeal joint dorsiflexion from 83.4° to 85.3° in participants with an excessively pronated foot posture. However, this difference was not statistically significant. People with pronated feet are more likely to exhibit limitation of dorsiflexion at the first metatarsophalangeal joint during gait, and inverted foot orthoses are unlikely to be effective in increasing dorsiflexion at the first metatarsophalangeal joint in these people. (J Am Podiatr Med Assoc 96(1): 32–37, 2006)

Relationship Between Weightbearing Ankle Dorsiflexion Passive Range of Motion and Ankle Kinematics During Gait

2017 ◽  
Vol 107 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Min-Hyeok Kang ◽  
Jae-Seop Oh
Keyword(s):  
Range Of Motion ◽  
Three Dimensional ◽  
Knee Extension ◽  
Ankle Dorsiflexion ◽  
Physically Active ◽  
Ankle Kinematics ◽  
The Difference ◽  
Analysis System ◽  
The Relationship ◽  
Paired T Test

Background: Measurement of weightbearing ankle dorsiflexion (DF) passive range of motion (PROM) has been suggested as a way to estimate ankle kinematics during gait; however, no previous study has demonstrated the relationship between ankle DF during gait and ankle DF PROM with knee extension. We examine the relationship between maximum ankle DF during gait and nonweightbearing and weightbearing ankle DF PROM with knee extension. Methods: Forty physically active individuals (mean ± SD age, 21.63 ± 1.73 years) participated in this study. Ankle DF PROM with knee extension was measured in the nonweightbearing and weightbearing conditions; maximum ankle DF during gait was assessed using a three-dimensional motion analysis system. The relationship between each variable was calculated using the Pearson product moment correlation coefficient, and the difference in ankle DF PROM between the nonweightbearing and weightbearing conditions was analyzed using a paired t test. Results: The weightbearing measurement (r = 0.521; P < .001) for ankle DF PROM showed a greater correlation with maximum ankle DF during gait than did the nonweightbearing measurement (r = 0.245; P = .029). Ankle DF PROM was significantly greater in the weightbearing than in the nonweightbearing condition (P < .001) despite a significant correlation between the two measurements (r = 0.402; P < .001). Conclusions: These findings indicate that nonweightbearing and weightbearing measurements of ankle DF PROM with knee extension should not be used interchangeably and that weightbearing ankle DF PROM with the knee extended is more appropriate for estimating ankle DF during gait.

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