Comparison of transverse plane tibial and frontal plane rearfoot motion and movement coordination between runners with medial tibial stress syndrome and healthy controls

Medial tibial stress syndrome (MTSS) is a common running related injury. Alterations in movement patterns and movement coordination patterns have been linked to the development of overuse injuries. The aim of this study was to compare transverse plane tibial and frontal plane rearfoot motion and the coordination of these movements between runners with MTSS and healthy controls. Ten recreational runners with MTSS and ten healthy controls ran at 11km.hr-1 on a treadmill. A three-camera motion analysis system, operating at 200Hz, was used to calculate tibia and rearfoot motion. Stance phase motion patterns were compared between groups using multivariate analysis; specifically, Hotelling’s T2 test with statistical parametric mapping (SPM1D). A modified vector coding technique was used to classify the coordination of transverse plane tibial and frontal plane rearfoot motion. The frequency of each coordination pattern displayed by each group was compared using independent samples t tests. Individuals with MTSS displayed significantly (p = .037, d = 1.00) more anti-phase coordination (tibial internal rotation with rearfoot inversion) despite no significant (p > .05) differences in stance phase kinematics. The increased anti-phase movement may increase the torsional stress placed upon the medial aspect of the tibia contributing to the development of MTSS.