Lower leg muscle structure and function are altered in long-distance runners with medial tibial stress syndrome: a case control study

Review written by Dr Melinda Smith info

Key Points

  1. Leg muscle structure and function was compared in long-distance runners with and without medial tibial stress syndrome (MTSS).
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Medial tibial stress syndrome (MTSS) is one of the most common running-related musculoskeletal injuries with high incidence (9.4%) and prevalence (9.1%) reported in runners (1). Understanding modifiable intrinsic (and extrinsic) factors that may contribute to MTSS symptoms is important for the development of effective prevention and management.

This study aimed to determine whether long-distance runners with MTSS displayed differences in lower leg muscle structure and function compared to matched asymptomatic runners.

Medial tibial stress syndrome has high incidence (9.4%) and prevalence (9.1%) in runners.
Addressing deficits in leg muscle strength and endurance is also likely to be important for runners with MTSS as they progress their training loads.


11 runners with MTSS were matched on sex, age, height, body mass, weekly running training distance and limb dominance with 11 asymptomatic (control) runners. Nine participants had bilateral symptoms and so analysis was conducted on 20 symptomatic MTSS limbs and

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