MTSS
ber of possible underlying etiological features which may cause or contribute to the manifestation of signs and symptoms. As such a thorough understanding of these factors is essential if the allied health professional is to make an appropriate clinical impression.
THE AUTHOR
Thomas Bennett MSc is a graduate sports rehabilitator and has a masters in sports medicine. He currently sits on the Executive Board of the British Association of Sports Rehabilitators and Trainers (BASRaT) and is a lecturer on the undergraduate and postgraduate sports rehabilitation programmes at St Mary's College, Twickenham.
References 1. Taunton JE, Ryan MB, Clement DB et al. A retrospective case control analysis of 2002 running injuries. British J Sports Med 2002;36:95-101 2. Clement DB, Taunton JE, Smart GW et al. A survey of overuse running injuries. Physician in Sports Medicine 1981;9:47-58 3. Sub Committee on Classification in Sports and Committee on the Medical Aspects of Sport, Standard Nomenclature of Athletic Injuries 1966; American Medical Association ed, Chicago 4. Slocum DB. The shin splints syndrome-medical aspects and differential diagnosis. Am J Surg 1967;114:857-881 5. Mubarak SJ, Gould RN, Lee YF et al. The medial tibial stress syndrome; a cause of shin splints. American Journal of Sports Medicine 1982;10:201-205 6. Michael RH, Holder LE. The soleus syndrome: a cause of medial tibial stress. American Journal of Sports Medicine 1985;13:87-94 7. Ugalde V, Batt ME. Shin splints: current theories and treatment. Reviews in Physical Rehabilitation Medicine 2001;13:217-253 8. Martire JR. Differentiating stress fracture from periostitis; the finer points of bone scans. Physician in Sports Medicine 1994;22:71-81 9. Allen MJ, Barnes MR. Exercise pain in the lower leg chronic compart- ment syndrome and medial tibial syndrome. Journal of Bone and Joint Surgery 1986;68(B):818-823 10. Anderson MW, Ugalde V, Batt M et al. Shin splints: MR appearance in a preliminary study. Radiology 1997;204:177-180 11. Batt ME. Shin splints-a review of terminology. Clinical Journal of Sports Medicine 1995;5: 53-57 12. Detmer DE. Chronic shin splints: classification and management of medial tibial stress syndrome. Sports Medicine 1986;3:436-446 13. Puranen J. The medial tibial syndrome: exercise ischemia in the medi- al fascial compartment of the leg. Journal of Bone and Joint Surgery 1974;56:712-715 14. Kortebein PM, Kaufman KR, Basford JR, et al. Medial tibial stress syn- drome. Medicine and Science in Sport and Exercise 2000;32:S27-S33 15. Beck BR. Tibial stress injuries: An aetiological review for the purpose of guiding management. Sports Medicine 1998;26:265-279 16. Gross TS, Edwards JL, McLeod KL, et al. Strain gradients correlate with the sites of periosteal bone formation. Journal Bone Mineral Research 1997;12:982-988 17. Messier SP, Pittala KA. Etiologic factors associated with selected running injuries. Medicine and Science in Sport and Exercise 1988;20:501-505 18. Krivicktas LS. Anatomical factors associated with overuse sports injuries. Sports Medicine 1997;24:132-146 19. Viitasalo JT, Kvist M. Some biomechanical aspects of the foot and ankle in athletes with and without shin splints. American Journal of Sports Medicine 1983;11:125-130 20. Yates B, White S. The incidence and risk factors in the development of medial tibial stress syndrome among navel recruits. American Journal of Sports Medicine 2004;32:772-780 21. Sommer HM, Valentyne SW. Effect of foot posture on the incidence of medial tibial stress syndrome. Medicine and Science in Sport and Exercise 1995;27:800-804 22. Burne SG, Khan KM, Boudville PB et al. Risk factors associated with exertional medial tibial pain: a 12-month prospective clinical study. British Journal of Sports Medicine 2004;38:441-445 23. Finestone A, Shlamkovitch N et al. Risk factors for stress factors among Israeli infantry recruits. Military Medicine 1991;156:528-530 24. Beck BR, Osternig LR.Medial tibial stress syndrome: the location of
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muscles in the lower leg in relation to symptoms. Journal of Bone and Joint Surgery 1994;76:1057-1061 25. Garth WP, Miller ST. Evaluation of claw toe deformity, weakness of the foot intrinsics and posteromedial shin pain. American Journal of Sports Medicine 1989;17:821-827 26. Saxena A, O'Brien T, Bunce D. Anatomical dissection of the tibialis posterior muscle and its correlation to medial tibial stress syndrome. Journal of Foot Surgery 1990;29:105-108 27. Holder LE, Michael RH. The specific scintographic pattern of shin splints in the lower leg. Journal of Nuclear Medicine 1984;25:865-869 28. Couture CJ, Karlson KA. Tibial stress injuries: decisive diagnosis and treatment of 'shin splints'. Physician in Sports Medicine 2002;30:29-39 29. Macleod MA, Houston AS, Sanders L et al. Incidence of trauma relat- ed stress fractures and shin splints in male and female army recruits. British Medical Journal 1999;318 30. Bergman BP, Miller SA. Equal opportunities, equal risk? Overuse injuries in female military recruits. Journal of Public Health Medicine 2001;23:35-39 31. Gemmell IM. Injuries among female army recruits: a conflict of legis- tration. Journal of the Royal Society of Medicine 2002;95:23-27 32. Jones B, Bovee M, Harris J et al. Intrinsic risk factors for exercise related injuries among male and female army trainees. American Journal of Sports Medicine 1993;21:705-710 33. Nielsen MB, Hansen K, Holmes P et al. Tibial periosteal reaction in soldiers: a scintographic study of 29 cases of lower leg pain. Acta Orthopaedica Scandinavia 1991; 62:531-534 34. Greaney RB, Greber FH, Laughan RL et al. Distribution and natural his- tory of stress fractures in US marine recruits. Radiology 1983;146:339-346 35. Devas MB. Stress fractures of the tibia or 'shin soreness'. Journal of Bone and Joint Surgery 1958;40:227-239 36. Andrish JT, Berfield JA, Walheim JA. A prospective study on the man- agement of shin splints. Journal of Bone and Joint Surgery 1974;56A:1967-1700 37. D’Ambrosia RD, Zelis RF, Chuinard RG et al. Interstitial pressure mea- surements in the anterior and posterior compartments in athletes with shin splints. American Journal of Sports Medicine1977;5:127-131 38. Roub LW, Gumerman LW, Hanley EN et al. Bone stress a radiological perspective. Radiology 1979;132:431-438 39. Batt M, Ugalde V, Anderson MW et al. A prospective controlled study of diagnostic imaging for acute shin splints. Medicine and Science in Sport and Exercise 1998;30:1564-1571 40. Fredericson M, Bergman G, Hoffman KL et al. Tibial stress reaction in runners: correlation of clinical symptoms and scintography with a new magnetic resonance imaging system. American Journal of Sports Medicine 1995;23:472-481 41. Bergman GA, Frericson M, Ho C et al. Asymptomatic tibial stress reac- tions: MRI detection and clinical follow up in distance runners. American Journal of Roentgenology 2004;183:635-638 42. Zwas ST, Elkanovitch R, Frank G. Interpretation and classification of bone scintographic findings in stress fractures. Journal of Nuclear Medicine 1987;28:452-457 43. Edwards PH, Wright ML, Hartman JF. A Practical approach to the dif- ferential diagnosis of chronic leg pain in the athlete. American Journal of Sports Medicine 2005;33:1241-1249
RECOMMENDED FURTHER READING
Ugalde V, Batt ME. Shin splints: current theories and treatment. Critical Reviews in Physical and Rehabilitation Medicine 2001;13:217-253 Edwards PH, Wright ML, Hartman JF. A practical approach to the differential diagnosis of chronic leg pain in the athlete. American Journal of Sports Medicine 2005;33:1241-1249
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