Medial Tibial Stress Syndrome

Medial Tibial Stress Syndrome (MTSS) is often characterised by a continual dull or intense pain along the distal two-thirds of the posteromedial crest of the tibia, which only intensifies further as the patient participates in weightbearing activities.

Patients also possess lower bone mineral density of the tibia along with lower cross-sectional area of the tibia, making them more susceptible to pain and stress in the region.

With excessive static navicular drop (ND) being typically associated with the diagnosis, Rathleff et al. aim to study static ND in relation to MTSS in both, dynamic and static conditions by examining two groups of patients - one with the condition; the other without - similar in age, sex, sporting activity of choice and former level of activity.

The patients were closely assessed whilst walking on a treadmill to evaluate the navicular drop using a two-dimensional video sequence analysis.

The key measures compared in this regard were static foot posture, static ND, dynamic ND (dND) and velocity of dynamic ND.

The study concluded that there was no notable difference in the static foot posture of the two groups.

The mean difference of the static ND between the groups was found to be 1.7 mm (P = .08).

It was also observed that patients with MTSS exhibited, on average, a 1.5-mm-larger dND (P = .004) during treadmill walking with a large mean velocity of dND measuring up to 2.4-mm/sec (P = .03).

Rathleff et al. were thus able to establish the importance of including the velocity of dND in further studies relating to the medial tibial stress syndrome; with a clear increase in its level being recorded in patients diagnosed with the condition.


  1. Michael S. Rathleff, Luke A. Kelly, Finn B. Christensen, Ole H. Simonsen, Soren Kaalund, Uffe Laessoe (2012) Dynamic Midfoot Kinematics in Subjects with Medial Tibial Stress Syndrome. Journal of the American Podiatric Medical Association: May/June 2012, Vol. 102, No. 3, pp. 205-212

Copyright 2016 MASS4D® All rights reserved. This article or any portion thereof may not be reproduced or used in any manner whatsoever without the prior written permission of MASS4D®