RESUMO
The main purpose of the study is to investigate the inversion/eversion muscle strength balance of the ankle in patients with medial tibial stress syndrome (MTSS). A dysbalance of these muscles may play a role in the pathophysiology of MTSS. Another aim is to measure the medial longitudinal arch and navicular drop in patients with MTSS. A total of 11 patients diagnosed with MTSS in the outpatient clinic of Ege University School of Medicine Sports Medicine Department were enrolled in this study. The control group consisted of 11 regularly exercising individuals. The mean age of the patient group and the control group was 21. 0 ± 1.9 years (18-23 years) and 23.2 ± 2.9 years (18-27 years), respectively. A detailed exercise questionnaire was administered to all subjects. Isokinetic muscle strength testing was performed at 30°/sec and 120°/sec to assess invertor and evertor muscle strength of the ankle. Photographs of the weight bearing and non-weight bearing foot were taken to measure the medial longitudinal arch deformation and the navicular drop. At 30°/sec, the average eversion concentric strength was significantly higher in the patient group, and the inversion/eversion strength ratio was significantly higher in the control group (p < 0.05). At 120°/sec velocity, average concentric eversion strength was significantly higher in the patient group (p < 0.05). The measurements of pronation indicators did not reveal any statistically significant differences between the two groups (p > 0.05). MTSS may occur without an increase of pronation indicators like medial longitudinal arch deformation or navicular drop. In such cases, one of the predisposing factors may be the strength dysbalance of the invertor/evertor muscles in favour of the evertor muscles. This observation may be of additional value in the prevention and therapy of MTSS. Key pointsAt 30°/sec, the average eversion concentric strength was significantly higher in the MTSS group, and the inversion/eversion strength ratio was significantly higher in the control group.At 120°/sec velocity, average concentric eversion strength was significantly higher in the MTSS group.MTSS may occur without an increase of pronation indicators like medial longitudinal arch deformation or navicular drop. In such cases, one of the predisposing factors may be the strength dysbalance of the invertor/evertor muscles in favour of the evertor muscles.
RESUMO
Anterior cruciate ligament (ACL) is the primary stabilizer of the knee. An impairment of any of the dynamic or static stability providing factors can lead to overload on the other factors and ultimately to deterioration of knee stability. This can result in anterior tibial translation and rupture of the ACL. The purpose of this study was to examine the influence of tibial slope on ACL injury risk on soccer players. A total of 64 elite soccer players and 45 sedentary controls were included in this longitudinal and controlled study. The angle between the tibial mid-diaphysis line and the line between the anterior and posterior edges of the medial tibial plateau was measured as the tibial slope via lateral radiographs. Individual player exposure, and injuries sustained by the participants were prospectively recorded. Eleven ACL injuries were documented during the study period. Tibial slope was not different between soccer players and sedentary controls. Tibial slope in the dominant and non-dominant legs was greater for the injured players compared to the uninjured players. The difference reached a significant level only for the dominant legs (p < 0.001). While the tibial slopes of the dominant and non-dominant legs were not different on uninjured players (p > 0.05), a higher tibial slope was observed in dominant legs of injured players (p < 0.05). Higher tibial slope on injured soccer players compared to the uninjured ones supports the idea that the tibial slope degree might be an important risk factor for ACL injury. Key pointsDominant legs' tibial slopes of the injured players were significantly higher compared to the uninjured players (p < 0.001).Higher tibial slope was determined in dominant legs compared to the non-dominant side, for the injured players (p = 0.042). Different tibial slope measures in dominant and non-dominant legs might be the result of different loading and/or adaptation patterns in soccer.