The Risk Factors of Medial Tibial Stress Syndrome in Division II Track-and-field and Cross-country Athletes


Ai Ogata

Document Type


Degree Name

Master of Science (MS)


Health and Human Performance

Date of Award

Spring 2019


Medial tibial stress syndrome (MTSS), commonly known as shin splints, is one of the most common overuse injuries among runners. MTSS is disruptive for intercollegiate athletes because of its long recovery period. Many risk factors have been suggested in prior studies, but not in a collegiate track-and-field and cross-country athletic population. Seventy-six collegiate track-and-field and cross-country athletes were invited to the study, and 47 participants completed the study. The study was composed of a questionnaire and measurements of potential risk factors bilaterally: hip external rotation, hip internal rotation, ankle dorsiflexion in non-weight bearing position, ankle dorsiflexion in weight-bearing position, ankle plantarflexion, and navicular drop. Participants were monitored for tibial pain during the 2018-2019 National Collegiate Athletic Association (NCAA) Division II indoor track-and-field season. As a result, 14 participants (12 women, 2 men) developed MTSS and 1 athlete suffered from a stress fracture of the tibia. Female gender, greater navicular drop, decreased ankle dorsiflexion in weight-bearing position, and previous history of MTSS were significantly associated with developing MTSS (p < .05). Hip rotation, ankle dorsiflexion and plantarflexion in non-weight bearing position, and Body Mass Index (BMI) were not associated with the development of MTSS. Our findings indicate that female gender, navicular drop, ankle dorsiflexion in weight-bearing position, and previous history of MTSS may have important clinical implications. Athletic trainers should screen these 4 factors in pre-season to build an injury-prevention program for track-and-field and cross-country athletes who are at high risk for developing MTSS.


Vipa Bernhardt

Subject Categories

Medicine and Health Sciences | Sports Sciences