Investigation of risk factors for history of medial tibial stress syndrome in referees

Abstract

Purpose: The aim of this study was to investigate potential risk factors associated with a history of medial tibial stress syndrome (MTSS) in football referees. Methods: A total of 39 referees participated in this cross-sectional study. Based on the definition criteria for MTSS reported in the literature, participants were divided into two groups: those with a history of MTSS (n=14) and those without (n=25). All assessments were conducted in a blinded manner, with examiners unaware of group allocation. The navicular drop test, Craig's test, and heel elevation endurance test were administered to evaluate lower extremity function. Hip internal and external rotation, knee flexion, and ankle dorsiflexion and plantarflexion ROM were measured using a standard goniometer. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Additionally, participants were asked about their athletic history and the comfort of the footwear they used during training and competition. Perceived running condition was evaluated using the Visual Analog Scale (VAS). Results: MTSS history was determined in 14 of the referees participating in the study. Statistically significant differences were found between groups regarding height length (p = 0.006), condition (p = 0.045), left knee flexion angle (p = 0.007) and right knee flexion angle (p = 0.046). According to the regression analysis result, MTSS history (right) and left knee flexion angle were found to be significantly related (p = 0.015). There was no significant difference or relationship between other variables (p> 0.05). Conclusion: According to our results, individuals with a history of MTSS had significantly greater height, while their running condition and knee flexion angle were significantly lower compared to those without a history of MTSS. These variables showed statistically significant differences between the two groups.