A Review on the epidemiology of Medial tibial stress syndrome injuries and the effect of stretching and strength exercise on its improvement (systematic review study)

Medial tibia stress syndrome (MTSS) is one of the most common musculoskeletal injuries caused by overuse in athletes and the military. Based on past studies, there is not available comprehensive systematic information on the percentage of its prevalence in different communities. On the other hand, studies have not examined the effect of stretching and strength exercises on the improvement of this syndrome. Therefore, the main purpose of this study is to investigate the scientific framework of research related to the prevalence of Medial tibia stress syndrome and the effect of stretching and strength exercises on its improvement.

For this study, the research background was searched through the databases of Google Scholar, PubMed, Science Direct, Elsevier and Scopus. The keywords "Medial tibia stress syndrome", "Stretching exercises and syndrome" and "Strength exercises and syndrome" were limited to 1988 to 2018, used.

The average of incidence of tibia's internal pressure syndrome in runners (33.67%) was higher than in college athletes (28.22%) and in college athletes were more than military (18.41%). Other results showed the total average of prevalence of MTSS in women was 27.07% and in men was 17.20%, indicating a high prevalence of MTSS in women compared to men. In general, ankle flexor dorsi muscles training lead to improve pain and reduce the incidence rate of MTSS injury. Also, flexor plantar flexor muscles stretching exercises, when combined with strength training, can improve pain and reduce the incidence of injury. Otherwise, stretching exercises alone do not have a significant effect on the improvement of MTSS.

The rate of injuries prevalence as a standard is used for determining its risk in sports and in different societies. Therefore, the present study can provide accurate information on the recognition of prevalence of MTSS and attention to prevention and treatment of MTSS in studied communities, especially runners and team physicians. It is worth noting that in the discussion of treatment, coaches and team physicians are advised to use ankle dorsi flexor muscles strength exercises to reduce the rate of pain and the incidence of MTSS.