Friday, February 19, 2010

The hip & MTSS

"Distinct Hip & Rearfoot Kinematics in Female Runners With a History of Tibial Stress Fractures"- Milner et al JOSPT 2-10.

The big rocks uncovered in this study was (at gound contact):
1. Very little difference in knee motion between injured & uninjured subjects.
2. The stress fx subjects demonstrated greater hip adduction.
3. " " subjects demonstrated greater rearfoot eversion.

I found it interesting that the rear foot eversion didn't seem to have an influence on peak motions at the knee; it was also contrary to the author's hypothesis (did it have an influence at the hip???). They do note however, 5 of the subjects had a movement towards knee abduction AFTER initial foot contact, when that lower leg should have been locking up. I'm wondering if this creates the possibility of timing issues- remember the study only looked at peak bone excursion.

The authors go on to say that orthotics to correct rearfoot eversion do not result in changes at the hip. Very cool, they suggest altering running mechanics through gait training as a mode of stress fracture reduction. Now I'm even more excited to sit down with Franz Boche in Fla. at GAIN '10 this June.

OK, of course there is no one-fix-all panacea exercise for stress fx prevention/rehab. But when orthotics are not the answer, how about this exercise for controlling those issues created by excessive rearfoot eversion(RLB, LLE L rotational reach- both c/ a BUE posterior overhead reach)?
Oh yeah- How about a study on the trail leg's mechanics on MTSS?


KP said...


I've got my athletic training students reading your blog (yeah, it's making them think!) but they keep asking me about your abbreviations...I do the best I can, but how about a cheat sheet?

Joe Przytula said...

RLB=Right leg balance

LLE=left lower extremity
BUE=bilateral upper exremity

JM said...


I have enjoyed reading your blog for sometime. Keep up the fine work. Great stuff!