The problem with the second mechanism stated is that the most tender MTSS pain location isn't near the origins of any of those muscles. The pain is most severe where finite element analysis shows the weak spot of the tibia to be. The thin part of the tibia that is also the apex of the curve. Also there is another theory that would exacerbate that particular distal location is the "tenting" effect of the contraction of the soleus/TP/FDL which pushes on the fascia surrounding the compartment which in turn pulls on the periosteum.
My transcript notes of the video: 00:11 In this video we're going to be doing an overview of a condition called medial tibial stress syndrome usually abbreviated mtss it's more commonly known as shin splint syndrome or just shin splints 00:25 if you look over here at this image of the right lower leg you can see in red here the typical location of shin splint pain and this is actually going to be the attachment side of some of the muscles 00:36 that end up getting overworked in medial tibial stress syndrome like the tibialis posterior muscle and even the tibialis anterior muscle is sometimes implicated in mtss this is a very common condition in 00:51 runners and what i want you to notice here about this picture is what is actually poor running form so if you look here this person is actually striking the ground with their heel now when you 01:04 learned the gait cycle typical gait just for walking there is heel strike at initial contact this actually changes with running it it turns out that proper running mechanics should actually have forefoot or at the 01:19 very least mid foot contact and having this heel contact actually increases the risk of developing medial tibial stress syndrome so there are several pieces of criteria to diagnose somebody with medial tibial 01:34 stress syndrome and the first is is the person that's going to describe pain as being along the distal one-third of the postero medial tibial border as you see right here in some cases the pain can be more 01:49 anteromedial in particular if the tibialis anterior is more implicated than the tibialis posterior but generally speaking it's going to be the posterior one-third of the postero medial tibial border 02:02 number two the pain needs to be exercise induced so it doesn't matter if the person's a runner a jumper or anything in between that specific activity in particular doing it more and more and more 02:14 needs to bring on that pain specifically that postero medial tibial pain and then number three painful palpation and that painful palpation needs to be a length of at least five centimeters five consecutive centimeters over the length 02:30 of the patient's familiar painful area and the more of these that are satisfied the more likely it is that the person has medial tibial stress syndrome so what is the mechanism of medial tibial stress syndrome well the exact 02:46 mechanism is under debate but one of the most plausible cases would be that of muscle imbalance in terms of strength and inflexibility and we're mainly thinking about muscles like the tibialis anterior and posterior and then also the 02:59 triceps siri group which contains the gastrocnemius and the soleus so let's take running for example so if somebody is doing more and more 03:09 running and they have weakness in any of these muscles in particular the gastrocnemius and the soleus well then that muscle is going to fatigue and when that muscle fatigues it's going to cause altered running mechanics and 03:24 by altered running mechanics it means increased reliance on let's say the tibialis anterior and posterior okay and you can see these muscles over here you can see where they attach on the tibia this right here in the back is 03:38 tibialis posterior this one would be tibialis anterior and we know that they originate on certain parts of the tibia but if you look more microscopically the point of contact is actually at the 03:50 periosteum of the bone and so overuse of these muscles during running especially over and over again is going to cause irritation of that periosteum at the origins of these muscles and so that's implying that medial tibial stress 04:04 syndrome is really just a specific form of periastitis irritation or inflammation of the periosteum of the tibia so what are some risk factors for developing medial tibial stress syndrome 04:18 well the first here is overload in particular overload that occurs too quickly we should always be trying to progress exercises but never progress too quickly if you progress the training duration the intensity the speed or 04:32 anything else too quickly you're not giving these muscles a chance to adapt and so that can lead to irritation of that periosteum as we were talking about and the development of shin splints running on hard or uneven surfaces To get the full transcript of the video and PDF notes with screenshot - Try Askify chrome extension
Very nicely explained.
The problem with the second mechanism stated is that the most tender MTSS pain location isn't near the origins of any of those muscles. The pain is most severe where finite element analysis shows the weak spot of the tibia to be. The thin part of the tibia that is also the apex of the curve. Also there is another theory that would exacerbate that particular distal location is the "tenting" effect of the contraction of the soleus/TP/FDL which pushes on the fascia surrounding the compartment which in turn pulls on the periosteum.
My transcript notes of the video:
00:11
In this video we're going to be doing an overview of a condition called medial tibial stress syndrome usually abbreviated mtss it's more commonly known as shin splint syndrome or just shin splints
00:25
if you look over here at this image of the right lower leg you can see in red here the typical location of shin splint pain and this is actually going to be the attachment side of some of the muscles
00:36
that end up getting overworked in medial tibial stress syndrome like the tibialis posterior muscle and even the tibialis anterior muscle is sometimes implicated in mtss this is a very common condition in
00:51
runners and what i want you to notice here about this picture is what is actually poor running form so if you look here this person is actually striking the ground with their heel now when you
01:04
learned the gait cycle typical gait just for walking there is heel strike at initial contact this actually changes with running it it turns out that proper running mechanics should actually have forefoot or at the
01:19
very least mid foot contact and having this heel contact actually increases the risk of developing medial tibial stress syndrome so there are several pieces of criteria to diagnose somebody with medial tibial
01:34
stress syndrome and the first is is the person that's going to describe pain as being along the distal one-third of the postero medial tibial border as you see right here in some cases the pain can be more
01:49
anteromedial in particular if the tibialis anterior is more implicated than the tibialis posterior but generally speaking it's going to be the posterior one-third of the postero medial tibial border
02:02
number two the pain needs to be exercise induced so it doesn't matter if the person's a runner a jumper or anything in between that specific activity in particular doing it more and more and more
02:14
needs to bring on that pain specifically that postero medial tibial pain and then number three painful palpation and that painful palpation needs to be a length of at least five centimeters five consecutive centimeters over the length
02:30
of the patient's familiar painful area and the more of these that are satisfied the more likely it is that the person has medial tibial stress syndrome so what is the mechanism of medial tibial stress syndrome well the exact
02:46
mechanism is under debate but one of the most plausible cases would be that of muscle imbalance in terms of strength and inflexibility and we're mainly thinking about muscles like the tibialis anterior and posterior and then also the
02:59
triceps siri group which contains the gastrocnemius and the soleus so let's take running for example so if somebody is doing more and more
03:09
running and they have weakness in any of these muscles in particular the gastrocnemius and the soleus well then that muscle is going to fatigue and when that muscle fatigues it's going to cause altered running mechanics and
03:24
by altered running mechanics it means increased reliance on let's say the tibialis anterior and posterior okay and you can see these muscles over here you can see where they attach on the tibia this right here in the back is
03:38
tibialis posterior this one would be tibialis anterior and we know that they originate on certain parts of the tibia but if you look more microscopically the point of contact is actually at the
03:50
periosteum of the bone and so overuse of these muscles during running especially over and over again is going to cause irritation of that periosteum at the origins of these muscles and so that's implying that medial tibial stress
04:04
syndrome is really just a specific form of periastitis irritation or inflammation of the periosteum of the tibia so what are some risk factors for developing medial tibial stress syndrome
04:18
well the first here is overload in particular overload that occurs too quickly we should always be trying to progress exercises but never progress too quickly if you progress the training duration the intensity the speed or
04:32
anything else too quickly you're not giving these muscles a chance to adapt and so that can lead to irritation of that periosteum as we were talking about and the development of shin splints running on hard or uneven surfaces
To get the full transcript of the video and PDF notes with screenshot - Try Askify chrome extension
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