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dc.contributor.authorBeck, Belinda R
dc.contributor.authorRudolph, Katrin
dc.contributor.authorMatheson, Gordon O
dc.contributor.authorBergman, A Gabrielle
dc.contributor.authorNorling, Tracey L
dc.date.accessioned2017-05-29T12:30:41Z
dc.date.available2017-05-29T12:30:41Z
dc.date.issued2015
dc.identifier.issn1050-642X
dc.identifier.doi10.1097/JSM.0000000000000126
dc.identifier.urihttp://hdl.handle.net/10072/67322
dc.description.abstractObjective: To identify physical and behavioral characteristics related to the incidence of tibial stress injuries (TSIs). Design: Case-control study. No clinical care was conducted. Setting: Research laboratories in the San Francisco (the United States) and Gold Coast (Australia) areas. Participants: Forty-eight patients (21 men and 27 women) with acute TSI, and 36 (16 men and 20 women) age-matched, sex-matched, height-matched, weight-matched, and activity-matched controls with no history of TSI. Independent Variables: Height, weight, body mass index, bone, lean and fat mass, lower limb alignment anomalies, foot type, orthotics, calcium, recent weight change, menstrual history, oral contraceptive use, medications, smoking, alcohol, sleep, training type, and intensity. Differences in continuous variables were tested using 1-way analysis of variance. Categorical variable comparisons were performed with Fisher exact test. Main Outcome Measure: Tibial stress injury. Results: Tibial stress injury cases had 2.7% more fat (P < 0.001) and 2.6% less muscle (P < 0.001) as well as lower trochanteric bone mineral content (BMC) (P < 0.001), lumbar spine (LS) area (P < 0.001), femoral neck BMC (P < 0.001), length (P < 0.05), area (P < 0.001), cortical width (P < 0.01), cross-sectional moment of inertia (P < 0.001), and index of bending strength (P < 0.001) than controls. Controls had lower LS BMC (P < 0.01), length (P < 0.001), and broadband ultrasound attenuation (P < 0.001). The use of orthotic insoles was more prevalent in TSI cases than controls (25% vs 5.6%, respectively; P < 0.02), as were foot anomalies (56.3% vs 27.8%, respectively; P = 0.01). Conclusions: Tibial stress injury cases had lower lean and higher fat mass, a tendency for smaller bones, and for foot anomalies compared with uninjured matched controls. bone mineral density was normal for both groups. Clinical Relevance: Enhancing lean mass and limiting gains in fat may provide some protection against TSI. Individuals with small skeletal frames are advised to increase training loads particularly gradually and to reduce training intensity at the first sign of pain in the shins.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.languageEnglish
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.publisher.placeUnited States
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom1
dc.relation.ispartofpageto7
dc.relation.ispartofjournalClinical Journal of Sport Medicine
dc.rights.retentionY
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchOrthopaedics
dc.subject.fieldofresearchSports science and exercise
dc.subject.fieldofresearchMedical physiology
dc.subject.fieldofresearchSports medicine
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode320216
dc.subject.fieldofresearchcode4207
dc.subject.fieldofresearchcode3208
dc.subject.fieldofresearchcode320225
dc.titleRisk Factors for Tibial Stress Injuries: A Case-Control Study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorNorling, Tracey L.
gro.griffith.authorBeck, Belinda R.
gro.griffith.authorRudolph, Katrin


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