Date of Award

August 2018

Degree Type

Thesis

Degree Name

Master of Science

Department

Kinesiology

First Advisor

Jennifer Earl-Boehm

Committee Members

Hayley Ericksen, Kristian O'Connor, Jennifer Earl-Boehm

Keywords

Biomechaincs, Exertional Medial Tibial Pain, Injury Prevention, Kinesiology, Running

Abstract

Introduction: Exertional medial tibial pain (EMTP) has been shown to be one of the leading injuries in females who have weakened hip strength. Increased trunk and hip kinematic excursion and decreased hip external rotation and hip abductor strength are related to injury in the athletic population but there is a lack of research in the role of hip strength in the development of exertional medial tibial pain in competitive female runners. Purpose: Therefore, the purpose of this study is to investigate differences in hip strength, hip kinematics, and trunk kinematics between those with a previous history of exertional medial tibial pain and healthy controls. Design: Cross sectional, case control design Participants: Twenty-one female competitive recreational runners ages 18-45 who are planning on participating in a race within the next 6 months were placed into two groups depending on their past medial history (11- healthy control and 10-EMTP group). Methods: 3D kinematic data were collected with reflective markers attached to the trunk and lower extremity segments during over-ground running trials using a 10-camera motion capture system, force platform, and timing system. Five running trials at 4.0-4.5 m/s were collected and peak angles of hip adduction, internal rotation, and extension and trunk flexion and lateral lean were averaged across the trials. Strength of the hip abductors external rotators, and extensors were collected during 3 maximal voluntary contractions using a handheld dynamometer and stabilization straps. To identify the differences between kinematic and strength variables, an independent t-test was performed to compare between groups with a significance level set at α<0.05. Results: No significant difference in normalized hip strength between those with a history of EMTP and healthy controls in hip abduction (p=0.913), hip external rotation (p=0.125), and hip extension (p=0.308). no significant difference in hip adduction ROM excursion (p= 0.711), hip internal rotation excursion (p=0.998) and trunk flexion ROM excursion (p=0.559) and trunk lateral lean ROM excursion (p= 0.559) between those with a history of EMTP and healthy control. The EMTP group found running more enjoyable and more eager to run. The healthy group showed less remorse for missing a run and ran in more races. Conclusion: Hip strength and hip and trunk excursion appear to show no difference between those who have a history of EMTP and those who are healthy and never had a history of EMTP, leading researchers to speculate that these factors are not related to EMTP. When looking at the holistic picture of kinesiology, clinicians and researchers have to take into consideration all variables due to the fact that there are multiple factors that can increase the risk of EMTP. Clinicians should build the protocol intervention around the athlete based on their needs. Word Count: 445

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