Milner Clare E, Ferber Reed, Pollard Christine D, Hamill Joseph, Davis Irene S
Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA.
Med Sci Sports Exerc. 2006 Feb;38(2):323-8. doi: 10.1249/01.mss.0000183477.75808.92.
Tibial stress fractures (TSF) are among the most serious running injuries, typically requiring 6-8 wk for recovery. This cross-sectional study was conducted to determine whether differences in structure and running mechanics exist between trained distance runners with a history of prior TSF and those who have never sustained a fracture.
Female runners with a rearfoot strike pattern, aged between 18 and 45 yr and running at least 32 km.wk(-1), were recruited for this study. Participants in the study were 20 subjects with a history of TSF and 20 age- and mileage-matched control subjects with no previous lower extremity bony injuries. Kinematic and kinetic data were collected during overground running at 3.7 m.s(-1) using a six-camera motion capture system, force platform, and accelerometer. Variables of interest were vertical impact peak, instantaneous and average vertical loading rates, instantaneous and average loading rates during braking, knee flexion excursion, ankle and knee stiffness, and peak tibial shock. Tibial varum was measured in standing. Tibial area moment of inertia was calculated from tibial x-ray studies for a subset of runners.
The TSF group had significantly greater instantaneous and average vertical loading rates and tibial shock than the control group. The magnitude of tibial shock predicted group membership successfully in 70% of cases.
These data indicate that a history of TSF in runners is associated with increases in dynamic loading-related variables.
胫骨应力性骨折（TSF）是最严重的跑步损伤之一，通常需要6 - 8周才能恢复。本横断面研究旨在确定有TSF病史的训练有素的长跑运动员与从未发生过骨折的运动员在结构和跑步力学方面是否存在差异。
招募年龄在18至45岁之间、采用后足着地模式且每周跑步至少32公里的女性跑步者参与本研究。研究参与者包括20名有TSF病史的受试者以及20名年龄和里程匹配、既往无下肢骨损伤的对照受试者。使用六相机运动捕捉系统、测力平台和加速度计在地面以3.7米/秒的速度跑步时收集运动学和动力学数据。感兴趣的变量包括垂直冲击峰值、瞬时和平均垂直加载率、制动期间的瞬时和平均加载率、膝关节屈曲幅度、踝关节和膝关节刚度以及胫骨冲击峰值。站立位测量胫骨内翻。对部分跑步者通过胫骨X线研究计算胫骨面积惯性矩。
TSF组的瞬时和平均垂直加载率以及胫骨冲击明显高于对照组。在70%的病例中，胫骨冲击大小成功预测了组别归属。
这些数据表明，跑步者的TSF病史与动态负荷相关变量的增加有关。
