Is the addition of running retraining to best standard care beneficial in runners with medial tibial stress syndrome? Protocol for a randomised controlled trial

Laura M. Anderson, Daniel R. Bonanno, Benjamin J. Calnin, Prasanna Sritharan, Richard W. Willy, Bircan Erbas, Mehak Batra, Hylton B. Menz

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Running retraining is commonly used in the management of medial tibial stress syndrome (MTSS) but evidence for its effectiveness is lacking. The primary aim of this study is to determine if the addition of running retraining to best standard care is beneficial in the management of runners with MTSS. Methods: This study is an assessor-blinded and participant-blinded, parallel-group, randomised controlled trial. The trial will recruit 64 participants aged between 18 and 45 years, with a clinical diagnosis of MTSS that has affected their running participation for at least four weeks. Participants will be randomised to receive best standard care (control) or running retraining and best standard care (intervention group) over an 8-week period. Best standard care will consist of load management advice, symptom management advice, footwear advice and a strengthening program. Running retraining will consist of a cue to reduce running step length. Outcomes will be measured at weeks 1, 2, 4 and 8. The primary outcome measure will be the University of Wisconsin Running Injury and Recovery Index at week 4. Secondary outcome measures include: (i) Exercise Induced Leg Pain Questionnaire—British Version, (ii) global rating of change scale, (iii) worst pain experienced during a run, (iv) weekly run volume, (v) reactive strength index score, (vi) single leg hop test, (vii) soleus single leg maximum voluntary isometric contraction, (viii) gastrocnemius single leg maximum voluntary isometric contraction, (ix) single leg plantar flexor endurance test, (x) running step length, and (xi) running step rate. Data will be analysed using the intention-to-treat principle. Discussion: This randomised controlled trial will evaluate if reducing running step length provides additional benefit to best standard care in the management of runners with MTSS over an 8-week period. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12624000230550.

Original languageEnglish
Article numbere12029
Pages (from-to)e12029
JournalJournal of Foot and Ankle Research
Volume17
Issue number2
DOIs
StatePublished - Jun 2024

Keywords

  • gait retraining
  • leg injuries
  • prevention
  • randomized controlled trial
  • running injuries
  • Standard of Care
  • Humans
  • Middle Aged
  • Male
  • Treatment Outcome
  • Running/physiology
  • Young Adult
  • Adolescent
  • Adult
  • Female
  • Exercise Therapy/methods
  • Medial Tibial Stress Syndrome/therapy

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