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A Neuromuscular Intervention for Exercise-Related Medial Leg Pain



2012, 21, 54 – 62

Context: Exercise-related medial leg pain (ERMLP) is a common complaint among athletes, and efforts toward rehabilitation are often unsuccessful. Objective: To evaluate the efficacy of a therapeutic intervention in ERMLP localized to soft tissue. Design: A quasi-experimental, nonequivalent control-group study. Setting: Athletic training facility. Patients: 20 volunteer male and female athletes (18–22 y old) with ERMLP. Complete data were available for 13 participants. Intervention: Treatment group (TRE, n = 7) received therapeutic intervention focused on relieving muscle hypertonicity in the deep compartment of the lower leg and restoring balance of the toe flexors and extensors. Control group (CON, n = 6) received no intervention. Main Outcome Measures: Self-reported pain intensity, pain threshold, and extensor hallucis longus to extensor digitorum brevis (EHL:EDB) electromyography ratio. Results: There were no significant differences in age, duration of symptoms, or pain measures between the 2 groups at baseline. CON demonstrated no significant changes in any of the outcome measures in posttreatment testing, but significant between-groups differences were identified for pain during activity (CON mean = 6.5, 95% CI 5.05, 7.95; TRE mean = 3.5, 95% CI 1.67, 5.33; P = .01), change scores for pain during activity (CON mean = 0.33, 95% CI –1.25, 1.91; TRE mean = –3.43, 95% CI:–4.6, –2.25; P < .001), change scores in pressure threshold (CON mean = –0.25, 95% CI –0.74, 0.23; TRE mean = 0.72, 95% CI 0.22, 1.37; P = .006), and change in EHL:EDB ratios (CON mean = 0.05, 95% CI –0.22, 0.33; TRE mean = 1.07, 95% CI 0.75, 2.07; P < .046). Conclusion: Therapeutic interventions focused on restoring muscle balance appear to be effective in resolving ERMLP.

Keywords: shin pain, muscle balance, MTSS


Authors: Katherine R. Newsham, Matthew D. Beekley, Christine A. Lauber

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