An epidemiological study of Medial Tibial Stress Syndrome Type II in club hockey players in the eThekwini Municipality

Abstract

Background: Field hockey is a high intensity sport that exposes players to intrinsic, extrinsic, and overuse injuries. An overuse injury that appears to be neglected in field hockey epidemiological research is Medial Tibial Stress Syndrome (MTSS TII). Objectives: This study aimed to determine the self-reported prevalence of MTSS TII in club hockey players within the eThekwini Municipality, any potential contributing possible risk factors that may contribute to its development, and identify the treatment-seeking strategies employed by these players. Methods: A quantitative, cross-sectional study was conducted to determine the prevalence and potential risk factors of MTSS TII among club hockey players in the eThekwini Municipality, KwaZulu-Natal, South Africa. An online self-administered questionnaire was distributed via the Durban Hockey Association to registered adult players (older than 18 years old) competing for clubs within the municipality. The questionnaire explored the demographics, potential risk factors contributing to MTSS TII, a MTSS TII assessment tool, MTSS TII history and education, and management of the condition. Results: Among the 137 participants, 10.9% (n=15) were self-diagnosed with MTSS TII. A higher prevalence of MTSS TII was found in women (60%) compared to men. A significant association was found between MTSS TII and duration of shoe use (Fisher’s exact test = 12.328, p=0.007), with 40% of those with MTSS TII used their hockey shoes for less than six months compared to 9% of those without MTSS TII. A total of 55 participants (40.1%) had a history of MTSS TII or had been diagnosed by a licenced practitioner. Physiotherapy was the most frequently consulted medical service (85%), with stretching (88.9%), massage (88.9%), and strapping (74.1%) reported as the most frequently used treatments. Notably, only 13.1% of participants reported receiving any education about MTSS TII from coaches or team staff (p<0.01). Discussion and conclusions: MTSS TII is a relatively common occurrence in field hockey players, particularly among women. This study clarifies the prevalence, potential risk factors, education, and management of MTSS TII in field hockey players. The results of this study, particularly the high percentage of players with a history of shin splints, indicate the need for injury prevention strategies.