Association of Medial Tibial Stress Syndrome with Proprioception, Foot Function and Balance Among Cricketers: A Cross-Sectional Study
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Background: Medial tibial stress syndrome (MTSS) affects physically active populations, but clinical differences between new-onset and recurring presentations among cricketers remain insufficiently characterized. Objective: To examine associations of MTSS presentation with proprioception, foot function, and dynamic balance among cricketers. Methods: This cross-sectional study included 148 cricketers with MTSS recruited through convenience sampling from clubs and academies in Lahore, Pakistan. Assessments included joint position sense (JPS), Foot Function Index, Y-Balance Test, navicular drop, manual muscle testing, and single-leg stance. Associations were evaluated using exact tests, Holm adjustment across four comparisons, and crude conditional odds ratios with exact 95% confidence intervals. Results: Participants comprised 35 (23.6%) new-onset and 113 (76.4%) recurring cases. Bilateral JPS impairment occurred in 12 (34.3%) and 10 (8.8%), respectively. JPS classification was associated with MTSS presentation (exact p = 0.002; adjusted p = 0.008). The odds ratio for bilateral impairment versus normal JPS, comparing new-onset with recurring cases, was 5.193 (95% CI: 1.782–15.590). Left-leg dynamic balance yielded p = 0.041 but adjusted p = 0.124. Right-leg dynamic balance and foot function yielded p = 0.139 and p = 0.153, respectively. Conclusion: JPS classification differed between MTSS presentations after multiplicity adjustment. Dynamic balance and foot function showed no clear associations after adjustment. These findings characterize affected cricketers without establishing causation or recurrence risk
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