Medial tibial stress syndrome. The location of muscles in the leg in relation to symptoms.

The legs of fifty cadavera were dissected to identify accurately the structures that attach to the tibia at the site of symptoms of medial tibial stress syndrome and that could potentially contribute to this condition. The origins of the soleus, the flexor digitorum longus, and the tibialis posterior muscles as well as that of the deep crural fascia were measured. The average sites of attachment and the ranges of attachment were determined for each structure. The soleus, the flexor digitorum longus, and the deep crural fascia were found to attach most frequently at the site where symptoms of medial tibial stress syndrome occur, while in no specimen was the tibialis posterior found to attach at this site. The data support recent reports that the soleus is probably the major contributor to traction-induced medial tibial stress syndrome. The data also contradict the contention that the tibialis posterior may contribute to this particular condition.