When working with MTSS patients, I’ve consistently seen something interesting. If we are ELITE in 5 specific areas, symptoms drop dramatically. When these boxes are checked, the athlete can achieve a neutral foot push off and is far less likely to fall into excessive navicular drop, especially during terminal hip extension. Here are the 5: 1️⃣ Dorsiflexion: 45 degrees of neutral foot dorsiflexion in a weight bearing lunge test. 2️⃣ Tibial Internal: Rotation Greater than 30 degrees bilaterally .If the tibia cannot internally rotate, the foot will compensate. 3️⃣ Hip Rotation: (90 degrees external rotation, 45 degrees internal rotation) If the hip cannot rotate, force gets dumped distally. 4️⃣ Hip Extension: 30 degrees passive hip extension. Without it, athletes push off early and collapse medially. 5️⃣ Hallux Extension: 90 degrees of big toe extension. This allows proper arch recoil and neutral push off. When these are present, stride mechanics clean up fast. The foot can stay neutral in late stance, and we dramatically reduce stress on the deep posterior compartment musculature. MTSS is not just shin issue. It is a stride mechanics issue. Curious what standards you all are using in your assessments.

Hi everyone! Being an athletic trainer in the secondary school setting can get a little hectic at times, so these are some rehabs I have created and posted in my ATR for athletes to utilize for general injuries, just wanted to share!