Also called exertional compartment syndrome or chronic compartment syndrome, exercise-induced compartment syndrome is a condition that causes pain down the front of the shin bone. The pain typically arises during physical activity or exercise and subsides during rest.
Exercise-induced compartment syndrome is linked to a buildup of pressure in the muscles of the leg. Normally, the fascia (the layer of tissue surrounding the muscle) can accommodate the increase in muscle size that occurs during exercise. In patients with exercise-induced compartment syndrome, the fascia is too tight, and as a result the muscle is constricted during activity. When the muscle expands and is constricted by the overly tight fascia, its blood supply is interrupted, which can cause severe pain.
The most common symptom of exercise-induced compartment syndrome is pain in the shin during activity that quickly subsides during rest. The patient may also notice a tingling or numbness in the leg due to the restricted blood flow.
Your physician will likely recommend rest, ice therapy, anti-inflammatory medications, and avoiding any specific activities that cause symptoms. If symptoms persist, surgery may be needed to release the tight fascia, called a fasciotomy.
Sometimes the bones of the lower leg-the tibia and fibula-can become misaligned due to deformity, trauma, or a previous fracture that has healed incorrectly.
The most common symptom of misalignment is severe pain when placing any weight on the injured leg.
Depending on the specific nature of the misalignment, your physician may recommend one of the following treatments:
- External devices such as braces or casts to guide the bone back into alignment
- Osteotomy, a surgery in which the bone is cut to shorten, lengthen, or alter its alignment
- Surgical insertion of rods or plates to stabilize the bone structure
"Shin splints" is the more common term for medial tibial stress syndrome. It's a common condition in runners as well as athletes whose sports involve sudden stops and starts, such as soccer, basketball, and tennis.
Shin splints are the result of excessive force being placed on the shinbone and connective tissues that attach the muscles to the bone. This "overload" can be caused by activities such as running downhill or on a slanted surface, running in worn-out footwear, or participating in a sport that involves sudden starts and stops.
- Tenderness or pain along the inside part of the lower leg
- Mild swelling in the lower leg
Your physician will probably prescribe "R.I.C.E." therapy-rest, ice, compression, and elevation-as well as anti-inflammatory medications, which should relieve the symptoms. You'll also be advised to ensure you wear proper footwear for exercising (possibly with arch supports) and to return to your normal activities gradually.
A tibial stress fracture is a crack in the shin bone (tibia), usually caused by excessive force from a weight-bearing activity such as running. It's an overuse injury that occurs gradually over time.
The impact of running places compressive force on the tibia, and contraction of the attached muscles can also exert a pulling force on the bone. When these forces exceed what the tibia can withstand, the result is a bony stress reaction that can progress into a tibial stress fracture.
- Gradual onset of pain on the inner side of the shin
- Shin pain that increases with impact activity and subsides with rest
Your physician will probably recommend total rest for the injured tibia, which usually involves using crutches and avoiding placing weight on the leg for several weeks. You may need to come in periodically for X-rays to ensure that the bone is healing properly while you recover.