Anterior Lower Leg

Shin Splints:
Shin splints is an umbrella term to describe pain located in the anterior (front) or posterior (back) of the shin, often caused by overuse or over training or muscular imbalances in the lower extremity. Symptoms include diffuse pain and tenderness on the medial (inside) aspect of the lower leg which is usually increased with running or walking with heavy footwear. Tenderness is present where the muscle attaches to the bone. Swelling can sometimes be seen and felt.

Treatment and prevention at home includes proper footwear, icing and proper warm-up.

Treatment at physiotherapy includes:
Education about the condition and how to avoid making it worse (footwear, orthotics, training advice).

Therapeutic modalities to improve circulation and/or reduce inflammation and pain such as ultrasound, laser, interferential current, electrical muscle stimulation, acupuncture.

Exercises to stretch or strengthen the appropriate muscles or stabilize the joint.

Manual therapy to improve the movement in the area.
Tape to rest the irritated tissues while they heal and help return to activity sooner.

Lower Leg Stress Fracture (fatigue fractures):

Stress fractures are often caused by prolonged and repeated running. Predisposing factors can include skeletal asymmetry, unequal leg lengths, abnormal running styles, poor running conditions or equipment and prior injury. Symptoms include pain with activity, tenderness to touch, and local swelling. Common sites include:

1) Fibula - located approx 5-7 cm from the tip of the lateralal malleolus (outside ankle bone). Typically occurs in long distance runners.

2) Tibia - Can be located on the inside of the shin bone and less commonly in the front of the shin. This site usually occurs in runners and is slow to develop. Diagnosis includes a bone scan usually.

Treatment includes rest, and varying degree of weight bearing. Medical advice should be sought.

Compartment Syndrome:
Compartment syndrome is a painful condition caused by increased pressure inside different muscle compartments in the lower leg. This increase in pressure is usually the result of bleeding in the anterior (front) or posterior (back) compartment due to soft tissue injury, fracture or overuse. This is a serious condition because the pressure can impair circulation by blocking the blood vessels that run through the compartment. The result is loss of blood flow to the foot which is a serious medical condition. Symptoms include pain with activity, weakness bending the foot upwards, loss of sensation and numbness in the lower leg and foot and local swelling and tenderness in the front of the shin. Treatment includes rest, ice, and elevation. You should seek advice by a medical professional immediately if you experience loss of circulation and feeling in the foot.

Tibialis Anterior Syndrome:
Tibialis Anterior Syndrome is acute inflammation of the tendon sheath (covering) of the tibialis anterior muscle. Symptoms include pain in the anterior shin especially with dorsiflexion (raising ankle/foot upward), pain on palpation, temperature increase, skin redness and swelling in the anterior and lateral (outside) shin.

Treatment and prevention at home includes proper footwear, icing and proper warm-up.

Treatment at physiotherapy includes:
Education about the condition and how to avoid making it worse.

Therapeutic modalities to improve circulation and/or reduce inflammation and pain such as ultrasound, laser, interferential current, electrical muscle stimulation, acupuncture.

Exercises to stretch or strengthen the appropriate muscles or stabilize the joint.

Manual therapy to improve the movement in the area.