Shins and Compartment Syndrome – Part 1

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PHOTO CREDIT: Jacques Marais

Great confusion exists about the difference between shin splints and compartment syndrome amongst runners. Shin splints is a term commonly used to describe pain experienced along the shin bone (tibia) in the lower leg. This may be caused by overtraining, hill repeats, training on hard surfaces, weak foot muscles and hip instability.

Symptoms of shin splints:

  • Pain down the shin bone.
  • Dull, burning ache prominent at the start of a workout that eases as the muscles warm up.
  • Stiffness in the lower leg muscles after training.

Treatment consists of rest, ice, physiotherapy management to control inflammation as well as strengthening of weak muscles. If untreated, stress fractures can occur.

Compartment syndrome is a much more serious condition. Muscles are split into groups and surrounded by fascia (tight connective tissue) to form compartments. Each compartment has its own nerve and blood supply, and is relatively inflexible. Whenever the pressure in this enclosed space increases, blood supply to the tissues is compromised and can result in cell death.

Symptoms of compartment syndrome:

  • A throbbing pain in lower leg exacerbated by exercise and relieved by rest.
  • Calf swelling during exercise.
  • Pins and needles in the leg.

This condition deserves immediate medical attention to prevent fasciotomy surgery where the compartment needs to be released. Consult either a doctor or a physiotherapist for treatment. Differentiating between these two conditions is crucial when making a diagnosis in order to prevent serious complications. Be on the lookout for the follow-up article on practical advice and exercises.

Article by Lené van Heerden (Physiotherapist)
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