Shin Splints or Anterior Compartment Syndrome

Shin splints is also known as ANTERIOR COMPARTMENT SYNDROME. It is a condition affecting the front of the lower leg (below the knee). It is commonly seen in adolescents and is only tends to present in sports activities.

It is characterised by a gradual onset of aching down the front of the shin, that increases in intensity with activity. Running activities are the commonest factor.

There has been in the past a long running debate as to the exact cause of the condition. There have essentially various schools of thought on the subject. The commonly accepted one is that during muscular activity the muscles demand a greater blood supply. This causes them to become engorged and pumped with blood. As the muscles in this part of the leg are confined in a relatively tight compartment this causes the pressure to increase considerably. It is thought that it is this rise in pressure that results in the pain as well as preventing further and possibly adequate blood flow into the muscle group.

Adolescents are thought to be susceptible to shin splints because it is not unusual for different parts of their musculo-skeletal structures to develop at different rates so rendering some parts 'developmentally behind' others. This is a common reason given for inexplicable 'growing pains' in children.

Another school of thought is that it is excessive pulling of the muscles on the bones they arise from that causes the pain. The former is now considered to be the comonest reason for the majority of 'shin splints'.

As with all conditions it is important to get a correct diagnosis. Shin splint type symptoms can be similar to pain from a stress fracture of the lower leg as well as possibility circulatory and/or nerve entrapment problems. Make sure you get a qualified diagnosis.

Treatment

Treatment inevitably involves rest from problematic activities. The length of time necessary varies. Two to three weeks is a ball park figure. Gentle resumation of activities should follow with close observation.

In my experience it is the rest that is the key, although physical therapy in the form of ice, electrotherapy and stretches for the anterior tibial muscles can help.

If symptoms persist after a period of treatment and rest then surgery may need to be considered if the problem is a serious hinderance to desired activity. This normally involves quite invasive, but relatively simple division of what are known as the fascial planes. These are the sheaths that surround groups of muscles. Such a procedure has a high success rate in resolving persistent problems of this nature.

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