Causes and forms of tibial edge syndrome

The muscles of the lower leg run in boxes, also called compartments. Each muscle is enclosed by a thin but extremely stable skin, the muscle fascia. Tibial edge syndrome occurs when training increases the circumference of the muscles of the lower leg and results in an increased pressure ratio in one or more boxes.

A corresponding training effect occurs mainly during muscle training, but also through sports and the associated muscle movements. If the muscle enlarges and the pressure in a compartment rises as a result, the muscle’s supply of oxygen-rich blood may be reduced because the vessels supplying the muscle are increasingly compressed and allow less blood to pass through. The blood accumulating in the vessels now in turn causes increased pressure.

This causes fluid to escape from the vessels, resulting in the formation of edema around the vessels. This in turn increases the pressure in and around the muscle. A vicious circle begins.

This can lead to the death of muscle cells-so-called necroses. The muscles of the so-called deep medial compartment are particularly frequently affected by tibial edge syndrome.These include the tibialis posterior muscle, flexortorum longus muscle and hallucis longus muscle. These muscles are used for longitudinal and transverse tension of the foot and form the arch of the foot. Excessive walking, especially on hard surfaces, can lead to a pronounced compartment syndrome and massive complaints.

Duration

The individual duration of symptoms of tibial edge syndrome can vary greatly. Depending on the degree of the disease as well as its localization and cause, the complaints can last from a few hours to several weeks. Typical is pain, which always occurs at the beginning of the symptoms and improves in the course of the training.

The longer a tibial edge syndrome lasts and is not treated, the more continuous the pain is perceived. Especially if the tibia is not protected, the duration of the disease can be significantly longer. An individually tailored therapy can help to shorten the course of the disease.

A prompt visit to a doctor right at the beginning of the symptoms is essential for a rapid healing of the disease. If conservative methods of treatment do not allow the disease to heal for a longer period of time, surgical treatment can be considered. During muscular training, the muscle can take up to 15 times its original volume.

Especially when the muscles are trained quickly, the muscle fascia around the muscle cannot adapt to it as quickly – compartment syndrome (tibial edge syndrome) develops. In addition to general strength training, the following sports techniques in particular are considered to be factors that promote shin-edge syndrome: When changing the floor covering, both in spring and autumn, the muscle groups can be overstressed, intensive training on hard surfaces also promotes shin-edge syndrome, as well as intensive running training with repeated jumping and landing manoeuvres and excessive forefoot strain. Furthermore, foot malpositions with simultaneous training can promote shin-edge syndrome. Malpositions include external rotation of the foot and pronation. If sports training is abruptly increased or the training regime is changed, if shoes are changed frequently or spike shoes are used, shin-edge syndrome can occur much more frequently.