Diagnostics
In the context of diagnostics, it is particularly important to interview the person concerned (anamnesis), which should reveal important clues. First of all, the doctor should find out how long the symptoms have existed and whether excessive sport is being done or whether the pain occurs during exercise or at rest. In addition, possible general symptoms such as fever, which could indicate inflammation, should be asked.
The further procedure includes the inspection and examination of the affected leg. This includes palpation of the tibia, which will be painful in case of periosteitis. Furthermore, the leg is examined for redness, swelling and, if necessary, water retention (edema).
The patient is also asked to perform some movements. In the case of chronic periostitis, which is usually more insidious, an X-ray of the tibia can provide further clues.Here the tibia is thickened by inflammation and small bone attachments, which are signs of a compensatory reaction of the bone, may be visible. A blood test may also contain indications of periosteitis. In the case of periostitis, for example, the typical signs of inflammation in the blood count (CRP and leukocytes) will be elevated.
Preventive measures
There are numerous possibilities to prevent periostitis. Especially during sports activities, overloading should be avoided and a consistent warm-up program should be followed. In addition, orthopedic malpositions, such as knock-knees or bow legs, should be compensated for by means of shoe insoles, as these can otherwise lead to incorrect loading.
To prevent periosteal inflammation caused by an invasion of bacteria, care should be taken to ensure that the skin in the area above the shin is intact and, in the case of wounds, that the wound is adequately disinfected and sterilely covered to minimize the germ load as far as possible. There are risk factors for the development of periosteitis of the shin bone. These include incorrect footwear, incorrect movement patterns and hard surfaces, such as road surfaces, when jogging.
A treadmill analysis with individual fitting of the jogging shoes can help to prevent future periostitis in athletes. In addition to fitting running shoes, insoles can be a useful measure to prevent shin splints. Orthopedic insoles should be compatible with the sports shoe that is worn.
In an orthopedic shoe store, insoles are individually fitted and any foot malpositions can be corrected. Patients should take the running shoes with them and show them to trained personnel. In case of acute periostitis, the tissue should be spared.
In the further course and as a future preventive measure, the leg muscles should be thoroughly stretched before and after training. This includes stretching exercises of the entire rear leg musculature, especially the calves and the front leg musculature. Adhesive fasciae promote the development of periosteitis of the shin bone.
Specific fascial therapy can help to prevent shin splints. The aim is to release adhesions of the connective tissue sheaths and tensions. Fascial treatment with fascial rollers, such as the Blackroll®, is popular. There are various exercises to relieve the legs with this form of self-massage.
