Synonyms
tibia, tibia plateau, tibial tuberosity, medial malleolus, tibial head, tibial head
Function of the shinbone
But what is this bone for anyway? Is the shin bone indispensable for the human body? The obvious function of the shin bone is to connect the thigh via the knee and the foot via the ankle joint. As the larger part of the two lower leg bones, the shin bone is thus an important supporting and buttressing pillar of the leg axis without which we would be unable to stand or walk. To a much greater extent than the second lower leg bone, the fibula, the shin bone provides stability and also serves as a firm anchorage point for muscles running along the lower leg and towards the foot.
Shin pain
Pain in the shinbone area can have a variety of other causes in addition to the fatigue fracture and shinbone edge syndrome described below, which occurs almost exclusively in runners and is therefore only an exceptional cause of pain in non-runners. Almost always, however, pain is caused by some form of overstrain. Strained muscles are just as conceivable as tendonitis or nerve irritation.
Even foot malpositions that should actually be corrected with the help of insoles can radiate as pain into the shin after a while. Correct, high-quality shoes and, if necessary, insoles are then essential. Nevertheless, if pain occurs – regardless of whether it is load-dependent and only manifests itself during sporting activity or permanently – a doctor should be consulted. As a rule, he will quickly differentiate between harmless and more serious injuries and irritations and recommend the optimal therapy.
Diseases of the shinbone
The most common disease of the tibia is arthrosis of the knee joint (= gonarthrosis, knee arthrosis). The fracture of the inner ankle is also a common disease, which is almost always combined with a fracture of the outer ankle (= fibula fracture; Weber fracture). Another combination injury is the Volkmann injury or also called Volkmann Dreick.
Here, the rear edge of the tibia breaks at the upper ankle joint. A tibial shaft fracture (= tibial shaft fracture) is relatively rare, but like the tibial head fracture (= tibial head fracture) it must be reconstructed with axial accuracy, as fracture-related malpositioning can lead to secondary problems such as osteoarthritis. A tibial community fracture is often seen in athletes.
This is usually a so-called fatigue fracture of the tibia (stress fracture). Inflammation of the tibia can also occur if the tendons in this area become inflamed. This is usually the case due to overloading or incorrect loading.
A fatigue fracture of the tibia, also known as a stress fracture or pathological fracture, occurs when the tibia is subjected to prolonged overloading – classically in athletes preparing for a major competition. Almost exclusively athletes who have a very large amount of training (e.g. marathon runners) and are also highly motivated and ambitious are at risk. Smaller warning signals of the body are often ignored and regeneration phases are sometimes shortened or even completely omitted.
Over a longer period of time, so many tiny injuries add up, both in the bone structure itself and in the surrounding tissue. As a result, the shinbone can no longer be properly protected and stabilized and at the same time becomes more susceptible to injury itself. Sooner or later the bone will break.
In contrast to a “normal” – so-called acute – bone fracture, the accompanying pain does not have to start abruptly and with high intensity. A tibial fatigue fracture may initially only be noticeable during training by slight pain. Later on, pain often occurs during rest phases, which are often followed by permanent pain.
The consequence of such a fatigue fracture may be a simple lower leg cast, as would be used for other fractures. As a rule, however, the relief of the affected lower leg is often already helpful. It remains the be-all and end-all in the further course of treatment.
In more complicated cases, unfortunately, splinting alone is sometimes not sufficient: if this is the case, surgical fixation of the fracture becomes necessary.The corresponding operation is performed analogous to the surgical treatment of an acute tibia fracture. A further disease of the tibia, which almost exclusively affects ambitious runners, is the tibial edge syndrome, which manifests itself with pain and a feeling of pressure in the tibia. In the beginning, the above-mentioned complaints only occur during specific stress situations and disappear quickly after the end of training.
Due to this very characteristic constellation, many sufferers unfortunately do not go to the doctor immediately, because they perceive their own complaints as strange but bearable. Gradually, however, the symptoms of tibial plateau edge syndrome become more severe, so that training sessions may have to be discontinued. Typically, the affected athletes then reach a point where the pain and the unpleasant feeling also remain at rest.
This is often the moment when the affected athletes consult a doctor for the first time. However, the problem with this temporal progression is obvious: the later a person with the symptoms of a “shin splint”, as the shin splint syndrome is also called in English, goes into medical treatment, the longer the subsequent healing process can last. The cause of the pain in this type of overload reaction is the irritation of the muscle attachment to the shin bone.
If the muscle is overtrained, it becomes inflamed and reacts irritated. Especially the point of attachment, which lies directly on the bone, can then hurt like hell due to the strong sensitivity of the periosteum to pain. This can be remedied by an early visit to the doctor, a consistent break from sports and by relieving the affected structures.
The tibial edge syndrome must heal completely. In this phase, even supposedly “loose” running is absolutely taboo. Physiotherapy can support the healing process as well as strengthening and stretching exercises.
To avoid shin splints from the outset, it is important not to train too much, too fast or too ambitiously. Every body needs time to get used to stress and to build muscles. Conscientious regeneration breaks are just as important as the actual training itself.
The disease, named after the physicians Dr. Osgood and Dr. Schlatter, belongs to the large group of so-called aseptic osteochondroses and only affects the shin bone. Aseptic osteochondrosis is the death of bones that is not caused by an infection with pathogens but by a lack of blood supply to the area in question. Since simply too little blood reaches certain areas of the tibia, bone formation is disrupted.
It can even lead to splintering of individual bone parts. In addition, almost all affected persons observe the development of a thickening at a certain point of the tibia just below the knee joint, which reacts very sensitively to touch and pressure. The direct cause of Osgood Schlatter’s disease cannot yet be conclusively explained.
It is very likely that mechanical overloading of the shinbone leads to that blood undersupply and thus to the disorders of bone metabolism. Interestingly, almost only male children or adolescents aged 10 to 15 years are affected by Osgood Schlatter’s disease. Once the suspected diagnosis has been confirmed by means of an x-ray image, it is important to provide absolute relief for the diseased tibia.
For the patient, this usually means no sport and in severe cases walking with crutches to provide complete relief. As a rule, this conservative therapy is sufficient as a treatment measure and, at the latest after the last growth spurt of puberty, the spook is over as suddenly as it appeared. (taken from the front):
- Thigh bone (femur)
- Fibula head of the fibula
- Inner joint roll (medial condyle)
- Shinbone (Tibia)
(taken from the front):
- Fibula (fibula)
- Shinbone (Tibia)
- Hock leg (talus)
- Syndesmosis
