Summary
In the so-called tibial edge syndrome, there is an imbalance between muscle volume, usually of the lower extremity, and the available space. The muscles of the lower extremities run in muscle boxes and are surrounded by a thin but stable muscle shell (fascia). If the muscles are trained too quickly, the muscle in the fascia will not have enough space.
The resulting pressure means that the blood in the muscle can no longer circulate properly. This can result in reduced blood supply and necrosis of the muscle. The increased pressure also puts a strain on the supplying nerves, which triggers the initial symptom – a pulling, burning pain.
Diagnostically, a tibial edge syndrome can be suspected if the patients report the pain after a running distance of about 500 m and it persists despite subsequent rest. Furthermore, an elastically tensed skin over the corresponding area of the box is usually evident. For further diagnostics, imaging techniques can be used, which can diagnose mainly other diseases causing the pain.
These include x-rays (to rule out fractures) and MRI (to rule out muscular causes). Ultrasound can also be performed to see inflammatory fluid in and around the muscle. Swelling of the muscle can also sometimes be seen with the ultrasound.Treatment for tibial edge syndrome can be conservative, on the one hand, by immobilization, cooling and the application of medication or physical anti-inflammatory measures, and on the other hand, in severe cases, open or minimally invasive surgery may be necessary, in which the affected muscle fascia is severed so that the pressure inside sings and the muscle can stretch again. After surgery, 60-100% of patients remain free of symptoms.
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