Therapy

In the treatment of tibial edge syndrome, a distinction must be made between conservative and surgical therapy. In conservative therapy, the sports that cause the symptoms should first be discontinued for a long time and the leg should be spared. Alternatively, sports such as swimming or cycling (pedaling with the heel) can be performed.

Cooling compresses can be applied to reduce the swelling of the leg. Anti-inflammatory medication can be administered in ointment or tablet form. If there is no improvement, an attempt can be made to inject a cortisone solution (cortisone) into the muscle compartment.

In addition, a conservative treatment approach can be attempted through physiotherapy, in which the periosteum is exercised by gentle but steady pressure. Surgical therapy is always induced when conservative treatment attempts fail to produce any improvement or when the pressure conditions increase to such an extent that the supply of oxygen-rich blood to the muscle is compromised. During the surgical procedure, a splitting of the fascia of the affected muscle is performed to reduce the dangerous pressure.

The procedure can be performed either as open surgery, but is increasingly being performed in endoscopic procedures. Sports can be practiced about 4 weeks later. The chances of success are good.

Approximately 60-100% of the patients are free of symptoms after the procedure. Sports tapes or kinesiotapes are used for a wide variety of diseases affecting the human musculoskeletal system. If pain is the main symptom, the treating physician is very often approached by the affected persons about the possibility of applying a tape bandage.

In general, it should be noted that taping is a very controversial therapy option for most diseases, such as shin splint syndrome.In the case of severe symptoms caused by tibial edge syndrome, other therapeutic options should be given priority and the tape should be used as an additional treatment method if necessary. As a rule, the use of the tape will not cause any damage if the prescribed and recommended therapy is carried out at the same time. Since there are known individual cases where the use of the tape has brought about improvement in an existing tibial edge syndrome, trying out this option is certainly possible.

A tape can help with shin-edge syndrome if it is known that the individual running style also promotes the development of the syndrome. Especially when running with a conspicuous pronation in the rolling movement, there is a risk of developing shin-edge syndrome. By applying a tape bandage, the irritated musculature can be stabilized under certain circumstances and the running style improved.

Whether or not the bandage is individually appropriate and leads to an improvement of the symptoms should be discussed with an orthopedist or sports physician specializing in this field. He or she can best assess the severity of the disease and the potential therapeutic success that can be achieved with the tape and make a recommendation. A tibial bandage, as used in the treatment of tibial edge syndrome, is a piece of fabric that is wrapped around the affected tibia.

The bandages are relatively stable and are usually intended to help stabilize the affected structures in sports injuries. It is recommended that the correct circumference of the bandage be ensured so that the bandage is neither too tight nor too wide around the shin and can achieve the desired effects in the treatment of shin-edge syndrome. Since there is no joint involvement in tibial edge syndrome, stabilization is usually not necessary.

Nevertheless, a bandage can help to reduce the symptoms of the syndrome somewhat. This is attributed in particular to the heat generated by the support and the resulting improvement in blood circulation. Although a bandage can help to reduce the symptoms, it should not be used as an excuse to continue to put pressure on the shin.

Since the support cannot treat the cause of tibial edge syndrome in any way, irritation of the structures should be avoided even when the support is used. Clarification by a physician is recommended at the onset of symptoms to ensure the best possible course of the disease. Treatment of tibial edge syndrome with a bandage alone, without consulting a physician and possible further stressing of the structures of the lower leg, can lead to serious consequences and should be avoided.

Specialists in the treatment of tibial crural syndrome are orthopedic surgeons and physicians who specialize in the treatment of sports disorders. They can best assess the individual sense of using the support and at the same time present further treatment options. Therapy with an ointment can be assigned to the conservative approach of treating this disease.

The ointments are applied to the painful area and should help to eliminate the symptoms of the disease. A causal therapy using ointments cannot be offered for tibial edge syndrome. The cause of the symptoms lies relatively deep under the skin, which is why the active ingredient of the ointment is usually unable to penetrate from the skin to this point.

Most of the active ingredients found in ointments are absorbed by the lymphatic system and distributed through it in the body until it can act in diluted form at the desired location. The pain reliever Diclofenac can be applied locally with the help of an ointment and is often used in the therapy of shin splints. Pain can be effectively treated by applying the ointment.

Another option to treat the pain with an ointment is to use a warming ointment. These ointments increase the blood circulation of the skin and can often relieve the pain caused by shin splints. The application of cortisone ointments is not recommended and is not part of the therapy of the disease.

Local application of the active substance does not achieve the desired effect of anti-inflammatory treatment. In special cases, however, the agent can be injected intramuscularly.Massage as a physiotherapeutic measure can effectively alleviate the symptoms of shin-edge syndrome. Massages make sense especially when the pain does not originate from the muscles but from the periosteum.

With the help of a special massage technique, the pressure load on affected structures, such as the periosteum, is reduced. One possible type of massage is the ice massage. This is particularly helpful in the acute stage, as the cold can alleviate the symptoms of the inflammation.

For example, one can wrap several ice cubes in a washcloth or towel and carefully massage a particularly painful area. In general, it is helpful to massage the painful area itself. In this case one speaks of a so-called “trigger point massage”.

Fascial rolls can also be used. When used correctly, they release tension and allow the muscles to relax. They also have a beneficial effect on the regeneration of the muscles.

A regular massage of the tibial and fibular muscles is more important in the prevention of tibial edge syndrome than in its therapy. Muscle-related complaints can be treated more effectively with stretching exercises. In principle, a tibial edge syndrome can be treated surgically if conservative treatment approaches no longer bring success.

However, there is still no well-founded surgical method for such a chronic tibial edge syndrome. If a compartment syndrome is the cause of tibial edge syndrome, surgical treatment of compartment syndrome can also treat the cause of tibial edge syndrome. Compartment syndrome is an increase in volume of the tibial and fibular muscles with a resulting increase in pressure in the individual muscle boxes.

This can lead to irritation of the periosteum and severe pain. The compartment syndrome can take on serious proportions as soon as the increased pressure threatens to cut off blood flow. In such a case, a relieving operation with splitting of the muscle fascia must be performed.

Accordingly, a tibial edge syndrome can be operated in this special case. The word chronic implies that the symptoms are no longer temporary but permanent. A healing in the chronic stage is therefore much more protracted and difficult.

Therefore, affected persons must recognize the first signs of tibial edge syndrome in time and take the right therapeutic measures to counteract chronification. In general, however, this syndrome is a chronic and therefore recurrent clinical picture. There is no complete cure, but acute symptoms can be alleviated effectively and in the long term, so that those affected are symptom-free for the moment.

However, a recurrence is possible at any time. Long-distance runners are particularly susceptible to this disease. A strong and continuous strain on the tibial and fibular muscles on hard surfaces provokes a recurrent tibial edge syndrome. Whether a chronic tibial edge syndrome can be cured therefore depends to a large extent on the discipline of those affected to adhere to preventive measures and avoid chronic overloading of the tibial and fibular muscles.