Overuse Injuries of the Lower Extremity: Shin Splints, Iliotibial Band Friction Syndrome, and Exertional Compartment Syndromes

Low-Energy Extracorporeal Shock Wave Therapy as a Treatment for Medial Tibial Stress Syndrome

“…However, the posteromedial aspect of the middle to distal third of the tibia should not be tender. 8,33,65 Radiographs are not useful in the early phase of stress fractures, 8 although they are useful in the late phase because they show periosteal reaction, callus formation, or sclerotic fracture line. High-resolution CT reliably shows cortical osteopenia with few small resorption cavitations.…”

Increasing Hamstring Flexibility Decreases Lower Extremity Overuse Injuries in Military Basic Trainees

“…For the purpose of this study, lower extremity overuse injuries included stress fractures, patellofemoral knee pain, muscle strains, tendinitis, plantar fasciitis, shin splints, and anterior compartment syndrome. 10,17 Recording and monitoring of lower extremity overuse injuries were done by weekly reviews of the log-in sheets at the troop medical clinic and review of the medical records to determine the diagnosis of any subject seen. Commanders of each company were contacted weekly to make sure there were no injuries that were unaccounted for by the troop medical clinic or medical records.…”

Low Regional Tibial Bone Density in Athletes with Medial Tibial Stress Syndrome Normalizes after Recovery from Symptoms

“…Although medial tibial stress syndrome is a well known clinical entity, 1–4,7–13,18,21–24,26,27 to our knowledge in only one study did the authors report that bone mineral density is reduced in the affected skeletal region. 19 The deficit in the tibial region was unexpected, given the subjects’ level of exercise and the fact that in most other skeletal regions their bone mineral density was higher than that of nonathlete control subjects.…”

“…Several hypotheses have been suggested to explain the pathophysiology of the medial tibial stress syndrome. A local inflammatory reaction at the musculotendinous attachment of the periosteum, 5,9,13,23,24 chronic posterior compartment syndrome, 1,9,26,28 or a microfracture with increased scintigraphic uptake (but no radiological evidence of stress fracture) 9,10,12,27 have all been proposed. Changes in bone signal in the affected region on MRI support the hypothesis that the skeleton is affected in the syndrome.…”

“…Medial tibial stress syndrome is characterized by localized pain in the distal posteromedial region of the tibia that increases during exercise; radiographs of the tibia appear normal. 1,4,9,13,24 Increased or altered activities usually precede the onset of symptoms and reduced activity often diminishes the pain. The pathophysiologic mechanisms of the syndrome are not known.…”