Dr. Timothy Young Talks About Anterior Shin Splints (Anterior Tibial Stress Syndrome)

Dr. Timothy Young Talks About Anterior Shin Splints (Anterior Tibial Stress Syndrome)

Dr. Timothy Young Talks About Anterior Shin Splints (Anterior Tibial Stress Syndrome)

Causes and definition:
 The anterior tibial muscle is on the front of the shin directly beside the shin bone or tibia.  Its purpose is to help decelerate the impact of the foot during gait.  A classic example would be a runner who was running downhill and after that heel hits the ground, rather than the foot immediately slapping to the ground the anterior tibial muscle helps to decelerate the foot as it slowly plantarflexes upon full impact.  Another classic example would be a tennis player who also has quick side to side motions and quickly lands heel first and the anterior tibial muscle engages to slow down the foot as it fully engages on the tennis court surface. 

Diagnosis: The diagnosis for this condition is similar to that of a posterior tibial shin splint.  Again this condition can range from the more severe case of a stress fracture of the tibia, to irritation where the muscle attaches to the bone (periosteum), to fatigue and involvement of the muscle itself but not the main attachment to bone.  This can be diagnosed by physical examination and is exacerbated by activity.  It can also be diagnosed in severe cases with a bone scan or MRI.  Again sometimes ultrasound or x-ray can be helpful. 

Treatment: The treatment for this is similar to that of posterior shin splints.  Because it is a mechanical problem it isn't there is some Has less fashion is often due to training and sport activity and this has to often be curtailed while the muscle and related attachments gets a chance to calm down and "rest".  Changing activities such as avoiding going up and especially downhill can be helpful for runners.  Avoiding a hard surface such as concrete for workouts or sport activities can be helpful.  Wearing shoes that have good shock absorption to help deal with impact of heel strike can be helpful and some shoes may be worse for this condition even the weight of the outsole is designed where the shoe impacts the ground at heel strike.  Cases respond to mechanical treatment and support that can include wearing good shoes. 

-Good shock absorbing shoes that are not cantilevered or flared at the back of the outsole.   

-Stretching and icing. 

-Taping such as KT tape. 

-A shin splints sleeve can be helpful. 

-Prescription orthotics are recommended especially for difficult cases. 

-Shockwave therapy is excellent treatment for difficult cases. 

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