Compartment Syndrome - Anterior - (Anterior shin splints)

What is Anterior compartment syndrome?

Anterior compartment syndromes arise when a muscle becomes too big for the sheath that surrounds it causing pain. The big muscle on the outside of the shin is called the tibialis anterior and is surrounded by a sheath. This is called the anterior compartment of the lower leg. Compartment syndromes can be acute or chronic.

Acute anterior compartment syndrome can occur as a result of:

• An impact which causes bleeding within the compartment and therefore swelling.
• A muscle tear which also causes bleeding.
• Over use injury which also causes swelling.

Symptoms of anterior compartment syndrome include:

• A sharp pain in the muscle on the outside of the lower leg, usually the result of a direct blow.
• Weakness when trying to pull the foot upwards against resistance.
• Swelling and tenderness over the tibialis anterior muscle.
• Pain when the foot and toes are bent downwards.

What can the athlete do?

• Rest, but try to exercise your upper body or cycle if it is not painful.
• Apply ice and compression for 20 minutes at a time.
• See a sports injury professional who can advise on rehabilitation.

What can a sports injury specialist or doctor do?

• Prescribe anti-inflammatory medication e.g. ibuprofen.
• Correct any biomechanical disfunction with orthotic devices.
• Operate. They could make a small cut or two in the muscle sheath to allow the muscle to expand out.

Chronic anterior compartment syndrome can occur as a result of:

• Over use and over developing the muscle through training.
• At rest the blood vessels are not at capacity. During exercise these blood vessels fill up much more and expand putting pressure on the sheath.
• The sheath becomes inelastic and unable to expand.

Symptoms include:

• Pain which increases during exercise which eventually makes running impossible.
• Pain goes after a short rest but comes back again during exercise.
• Difficulty in lifting the toes and foot up.
• Pain when pulling the toes and foot downwards.

What can the athlete do?

• Rest until there is no pain.
• Apply sports massage techniques to increase the elasticity of the muscle sheath.
• Apply heat and use a heat retainer.
• See a sports injury specialist.

What can a sports injury specialist or doctor do?

• Prescribe diuretics and anti-inflammatory medication.
• Analyse your training methods, running gait and types of shoe to determine any contributory factors.
• Use sports massage techniques to stretch the muscle sheath.
• Operate. They could make a small cut or two in the muscle sheath to allow the muscle to expand out.