Anterior Compartment Syndrome

Tibialis anterior muscleAnterior compartment syndrome, also known as anterior shin splints arises when the big muscle on the outside front of the lower leg becomes too big for the sheath that surrounds it causing pain.

Anterior compartment syndrome can be acute or chronic. Acute compartment syndrome is sudden onset and causes considerable pain. It is often due to an injury or impact to the big tibialis anterior muscles at the front of the leg which swells up. Chronic anterior compartment syndrome comes on gradually and may be due to the muscle growing too big for the sheath surrounding it.


Symptoms of acute and chronic anterior compartment syndrome include pain in the tibialis anterior muscle on the outside of the lower leg.

There will be weakness in the muscle so trying to pull the foot upwards against resistance may be difficult and pain may also be reproduced by pulling the foot downwards to stretch the muscle. In severe cases foot drop or a slapping gait may be seen as the athlete cannot properly lift the foot up when walking.

Acute compartment syndrome

An acute compartment syndrome is likely to have followed a direct impact, tear or contusion to the muscle.  It may also happen as a result of a chronic compartment syndrome flaring up painfully through over use.

Chronic compartment syndrome

Symptoms of a chronic compartment syndrome will be similar but will have come on over a period of time. It may be possible for the athlete to run for a few miles pain free before the injury comes on, gradually getting worse until they must stop. A period of rest will relieve symptoms only for the compartment syndrome to return again later a few miles into a run.

Anterior compartment syndrome treatment

Self help treatment

Shin and calf supportFor both an acute and chronic compartment syndrome rest and applying cold therapy is important. This will reduce the pain and swelling which will take the pressure off the sheath surrounding the muscle. Apply ice or cold therapy and compression for 20 minutes at a time every hour initially until the pain and swelling goes down.

An acute compartment syndrome is a medical emergency and professional advice should be sought immiediately as permenant nerve and muscle damage can occur.

If the compartment syndrome is chronic then professional advice may be needed to identify the causes and advise on treatment.

The anterior compartment syndrome taping can provide instant relief from pain by supporting the muscle. It can be worn all the time initially whilst it is painful and later on to support the lower leg when returning to normal training.

Professional treatment

Taping for anterior compartment syndromeA doctor may prescribe anti-inflammatory medication e.g. ibuprofen which will help with pain and swelling. If the injury is chronic then correcting any biomechanical disfunction with orthotic devices should be considered. Foot problems such as over pronation may be causing the tibialis anterior muscle to work too hard resulting in over use and causing the muscle to grow too large for the sheath.

Training methods, running gait, types of shoe should also be considered as the wrong type of running shoe can cause or make the condition worse. See a specialist running shoe retailer for advice on what is best for your type of feet.

Shin stretchingIn some cases surgery may be indicated. A surgeon will measure the pressure within the muscle sheath itself and an operation to make a small cut or two in the muscle sheath to allow the muscle to expand can be performed.