Anterior Compartment Syndrome

Tibialis anterior muscle - Anterior compartment syndrome

Anterior 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 a 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 a 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

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 overuse.

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

Severe acute compartment syndrome is a medical emergency and professional medical attention should be sought as soon as possible as long-term damage to nerves or muscle can occur due to restricted blood flow.

For 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 go down.

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

A doctor may prescribe anti-inflammatory medication e.g. Ibuprofen which will help with pain and swelling. In severe acute cases, surgery may be indicated to release the pressure in the compartment. 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. If the injury is chronic then correcting any biomechanical dysfunction with orthotic devices should be considered. Foot problems such as overpronation may be causing the tibialis anterior muscle to work too hard resulting in overuse and causing the muscle to grow too large for the sheath.

Training methods, running gait, type 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.

Anterior shin splints taping

The following guidelines are for information purposes only. We recommend seeking professional advice before attempting any self-treatment.

This is an excellent taping for shin splints, periostitis or tibialis posterior strain. It is virtually identical to the shin splints taping technique for pain on the inside of the shin only the tape goes the opposite way round to support the outside of the shin.

What you will need:

All you will need is 3.5 cm zinc oxide tape, and if you have hairy legs some underwrap and adhesive spray. It is better to apply tape directly to the skin if possible so if you will be taping on a regular basis then it is recommended you shave your legs otherwise use the underwrap.

Step 1

Starting with the bony bit on the outside of the ankle apply a strip of tape across the front of the ankle, around the back of the Achilles tendon (not too tight here) and then diagonally across and up the front.

Step 2

Make sure it is not too tight around the back of the Achilles tendon but you might like to try a little pressure as the tape comes up the front. You may need to experiment a few times. Repeat step 1 with another strip of tape slightly overlapping the first.

Step 3

Repeat this once more working from the bottom upwards. Make sure the tape covers the painful area on the inside of the shin. When done correctly this can help support the muscles on the outside of the shin during healing and rehabilitation.

If done correctly this is a very good taping that will take the pressure off the lower shin. Remember that you can rid yourself of shin splints but must also use all other methods of treatment possible.

This article has been written with reference to the bibliography.