Chronic exertional compartment syndrome is one cause of exercise-related lower leg pain. There are four compartments in the lower leg. Each compartment has a wall that is surrounded by “fascia,” a thin layer of tissue that surrounds muscles. The compartments contain muscles, nerves, and blood vessels. During exercise, muscles swell, and fluid enters the compartment spaces. However, if the fascial wall of a compartment is too tight, blood flow may be cut off to the nerves and muscles. This results in pain in the compartment, as well as pain or tingling in the area of the lower leg supplied by the compartment’s nerves. It is more common in running sports, basketball, gymnastics, soccer, field hockey, and dance.
Symptoms include dull or crampy lower leg pain which starts at some point during exercise. If athletes stop and rest, the pain gradually goes away. With each workout, the leg pain returns at the same time in the exercise routine. If athletes do not stop exercising and try to push through the discomfort, the pain will increase in severity. Patients may experience numbness, tingling, and/or burning in the lower leg and foot. Patients may even feel like their foot is heavy or slaps the ground firmly while running.
Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson performs compartment testing for accurate diagnosis. Patients may require surgery for compartment release.
There are many causes of shin pain in athletes. Shin splints are the most common cause, other causes include medial tibial stress syndrome, stress fractures and exertional compartment syndrome. Shin splints are caused by overuse of muscles that attach to the tibia, which becomes inflamed. Frequently, shin splints begin after initiating or modifying a running/exercise program.
Symptoms include pain over the inner part of the shin that worsens with activity. As the pain with shin splints progresses, the pain may occur earlier into activity and with less activity.
Treatment often includes a period of rest, activity modification, and physical therapy. Dr. Sampson will rule out other causes of shin pain and supervise a return to activity.
A stress fracture is a fracture that is caused by too much stress being put on a bone. It is not typically caused by trauma and it develops gradually over time. It most commonly affects bones of the lower extremity, such as the tibia in the lower leg, the metatarsal bones of the foot, and the femoral neck at the hip joint. However, it can occur in any bone. Upper extremity stress fractures can occur in overhead athletes and gymnasts. Causes include repetitive high-impact exercise, increase in training volume or intensity, poor fitting athletic equipment, low bone density, and poor nutrition.
Symptoms include a gradual onset of pain with activity that progresses to affect daily activities. The pain will develop at the site of the fracture.
Treatment often includes an extended period of rest with immobilization in a cast, walking boot, and/or crutches. Dr. Sampson helps identify cause of injury and supervises healing and a return to activity.
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