Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Anterior tibialis tendonitisAnterior lateral tibial periostitisAnterior lateral tibial stress syndromeAnterior lateral stress fracture ++ 844.9 Sprains and strains of unspecified site of knee and leg ++ S86.919A Strain of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter ++ 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation +++ Description ++ Lower anterior lateral leg pain provoked by activityPain is localized in the anterior lateral aspects of the tibiaProduced by stress or traction that causes microtrauma to the soleus muscle at the origin point of the shinboneStress-reaction inflammation of the periosteal and musculotendinous fascial junctionsResults from repeated activity without proper conditioning or allowing enough recovery time between activitiesAttributed to muscles of the lower extremities being overloaded or by biomechanical irregularitiesRecurring dull ache along the anterior lateral aspect of the upper tibia +++ Essentials of Diagnosis ++ Diagnosis is usually made by clinical examinationPain increases with active dorsiflexion and when the anterior tibialis muscle is stretched into plantarflexionMuscle length and strength imbalances, especially a tight gastrocnemius-soleus muscle groupCommon to see compartment syndrome associated with shin splints +++ General Considerations ++ Pain with repetitive activity, when the involved musculotendinous unit is stretched +++ Demographics ++ Affects all agesAthletes who increase activity intensity and/or duration along with a lack of appropriate recovery between workoutsBeginning runners +++ Signs and Symptoms ++ Pain: mild to severePain with weight-bearing activities and gaitTightness in gastrocnemius, soleus, and plantar musclesDescribed as a dull ache to lower extremitiesPoint tenderness to tibia at anterior lateral aspectPossible swellingMuscle guarding with passive movement +++ Functional Implications ++ Pain with standing or during activityInability of injured lower extremity to bear weightPain with closed chain ankle movements (i.e., driving) +++ Possible Contributing Causes ++ Impaired standing balanceRunning on too hard of a surfaceHistory of high/repetitive impact activitiesTraumaImproper footwearChronic ankle injuriesOvertrainingMuscle imbalance with ankle dorsiflexors and plantarflexorsTight or strong ankle plantarflexors overpowering the dorsiflexorsSupinators with decreased shock absorption +++ Differential Diagnosis ++ Vascular diseaseCompartment syndromePopliteal artery entrapment syndromesEntrapment of superficial peroneal nerveSpinal stenosisFascial herniasTenosynovitisCellulitisDeep vein thrombosisInfective or varicose periostitisTumorFibular dislocationAnkle sprainAchilles tendonitisLateral collateral ligament sprainLateral meniscus tearPeripheral vascular injuries +++ Imaging ++ X-ray for fracture, often limited viewComputed tomography (CT) scan for detailed imagingBone scan if stress fracture is suspectedMRIMRAArteriograms +++ Diagnostic Procedures ++ ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth