Inflammation of the outer shin bone

Anatomy: The calf muscles are divided in three muscle groups (compartments) by powerful muscle membranes (fascie). A forward, an exterior and a rear muscle group (which is divided in a superficial and a deep part). The large rear muscle groups’ muscle membrane (fascie) is fastened on the inner edge of the shin bone, while the forward muscle group is fastened on the external edge of the shin bone (Photo).

Cause: In cases of repeated uniform loads, a stress related inflammation can occur where the muscle membrane fastens on the edge of the shin bone. The condition is most often seen in athletes who jump a lot and with frequent change of running surface or shoes.

Symptoms: Pain upon applying pressure, particularly on the exterior edge of the shin bone and upon straining, and is aggravated when the foot is bent upwards against resistance (extension). Occasionally an irregular bone edge can be felt on the shin bone.

Acute treatment: Click here.

Examination: In light cases medical examination is not necessarily required. In cases with more pronounced pain or lack of progress despite relief, a medical examination is recommended to ensure the diagnosis and rule out amongst other things a stress fracture. A normal medical examination is usually sufficient in order to make the diagnosis. It can be necessary to supplement with X-ray, scintigraphy or ultrasound scanning.

Treatment: The treatment involves relief, stretching and slow rehabilitation. It is imperative that there are good shock absorbing soles in the shoes. In cases where there is a lack of progress the treatment can be supplemented with medical treatment in the form of rheumatic medicine (NSAID) or the injection of corticosteroid (which is always a part of a longer lasting rehabilitation). In severe cases with no effect from relief, correct rehabilitation and medical treatment you can surgically split the membranes (fasciotomy) which fasten on the edge of the shin bone (article).

Complications: If the course does not progress smoothly, you should be medically re-examined to ensure that the diagnosis is correct, and that complications have not arisen in the form of stress fracture.

Special: Shock absorbing shoes or inlays will reduce the load. In cases with lack of progress or relapse after successful rehabilitation, a running style analysis can be considered to evaluate whether correction of the running style is indicated.