Term
Complete the sentence:
Shin splints is a non-specific term describing any activity induced leg pain along the ...-... or ...-... aspects of the proximal ... of the tibia. |
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Definition
Shin splints is a non-specific term describing any activity induced leg pain along the postero-medial or antero-lateral aspects of the proximal 2/3rd of the tibia.
*i.e.: tendinitis, stress fracture, periostitis, ECS, irritiation of interosseous membrane*
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Term
| Periostitis is an inflammation of a membrane lining the outer s urface of all bones. Which membrane is that? |
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Definition
Periostitis: inflammation of periostum membrane
> at tendo-periosteal junction (tendon attach to bone)
> provides attachment for mm and tendons
*lines outer surface of all bones and densely innervated with nociceptors = sensitive to manipulation* |
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Term
| What is the common MOI for periostitis? |
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Definition
| MOI: repeated stress without adequate recovery |
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Term
| Where is periostitis commonly found? Where will pain usually be reported? |
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Definition
> soleus & tib. posterior
> pain is reported over posteromedial tibia
*palpation: local pain to attachment, few cm in diameter*
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Term
What action of the ankle may be a potential cause for tibialis posterior periostitis?
a) eversion
b) pronation
c) supination |
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Definition
b) pronation
> pes planus + over-pronation with gait = ↑ stress and eccentric load on tib. post = ↑ load at MTJ and tendo-periosteal junction |
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Term
Complete the sentence
Tibialis posterior is a strong ... and ... that helps to control ... during gait. |
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Definition
| Tibialis posterior is a strong supinator and invertor that helps to control pronation during gait. |
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Term
True or false?
Someone with periostitis will be in constant pain. |
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Definition
False
> only painful with activity
* resolve w/ rest (few min)*
* progressively takes longer to resolve (up to 1-2 days)
*left untreated: show up earlier with activity and become chronic* |
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Term
True or false?
Stress fractures most commonly affect the fibula. |
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Definition
False
stress fractures most commonly affect the tibia and not the fibula
*microfracture of the bone from trauma being greater than remodelling capacity of the bone* |
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Term
| Where is pain from a stress fracture usually felt? |
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Definition
very point specific at the middle distal 1/3rd of the medial tibia
> palpating off the site of the fracture significantly decreases pain |
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Term
True or false?
Stress fractures pain may progressively be felt at night. |
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Definition
True
first only with activity→ lingers→ progressively earlier in activity→ with simple weight bearing→ experience night pain |
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Term
| How long may a stress fracture take to resolve, before returning to activity? |
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Definition
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Term
| Aside from peroneus longus and brevis, name the nerve belonging to the lateral compartment of the leg. |
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Definition
Lateral compartment
> peroneus longus
> peroneus brevis
> superficial peroneal nerve |
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Term
| Which nerve resides in the superficial posterior compartment of the leg? |
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Definition
Superficial posterior compartment
> gastrocnemius
> soleus
> sural nerve |
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Term
Which does not belong in the anterior compartment of the leg?
Tibialis anterior, FHL, EHL, EDL, deep peroneal nerve, anterior tibial artery and vein
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Definition
FHL does NOT belong
Instead: Tibialis anterior, EHL, EDL, deep peroneal nerve, anterior tibial artery and vein |
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Term
Which does not belong in the posterior compartment of the leg?
tibialis posterior, FHL, EDL, tibial nerve, peroneal artery & vein, posterior tibial artery & vein
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Definition
EDL does NOT belong
Instead: tibialis posterior, FHL, FDL, tibial nerve, peroneal artery & vein, posterior tibial artery & vein
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Term
| What condition is defined as an increase in intracompartmental pressure? |
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Definition
| Exertional compartment syndrome/ECS: increase in intracompartmental pressure |
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Term
| Aside from pain in the anterior compartment, what other impairments might arise from anterior ECS? |
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Definition
Pain in anterior compartment
> paraesthesia between 1st and 2nd toes (from deep peroneal nerve)
> possible foot drop (from m fatigue/cannot contract properly) |
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Term
| What action of the ankle as well as stretch of the ankle will increase pain with anterior ECS? |
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Definition
> active dorsiflexion
> stretch muscle into plantarflexion |
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Term
| Which muscle will commonly be overused with anterior ECS/Exertional Compartment Syndrome? Which muscle will be hypomobile? Which muscle will be weak? |
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Definition
overused m = tibialis anterior
hypomobile m = triceps surae
weak m = tibialis anterior |
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Term
| Which action (passive and active) of the foot will increase pain with posterior ECS? |
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Definition
> Active supination
> Passive dorsiflexion + eversion |
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Term
| Which muscles will commonly be weak with posterior exertional compartment syndrome? Which muscle will usually be tight? What position will you commonly found the foot with posterior ECS? |
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Definition
> Weak m = tibialis posterior (or inflammed)
> Tight m = triceps surae
> Foot position = pronation
*post. ECS: pain in posteromedial leg, deep posterior compartment, possible paraesthesia (tibial nerve) in instep and possible weak toe flexion and inversion (FHL, FDL, tib post)* |
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Term
| With posterior ECS, which nerve will be affected if there is paraesthesia felt? |
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Definition
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Term
| With posterior ECS, which muscles will be affected with weak toe flexion and inversion? |
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Definition
| FHL, FDL, tibialis posterior |
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Term
| What is the common cause of an acute compartment syndrome/ACS? |
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Definition
Tibial fracture
> medical emergency: hemorrhage + accumulation of necrotic debris, inflammation and arterial occlusion= places a high amt of pressure on surrounding tissues within compartment
* pain w/ activity + compartment is red and shiny* |
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Term
| What are common causes of Shin Splints? |
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Definition
> Training on hard/uneven surfaces
> Excessive training (sudden increase in regular training)
> Improper footwear (lack of shock absorption, old footwear)
*other: m strength vs flexibility; inadequate nutrition alter repair process from lack of vitamin, calcium, Vitamin D* |
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Term
Complete the sentence
It is known not to increase distance more than ....% per week to be pain free. |
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Definition
| It is known not to increase distance more than 10% per week to be pain free. |
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Term
In order to recover from a shin splint, what is the suggested percentage reduction in activity?
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Definition
> reduce activity to 50%, cross train, avoid hard uneven surfaces, stretching & strengthening
*appropriate warm up/cool down: 5-10 min of light jogging/specific warm up(
*Modification of activity = essential for recovery*
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