Stress fracture is common in the tibia (34%), fibula (24%), metatarsals (20%), and femur (20%); thus 58% occur in the shin.5
External compartment syndromes in the shin typically manifest as a feeling of pain, muscle tightness, or cramping brought on by exercise, and intra-compartmental pressure is increased.
Musculoskeletal "shin splints" are related to the functions of the three leg compartments. The anterior compartment is responsible for two major movements. The primary movement is dorsiflex-ion of the ankle and foot to provide clearance of the swinging limb and the eccentric function of controlling plantarflexion of the ankle and digits. The secondary function of the anterior compartment is to decelerate rear-foot pronation by the anterior tibialis muscle. The lateral compartment controls rear-foot supination and provides balance for the strong inverter pull from the anterior and posterior compartments. The posterior compartment includes both the superficial and deep muscles. Of the deep posterior muscles, the posterior tibialis provides control of rear-foot pronation and prevents midfoot collapse during weight acceptance. The soleus fibers and the flexor hallucis longus also have been implicated in the symptoms of postero-medial shin splints.2
Dry needling acupuncture therapy is very effective in both preventing and treating shin pain. The three compartments should be treated together. The trigger points in the thigh and the core muscles should be needled as well.
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