Posterior Shin Splints
- A complex syndrome characterized by exercise induced pain in the mid leg.
- Contributing factors include varus hindfoot, excessive forefoot pronation, genu valgum, excessive femoral anteversion & external tibial torsion.
- May encompasses a wide spectrum of disorders including periostitis near origin of soleus and FDL origins and stress fractures.
- Probably not related to pathology of the origin of the tibialis posterior.
- Involved in the etiology of shin splints is the normal pronation of the forefoot during stance phase.
- Excessive or unbalanced pronation may be a cause of shin splints.
- Shin splints are rare with age under 15 years.
- Stress fracture.
- Chronic exertional compartment syndrome.
- Popliteal artery entrapment.
- Muscle strain.
- Tenderness is localized to posteromedial border of tibia in mid to distal third regions.
- Tenderness is usually more localized with stress fractures.
- Usually normal in periostitis.
- Rest is the key to treatment of stress fractures and periostitis.
- Stress fractures may take up to 12 weeks to heal completely.
- Casting may be indicated.
- Fasciotomy of the posterior may be indicated in severe cases.