Periostitis and Compartment Syndrom Flashcards
What is Periostitis
Inflammation of the periosteum (wraps around bones)
Periostitis, compartment syndrome, tibialis posterior tendinitis and tibial stress fractures are sometimes under the lay term?
Shin splints
Shin splints
A non-specific phrase that describes pain along the medial border of the tibia with exercise
Definition Periostitis
Pain along the medial border of tibia with exercise
Causes of periostitis
Overuse- overtraining, poor techniques, training on hard/uneven surfaces, improper foot wear
Predisposing factors periostitis
Poor Biomechanics- excessive pronation, varus knee (bow legged), excessive external hip rotation- tight GN/SOL
Medical treatment periostitis
-Diagnosed by bone scan
-Non-steroidal Anti-Inflammatory
-Ice
-Rest
-Avoidance of activity
Symptom picture periostitis
-Excessive pronation likely present- bilateral
-Initial acute inflam-chronic inflam-adhesions + fibrosing of tissue
-Most commonly- px on posteromedial border tibia- may extend to tibia 2-3cm- long-2/3cm down tibia
-Px worse first few steps in morning
-Px worse during pre-swing
-Tightness/cramping if clt “runs through” the px
Definition Compartment syndrome
Result of increase pressure with in compartments of lower leg
4 Compartments surrounding tibia/fibula divided by dense
Inelastic fascia
What are the 4 compartments of the lower leg
-Anterior compartment
-Lateral compartment
-Superficial posterior compartment
-Deep posterior compartment
Anterior compartment includes
-Tibia anterior
-Extensor digitorum longus
-Extensor hallicus longus
Lateral compartment includes
Peroneal longus (fibularis)
Peroneal brevis (fibularis)
Superficially posterior compartment includes
GN/SOL
Deep posterior compartment includes
-Tibia posterior
-Flexor Digitorum longus
-Flexor hallicus longus
Compartment most prone to be affected?
Anterior most prone to be affected, followed closely by deep posterior
Compartment syndrome Usually occurs in
Athletes under 40yrs
Causes of acute compartment syndrome
Trauma- direct blow to the compartment
Causes of chronic compartment syndrome
Overuse- over training, poor techniques, training on hard surfaces
Predisposing factors compartment syndrome
‘Anatomical configuration-affected compartments smaller than normal
-Muscle imbalance/tighness
-Improper foot wear
Medical treatment acute Compartment syndrome
Immediate fasciotomy
Medical treatment chronic compartment syndrome
-Rest
-Limit activity
-Stretch
Symptom picture acute compartment syndrom
-Medical emergency-bleeding/swelling within compartment
-Pain severe/persistent
-skin is taut + Shinny
-Affected compartment harder/hotter than unaffected side
-Peraesthesia may be present (motor loss)
-Dorsiflection+ toe extension/inversion are painful
-Pain with passive stretch to compartment
Symptom picture chronic compartment syndrome
-Noticed with exercise
-Pain begins same time/ distance into activity
-Increase blood flow to muscle- increases the size, usually enough space in compartment for hypertrophy and muscle return to regular size after 5 mins
