Periostitis and Compartment Syndrom

Question 1

What is Periostitis

Answer 1

Inflammation of the periosteum (wraps around bones)

Question 2

Periostitis, compartment syndrome, tibialis posterior tendinitis and tibial stress fractures are sometimes under the lay term?

Answer 2

Shin splints

Question 3

Shin splints

Answer 3

A non-specific phrase that describes pain along the medial border of the tibia with exercise

Question 4

Definition Periostitis

Answer 4

Pain along the medial border of tibia with exercise

Question 5

Causes of periostitis

Answer 5

Overuse- overtraining, poor techniques, training on hard/uneven surfaces, improper foot wear

Question 6

Predisposing factors periostitis

Answer 6

Poor Biomechanics- excessive pronation, varus knee (bow legged), excessive external hip rotation- tight GN/SOL

Question 7

Medical treatment periostitis

Answer 7

-Diagnosed by bone scan
-Non-steroidal Anti-Inflammatory
-Ice
-Rest
-Avoidance of activity

Question 8

Symptom picture periostitis

Answer 8

-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

Question 9

Definition Compartment syndrome

Answer 9

Result of increase pressure with in compartments of lower leg

Question 10

4 Compartments surrounding tibia/fibula divided by dense

Answer 10

Inelastic fascia

Question 11

What are the 4 compartments of the lower leg

Answer 11

-Anterior compartment
-Lateral compartment
-Superficial posterior compartment
-Deep posterior compartment

Question 12

Anterior compartment includes

Answer 12

-Tibia anterior
-Extensor digitorum longus
-Extensor hallicus longus

Question 13

Lateral compartment includes

Answer 13

Peroneal longus (fibularis)
Peroneal brevis (fibularis)

Question 14

Superficially posterior compartment includes

Answer 14

GN/SOL

Question 15

Deep posterior compartment includes

Answer 15

-Tibia posterior
-Flexor Digitorum longus
-Flexor hallicus longus

Question 16

Compartment most prone to be affected?

Answer 16

Anterior most prone to be affected, followed closely by deep posterior

Question 17

Compartment syndrome Usually occurs in

Answer 17

Athletes under 40yrs

Question 18

Causes of acute compartment syndrome

Answer 18

Trauma- direct blow to the compartment

Question 19

Causes of chronic compartment syndrome

Answer 19

Overuse- over training, poor techniques, training on hard surfaces

Question 20

Predisposing factors compartment syndrome

Answer 20

‘Anatomical configuration-affected compartments smaller than normal
-Muscle imbalance/tighness
-Improper foot wear

Question 21

Medical treatment acute Compartment syndrome

Answer 21

Immediate fasciotomy

Question 22

Medical treatment chronic compartment syndrome

Answer 22

-Rest
-Limit activity
-Stretch

Question 23

Symptom picture acute compartment syndrom

Answer 23

-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

Question 24

Symptom picture chronic compartment syndrome

Answer 24

-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

Question 25

When massage front of the leg on someone with chronic periostitis it’s important you

Answer 25

-Do not pull off more of periosteum
-When working front Always work upward on legs