Tibialis Anterior - "Anterior Compartment Syndrome"
Tibialis Anterior Trigger Points - Overview
Anterior compartment syndrome is usually caused by swelling or enlargement of tibialis anterior in the anterior compartment of the lower leg
Trigger points in the tibialis anterior are often associated with painful conditions of the lower leg including "shin splints".
These trigger points are also typically found to be active in people who suffer from the more chronic condition - Anterior Compartment Syndrome.
Anterior Compartment Syndrome
Muscles are covered by an inflexible fibrous sleeve called fascia. Fascia creates a compartment for the muscle, with bone forming one side and the fascia covering the other sides.
In the lower leg the two bones, the tibia and the fibula, create a more rigid compartment.
The tibialis anterior muscle runs over the tibia and fibula and is enclosed by the fascia.
Anterior compartment syndrome is usually caused by swelling or enlargement of tibialis anterior in the anterior compartment of the lower leg.
Increased intramuscular swelling, as a result of trauma or overuse, creates pressure inside the compartment which impedes blood flow and muscle function.
The nerves in the compartment may be compressed causing numbness and weakness in the foot.
Anterior compartment syndrome is more often a chronic rather than an acute injury.
Runners and other athletes involved in activities that require a lot of repetitive flexion and extension of the foot are most susceptible.
Pain, especially when dorsiflexing the ankle to lift the foot or when raising the toes, and decreased sensation and weakness in the foot may be experienced.
Virtually any injury involving bleeding or local swelling may lead to compartment syndrome.
Cause of Injury
Acute: trauma to the tibialis anterior muscle causing bleeding and/or swelling.
Chronic: overuse of the muscle causing inflammation and swelling and increased pressure in the compartment.
Rapid growth of the muscle before its fascial envelope can expand (as seen with anabolic steroid use).
Signs and Symptoms
Pain and tightness in the shin (especially the lateral side). Worsens with exercise. Decreased sensation on top of the foot over the second toe. Weakness and tingling in the foot.
Complications if Left Unattended
Raised pressure in the compartment may lead to permanent nerve and blood vessel damage if left unattended.
The underlying cause of the condition will most likely continue to cause irritation and swelling if not treated.
Immediate Treatment
Rest, ice and elevation (no compression). Anti- inflammatory medication. Sports massage may be used to stretch the fascia.
Rehabilitation and Prevention
Stretching the muscles in the front of the shin will help to alleviate some of the pressure and elongate the muscle.
Massage to stretch the fascia may also help to speed recovery. Gradual strengthening and a good flexibility program will help prevent this condition.
Avoiding direct trauma to the shin area will prevent acute compartment syndrome.
Long-Term Prognosis
If treated before damage to the nerves and blood vessels becomes serious, the recovery rate is very good.
Acute or severe chronic anterior compartment syndrome may require surgical intervention to relieve the pressure in the compartment.
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