Do Leg Pains Truly Occur and How to Manage Them?

The cause of the occurrence of pain-related conditions is the pressure caused by increasing pressure during exercise in the area of the forearm, which surrounds the anterior tibial muscles, long toe extensors, long hallux extensors, and short tarsal muscles. An increase in the volume of the anterior compartment muscles leads to an increase in pressure in this area, which results in a decrease in blood flow to this region and manifestation of pain. The main causes of the occurrence of the painful syndrome of the leg include a too rapid increase in intensity, duration, or frequency of training. Additionally, individuals with excessive pronation (the outer edge of the foot is higher than the inner edge) are significantly more susceptible to this injury. Weaker anterior tibial compartment muscles in combination with a stronger posterior muscle group can also contribute to the development of this painful syndrome.

The recognition of pain symptoms in the shank is based primarily on the determination of the presence of pain triggered by exertion in the most distant two-thirds of the shank. In the case of the anterior-knuckle syndrome, the pain is localized in the anterior region, whereas in the central-knuckle syndrome, the pain is localized in the most distant two-thirds of the central edge of the shank. The activities that most often lead to pain are running or long walks. Reducing or completely stopping these activities will cause the pain to disappear. The pain is never accompanied by vascular or neurological symptoms.

In the case of acute pain, treatment methods in accordance with the P. R. I. C. E. Principle are used until the pain subsides. During training, it is important to extend rest periods and shorten the duration of exercises. In general, the warning signal is pain symptoms. If they occur, the training should be interrupted, otherwise it can be continued. In addition, to alleviate the pain, functional massage, kinesiotaping or dry needling (a form of acupuncture) can be used. These procedures are currently performed by physiotherapists. Maintaining proper muscle elasticity is also essential, especially in individuals with diagnosed anterior shin pain syndrome. It is also important to increase the elasticity of the soleus muscle. In some cases, surgery may be required to reduce pressure in the inter-tendon space, but this is a medical decision. For patients with pain in the medial shin due to overload, we can focus on alternative forms of physical activity such as cycling or swimming. The return to training (running and other forms of activity) is possible after the pain caused by activity subsides. It is also important to remember to warm up and stretch the muscles. The most important aspect of treatment is the correct diagnosis, which is made by a doctor or physiotherapist. After determining the cause of the pain, the athlete should stop the activities causing pain.