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Shin splints or anterior compartment syndrome?

One of the most common over- use injuries of skaters is shin splints. Although the term is routinely used, it does not represent a specific clin- ical

pathology but instead describes

chronic shin pain as a result of overuse. In skaters, shin splints are often ac-

companied by pain at the beginning of practice that gradually subsides, only to return much later after skating. To say that skating actually caused the shin splints is sometimes hard to determine, especially if the skater is involved in other activities such as track, basketball, volleyball, etc. Masking itself as shin splints is a condition known as anterior compart- ment syndrome, which sometimes occurs as an acute injury from a direct blow to the lower leg. High-level skaters whose boots are too stiff will often inadvertent- ly land their jumps in such a way that it causes a direct blow to the outside of the leg at a point where the top edge of the boot comes in contact with the leg. Te muscles in this area of the low-

er leg are enclosed within fascial com- partments that separate them from other muscles. Repetitive overuse of these mus- cles when jumping causes these tissues to swell, increasing compartmental pressure. As a result, the peroneal nerve (lower leg and foot) and tibial artery are squeezed within the compartment; the more pres- sure within the compartment, the worse the pain will be. Ceasing to jump allows the pain to subside, usually within about 30 minutes as compartmental pressures return to normal. However, immediately upon jumping again, the pain returns. Anterior compartment syndrome and

shin splints are frequently confused with one another, because they are commonly felt in the same region of the lower leg. Criteria to determine the difference in- clude:

Compartment syndrome: reduction of pain within a short period of time after ceasing to jump. Shin splints: pain usually increases after the activity, with delayed onset of soreness. Compartment syndrome: usual-

ly produces pain with palpation (use of hand/finger pressure for examination), but only if the compartment pressure is increased, such as immediately following a long jump session. Shin splints: likely to be tender to palpation long after skating has ended for the day. Compartment syndrome: less likely

to be painful from stretching or manual resistance because neither of these increas- es the pressure within the compartment. Shin splints: produce pain while stretch- ing and using manual resistance. Posterior tibial tendon issues can also mimic shin splints, but the dis- tinction is obvious to a physical thera- pist through evaluation and palpation. True compartment syndrome is a

rare condition, and making the proper diagnosis between the two is extremely important since the treatment strategies differ. Preventing these conditions re- quires properly fitted boots; good support in the boots (but not too stiff); a correctly mounted blade; routine stretching exer- cises before skating; and myofascial re- lease with rolling (muscle/interconnective tissue stretching technique) after skating. Also, the use of custom orthotics is highly recommended.

Mr. Edge

Mr. Edge is a qualified skate technician with years of ex- perience. He answers questions on boots, blades and foot problems related to your equipment. Te opinions of Mr. Edge are his own and do not necessarily reflect the opin- ions of U.S. Figure Skating or SKATING magazine. Re- member, if you have problems with your feet, check with a doctor — the problem may well be with your boot, but it could be more serious. Check with your local pro shop for more information about boots and blades.

series The

by Olga Jaffae

skating fantasy books for readers of all ages

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