Exercise Induced Leg Pain

Gavin BowyerExercise Induced Leg Pain (Chronic Compartment Syndrome)

This condition is sometimes labeled “shin splints”. That isn’t really a useful diagnosis, and can mean a variety of leg problems associated with sport. Exercise Induced Leg Pain is perhaps a more helpful label, although there are still a number of possible diagnoses to consider.

Chronic Compartment Syndrome

In this condition the natural swelling of the muscles that occurs with exercise brings about a problem with the micro-circulation, resulting in a type of cramping pain. Characteristically, the pain comes on within about 15 minutes of starting exercise such as running. The shin muscles often feel tight or “as though they will explode”. It will often start to be a problem when there has been a change in intensity or type of training. The pain eases within a few hours of its onset, once the exercise has stopped, but may leave a dull ache. There will sometimes be a sensation of numbness or pins and needles.

Diagnosis

A number of different conditions can cause leg pain in exercise, ranging from stress fractures through to the compartment syndrome outline here. It is important to reach a diagnosis, as a range of treatments is available depending on the condition being treated. A bone scan or MRI can exclude or confirm stress injuries; compartment pressure monitoring is very useful when chronic compartment syndrome is suspected – this can be done as an outpatient procedure, taking about half an hour.

Gavin BowyerTreatment

The treatment will depend on the cause of the leg pain. It might include adapting or altering training, custom-made orthotic insoles, physiotherapy, and in some cases surgery to decompress the compartments. Treatment should, of course, be followed by a graded and supervised return to sporting activity.

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