Tibial periostitis is an overuse and strain syndrome that manifests on the anterior surface of the tibia, and is a common condition in athletes. As its name indicates, it is an inflammation of the periosteum of the tibia, which can appear either after a stress fracture of the tibia, or due to inflammation of the muscles in the area.
The periosteum is the fibrous membrane that forms the covering of the bones. It consists of a dense outer layer containing numerous vessels and an inner layer of connective tissue cells, which act as osteoblasts when the bone is injured, thus participating in new bone formation. The periosteum serves as a supporting tissue for the blood vessels that supply and nourish the bone, as well as for the attachment of tendons and ligaments.
When there is intense and repeated activity of the muscles that attach to the tibia, then intense irritation may occur in its periosteum. This happens because the action of these muscles results in the creation of tensile forces (pulling forces) of the periosteum. It usually happens either to people who stand for long hours or to athletes, poorly trained, who run on hard, uneven, or concrete ground, and wear inappropriate sports shoes, to athletes whose sport includes running, explosive movements and jumps, or even and in rapidly growing adolescent athletes. However, it can also appear in non-athletes, in cases of stress on the ankle and the end of the foot, e.g. walking on uneven ground, standing for long hours, climbing, hunting in the mountains, etc.
The condition can often coexist with a tibial stress fracture or chronic tibial compartment syndrome. The symptoms that we can observe in shin periostitis are mainly the pain on the anterior surface of the shin, the possible existence of some inflammation, the redness, the local increase in temperature and the easy and frequent fatigue after daily activities.
A good clinical evaluation is required for the diagnosis of tibial periostitis, while some radiological examination may also be needed, in order to rule out other conditions with similar symptoms. A properly designed physical therapy rehabilitation program is one that can relieve the patient of symptoms and help him return to his sports and competitive activities.
