What Are the Most Common Shin Splint Symptoms?

Tibialis anterior muscle: One of the anterior muscles of the calf. Together with the long extensor and long extensor muscles, it starts from the tibia, the upper end of the fibula, and the interosseous membrane, descends deep through the transverse ligaments of the calf and the cruciate ligament, and ends at the base of the first wedge bone and the first metatarsal bone. This muscle can make the dorsiflexion of the foot and invert the center of the foot; when the foot bone is fixed, it can contract with other muscles to make the calf lean forward. Dominated by deep peroneal nerve. The tibialis anterior muscle starts from the outer side of the tibia, the tendon goes down through the front of the ankle joint, to the medial edge of the foot, and ends at the medial wedge and the plantar surface of the first metatarsal. The tibialis anterior muscle can extend the ankle joint, which can cause foot inversion. This muscle is innervated by the deep peroneal nerve (lumbar 4, 5, iliac 1).

Tibialis anterior muscle: One of the anterior muscles of the calf. Together with the long extensor and long extensor muscles, it starts from the tibia, the upper end of the fibula, and the interosseous membrane, descends deep through the transverse ligaments of the calf and the cruciate ligament, and ends at the base of the first wedge bone and the first metatarsal bone. This muscle can make the dorsiflexion of the foot and invert the center of the foot; when the foot bone is fixed, it can contract with other muscles to make the calf lean forward. Dominated by deep peroneal nerve. The tibialis anterior muscle starts from the outer side of the tibia, the tendon goes down through the front of the ankle joint, to the medial edge of the foot, and ends at the medial wedge and the plantar surface of the first metatarsal. The tibialis anterior muscle can extend the ankle joint, which can cause foot inversion. This muscle is innervated by the deep peroneal nerve (lumbar 4, 5, iliac 1).

Tibia: Anatomical structure name. See "Lingshu · Meridian". Also known as cheekbones, osteogenesis. Anatomy of the same name bone. Located inside the calf. Ginseng. Thick long bones located on the inner side of the calf. The upper end is enlarged with the femur to form the knee joint. The rough uplift at the front is called the tibial tuberosity. The lower end is slightly enlarged. The medial protrusion is called the medial malleolus.

Chinese name

Tibialis anterior muscle

Foreign name

tibialis anterior

Location

From the outside of the tibia

Features

Ankle extension

Anterior Tibial Anatomy

It is located under the anterolateral skin of the lower leg, close to the lateral surface of the tibia, and above the lateral side is adjacent to the long toe extensor and the lower side is adjacent to the long extensor. Starting from 2/3 of the lateral surface of the tibia and adjacent interosseous membrane of the calf. The muscle bundle travels down the long tendon, through the front of the ankle joint, to the medial edge of the foot, and stops at the base of the first wedge bone and the first metatarsal bone. This muscle contracts, causing foot extension (dorsiflexion), varus and adduction (when walking and running). In addition, it has the effect of maintaining the medial arch. The use of weight-bearing hooks and other exercises can develop the strength of the anterior leg muscles such as the tibialis anterior muscles, long extensors, and long toe extensors. The tibialis anterior muscle is innervated by the deep peroneal nerve.

The tibia is a long bone on the toe side of the calf, divided at one end. The proximal end of the tibia is swollen and protrudes to the sides to become the medial and lateral condyle. The upper surface of the two condyles is smooth as an articular surface, the intercondylar area is between the two condyles, and the middle is the intercondylar eminence. There is a rough bulge in front of the proximal end of the tibia called tuberosity as the site of patellar ligament attachment. Behind the lateral condyle there is a circular fibula joint surface associated with the fibula head.

The cross section of the tibial body is triangular, and its anterior edge and anterior medial length are located under the skin, which is the most prone to fracture. The upper part of the back of the tibial body has an obliquely soleus line (soleal line), which is where the soleus muscle is attached.

The distal end of the tibia is swollen, and its cross section is square. A concave articular surface on the outside is called the fibular notch and the fibula-related segment to form a tibiofibular connection. There is a medial malleolus protruding downward on the medial side. The lower end of the distal end of the tibia is smooth and covered with articular cartilage. It forms the joint socket of the ankle joint with the external articular surface of the medial malleolus and the internal articular surface of the lateral malleolus.

Tibia anterior muscle and tibial related diseases

(1) Tibial osteitis: Tibial osteitis usually occurs in children with previous or no history of tibial injury or sore throat. The pain is severe. Acute tenderness begins at the metaphysis and cannot bear weight. Systemic symptoms include fever, tachycardia, and polymorphonuclear cells. Patients require hospitalization and multiple blood cultures. X-rays of the tibia were normal at the onset. Once the possibility of the disease is suspected, before the blood culture results are reported, a large dose of a broad-spectrum antibiotic effective for penicillin-resistant Staphylococcus is routinely applied to achieve an appropriate bone blood level. Splint fixation is usually helpful for treatment, and antibiotics should be used for 4 weeks in confirmed cases. Unless antibiotic treatment is ineffective, toxic reactions are large, or infection spreads, surgical drainage is rarely required. Tibia osteitis is sometimes difficult to distinguish from insect bites, small wounds and abrasions, and cellulitis caused by folliculitis.

Low-toxic osteitis of the tibia (Brodie abscess) can cause chronic pain in the upper tibia.

(2) Bone tumors: The tibia is a common site of many primary bone tumors. Therefore, for leg pain that cannot be clearly diagnosed, conventional radiographs of the tibia should be taken.

(3) Anterior tibial fascial compartment syndrome: Anterior tibial fascial compartment syndrome is a common complication of tibial shaft fractures, which can occur after strenuous activities of the lower limbs, and is more common in athletes. Swelling of the tibialis anterior fascia compartment causes ischemia of the tibialis anterior muscle group, which is generally manifested as anterior tibial pain. In severe cases, the swelling develops progressively, eventually leading to muscle necrosis. The affected leg has extensive edema, pain, and bright skin. Muscles and long extensors are affected first, weakness or inability to extend the ankle and fingers; dorsal foot arteries cannot be reached, and the first toe web sensation caused by deep peroneal nerve ischemia is missing. It is recommended to monitor the fascial compartment pressure for high-risk and suspicious cases. Decompression of the anterior tibial fascial compartment immediately in severe cases can avoid muscle necrosis.

(IV) Stress fractures of the tibia: Stress fractures of the tibia usually start with sudden or subacute leg pain, manifested as sharp bone pain and severe swelling. X-ray films are sometimes difficult to show linear fractures. Repeated radiographs are needed for patients with persistent pain. Radioactive bone scans show local thermal nodules to help establish the diagnosis. In many cases, the diagnosis cannot be confirmed until the presence of epiphyses. Paget's disease is also common, but it is easier to diagnose with X-rays.

(5) Mid Tibia Syndrome / Tibial Splint: In athletes, the middle tibia is painful. The pain can be very severe, and usually there is tenderness along the posterior medial edge of the lower tibia. In some cases pain symptoms are caused by stress fractures, and in others the cause is unknown. Other causes include osteofascial compartment syndrome, fascial hernia, interosseous tear, periosteal tear, tendinitis, muscle sprain, and periostitis. When the symptoms are chronic, fractures are ruled out, and separating the calf fascia can relieve pain.

(6) Spinal tuberculosis: Severe tibia pain (shock-like pain) is common in spinal tuberculosis, and there are other symptoms, such as the Argyll-Robertson pupil (the pupil's response to light disappears and the regulatory response exists). Serological tests can confirm the diagnosis.

Tibialis anterior muscle test

Examination method of tibialis anterior muscle

In the supine position, the patient was instructed to straighten his feet, adduct and lift the inner edge of the foot. The examiner gave impedance and touched the contracted muscles in front of the tibia to determine his muscle strength.

Clinical significance of tibialis anterior muscle

The tibialis anterior muscle strength test is a method to check whether the muscle is paralyzed and the degree of paralysis. The main function of the tibialis anterior muscle is to make dorsiflexion and varus of the foot. When this muscle is paralyzed, the dorsiflexion of the foot and the inner edge of the foot lift are obstructed, and the foot is drooping and slightly abducted.

A method to check whether the tibialis anterior muscle is paralyzed and the degree of paralysis. This muscle is innervated by the deep peroneal nerve, and its nerves come from the lumbar spinal cord 4 to the phrenic pulp 1. This muscle is one of the anterior muscles of the calf. It starts from the outer side of the tibia. The lower end moves the tendon through the calf transverse ligament and the deep side of the cruciate ligament to the medial edge of the dorsal foot. . Its function is to make dorsiflexion and varus of the foot. During the examination, the patient took a supine position, with his feet straight, adducted, and the inner edge of the foot raised. The doctor gave impedance and touched the contracted muscles in front of the tibia to measure his muscle strength. When the muscle is paralyzed, the dorsiflexion of the foot and the inner edge of the foot are impaired, and the foot is drooping and slightly abducted, which is a sign of deep peroneal nerve paralysis.