Common Conditions

Delayed Onset Muscle Soreness

A dull ache in the lower leg muscles (typically the calf) that develops 24-48 hours after unaccustomed physical activity such as running, jumping or performing calf raises at a gym and typically occurs most prominently in the first one or two sessions of a new exercise regime.

Shin Splints (Medial Tibial Tenoperiostitis)
Damage and inflammation of the connective tissue joining muscles to the shin bone, usually as a result of overuse such as excessive running or walking. Typically associated with pain along the front/inner border of the shin bone (Tibia) that increases when firmly touching the affected region. Symptoms may warm up (ease) with activity, but then be worse with rest following the activity (such as the next morning).

Referred Pain
Pain referred to the lower leg from another source such as the lower back or knee, often associated with symptoms above or below the lower leg (such as lower back pain or stiffness or pain in the groin, thigh, knee, ankle or foot). Typically associated with pain on firmly touching the region responsible for the referred pain and/or loss of movement in that region. Sometimes in association with pins and needles or numbness in the affected leg or foot.

Chronic Compartment Syndrome (Deep Posterior)
Exercise induced muscle swelling causing an increase in local tissue pressure in the calf with subsequent pain or ache in the calf or inner border of the tibia and a feeling of tightness in this region. Symptoms typically increase with exercise (such as jogging) and decrease with rest. Sometimes pins and needles, numbness or weakness may be present in the lower leg, ankle, or foot.

Chronic Compartment Syndrome (Anterior)
Exercise induced muscle swelling causing an increase in local tissue pressure in the muscles located at the front/outer aspect of the shin (anterior compartment) with subsequent pain or ache and a feeling of tightness in this region. Symptoms typically increase with exercise (such as jogging or walking) and decrease with rest. Sometimes pins and needles, numbness or weakness may be present in the lower leg, ankle, or foot.

Tibial Stress Fracture
Stress fracture of the shin bone typically due to overuse associated with excessive weight bearing activity such as distance running. Associated with shin pain that is aggravated with weight bearing activity, pain on firmly touching the affected region of the bone and sometimes night pain.

Fibula Stress Fracture
Stress fracture of the outer lower leg bone (fibula) typically due to overuse associated with excessive weight bearing activity such as running. Associated with outer shin/lower leg pain that is aggravated with weight bearing activity, pain on firmly touching the affected region of the bone and sometimes night pain.

Less Common Conditions

Pes Anserinus Tendonitis
Tissue damage and inflammation to one or more tendons attaching to the inner border of the shin bone at the top of the bone (near the knee) resulting in pain in this region. Usually an overuse injury resulting from activities such as repetitive running particularly in combination with change of direction and rapid acceleration/deceleration. Pain is usually experienced on firmly touching the affected region and there may be noticeable swelling.

Osgood-Schlatter Disease
A condition affecting adolescents during a period of rapid growth resulting in inflammation of the growth plate located at the top of the shin where the patella tendon attaches to shin bone just beneath the knee cap. Occurs in association with high activity levels. There is usually an increased bone prominence at the top of the tibia (beneath the knee cap) coinciding with the location of pain that is sore to firmly touch. Pain may also increase during activities such as squatting, running, jumping, kneeling and climbing stairs.

Chronic Compartment Syndrome (Peroneal)
Exercise induced muscle swelling causing an increase in local tissue pressure in the muscles located at the outer aspect of the lower leg (peroneals) with subsequent pain or ache and a feeling of tightness in this region. Symptoms typically increase with exercise (such as jogging or walking) and decrease with rest. Sometimes pins and needles, numbness or weakness may be present in the lower leg, ankle, or foot.

Entrapment Syndromes
Compression of blood vessels or nerves due to trauma, use of a tight brace or cast or pressure from local tissue sometimes due to anatomical abnormalities. May cause a variety of symptoms depending on the nerve or blood vessel affected. Symptoms may include pain in the calf, shin, ankle or foot that increases with exercise and decreases with rest, or pins and needles, numbness or weakness in this region.

Varicose Veins
Veins that have become enlarged or tortuous in the lower leg due to dysfunctional valves within the veins. May cause symptoms such as an ache or heaviness in the region of the veins and lower legs that often increases following exercise and at night, visibly prominent veins, a brownish blue shiny skin discolouration near the veins, swelling of the ankles and sometimes itchiness and cramps.

Deep Vein Thrombosis
A blood clot that forms in the veins of the lower leg. May be asymptomatic, although many cases will cause pain in the lower leg, swelling, redness and increased temperature of the lower leg, ankle and foot. Some risk factors may include: obesity, heart disease, advanced age, smoking, pregnancy, taking a high dose combined oral contraceptive pill, family history of DVT, recent surgery or injury, immobilisation, infection and air travel.