Your patients may complain of leg pain after exercising. Three most common causes of exercise-induced leg pain include stress fracture,  exertional compartment syndrome, and stress syndrome of the medial tibial. Here’s what you can do to treat these ailments and stop the pain.

Runner on track with leg pain after exercising

Heavy exercise can do a number on legs, knees and even the lower back. When people exercise on a regular basis, it is quite likely they may eventually develop exercise-induced leg pain.

The issue manifests itself through pain, pressure, and varying degrees of discomfort in the calf or the “shin” region. It usually happens during periods of exertion.

Leg pain after exercising has a formal name. The diagnosis of exercise-induced leg pain or EILP is a broad term used to describe pain from many different causes.

This pain detrimentally impacts the bones, muscles, and other areas of the leg.

The body achieves what the mind believes…”

Bones of the lower limb, knee and foot; four figures. Colour Wellcome V0007926

Basic Leg Anatomy

As a physical therapist, you probably have an understanding of lower leg anatomy. The tibia, the larger of the two leg bones rests immediately underneath the skin. It supports 85% of a person’s body weight. The fibula, just behind the tibia, handles the other 15%. Additionally, there are muscles. These are divided into four distinct compartments through fascia, which is a very tough area of tissue.

Stress Fracture

When a patient comes to you with leg pain after exercising, the first most common cause from over exertion is a stress fracture.

When a person exercises, their bones are subjected to various degrees of force. If that force is significant enough, it could fracture or break a bone.

The break could be a hairline break, chipped, a large break, or shattered.

The best treatment for a stress fracture is rest; however, impact activity must be ceased during the healing process.

The use of a foam roller tool, the application of heat and cold, and similar steps are commonly recommended to those that have experienced a stress fracture as a result of overexertion during exercise.

Exertional Compartment Syndrome

The second most common cause of exercise-induced leg pain is exertional compartment syndrome.

When a person overexerts themself – the oxygen in the lower leg muscles gets depleted. When this happens, the muscles fall back on anaerobic-based metabolism, which utilizes the muscle’s reserves.

This results in inflammation.

If the tissue in the leg is tight, the muscle cannot easily expand, which results in immense pressure in the compartment. This could result in drastically reducing or completely stopping the blood supply to the leg. While stopping activities and utilizing cold packs commonly helps this condition, severe cases may require Compartment Decompression surgery.

Runner wearing compression socks for shin splints

Medial Tibial Stress Syndrome

The third most common cause of exercise-induced leg pain is stress syndrome that impacts the medial tibial region.

This was once referred to as “shin splints”.

The underlying cause of this issue is unknown; however, many believe it could be caused by the pull of an area of the fascia, while others believe it is the first stage of a stress fracture.

The pain of this syndrome commonly occurs where the muscle is attached to the tibia in the area of the inner edge. While this may occur during normal exercising, if the pain does not go away within a few hours, a more serious issue has occurred.

To avoid this issue,  focus on core stability exercises, recommend good workout shoes that have a high level of absorbency, and insoles that are orthotic in nature.

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