Institute for Sports Medicine Frankfurt Main

1. Risk kinds of sport:

Kinds of sport with high jump stress, e.g. apparatus gymnastics, track and field athletics, volleyball, rhythmic sport gymnastic, dancing, kinds of running

2. Anatomy:

The Tibiakante is the interior edge of the shinbone. There is, as at each bone, a bone skin. This can be inflammatory changed by appropriate false loads (= Tibiakantensyndrome).

3. Function:

The musculature which lies at the internal seeming leg edge, lifts the interior edge of the foot and supports it.

4. Injury mechanism:

- acute traumata (kick or impact)
Favouring factors:
- wrong footwear, wrong run style, to long training on hard underground

5. Symptoms:

- Pain at the front edge (inside) of the shinbone
- Pain within this range when rising in the morning
- in cases of acute painfulness with each step within the range of the shinbone
- Occurrence of the symptoms first only during higher stress (e.g. after a fast start/run/jumps)
- pressure painfulnesst in the seeming leg region
- swelling
- Pressure-sensitiveness also the deep calf musculature

6. First measures:

- in acute cases immediate stress reduction (no run and jump stress)
- avoidance of hard grounds (asphalt, concrete) and particularly synthetic tracks
- no spike shoes
- Avoidance of any kind of loads, which provoke the pain
- Cooling
- ointment dressing

7. Diagnostics:

- clinical investigation with the physician
- Roentgen or Szintigraphy, in order to exclude a bony participation (hair-crack in the bone)

8. Therapy:

a) Conservative therapy
- Inserts
- exculpatory dressings (Tape)
- Injections
- possibly analgetic, anti-inflammatory and decongestant medicines
b) Operational therapy
- none

9. Physiotherapy:

- stabilizatin exercises for the leg axis
- propriozeptives training
- strengthening and stretching measures
- Run school
- Electrical therapy
- Massage shinbone - and calf musculature
- Applications of ices

10. Prevention:

- regular extension exercise of the entire calves - and leg musculature both before and after the load
- if it is not necessary without spikes and lug shoes do or use these only economically
- Run style training (technology)
- To advise against is from an abrupt change of the underground
- possibly shoe lifts supply

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