Exercise Induced Leg Pain

Exercise induced leg pain is the term used to describe pain in the leg (knee to ankle), however unfortunately the term ‘shin splints’ is still used by medical professionals, coaches and athletes. ‘Shin splints’ is a generic term that could mean one of many injuries and is not a diagnosis.

‘Shin splints’ is a confusing term and people can think it is ‘splints’ in the Tibia (shin bone) which would be more of a fracture. This can lead to poor management. It is important to obtain a diagnosis so the right treatment can be given.

There are many causes of exercise induced leg pain. History taking is therefore key to help differentiate between different types of exercise induced leg pain, most can be managed conservatively in the early stages.

There are many factors to consider when looking at exercise induced leg pain; lower limb biomechanics, gender, sport, family history, playing surface, footwear (fit for purpose) and medical history.

Below there is some of the most common causes of exercise induced leg pain:

Chronic Exertional Compartment Syndrome
Pain normally within 15-20 minutes of exercise, severe enough for the patient to stop their activity. The pain will reduce after a rest period of a few minutes.

Biomechanical Over Load Syndrome
Similar symptoms to Chronic exertional compartment syndrome, however responds to conservative treatment, true Chronic exertional compartment symdrome carries a surgical treatment

Medial Tibial Stress Syndrome
Pain during exercise in the anterior-medial leg. Usually able to run through the pain, with the pain reducing after exercise but lasting up to 64 hours. Diffuse tenderness on palpation.

Stress Fracture
Pain during and post exercise, the pain is often acute with the pain continuing days to weeks after the activity. There is specific tenderness on palpation.

Popliteal Entrapment Syndrome
Intermittent claudication and cramp type pain on exercise in the posterior leg and knee, with pain ceasing on rest.

Superficial Nerve Entrapment Syndrome
Pain, paraesthesia, numbness and muscle fatigue within the lateral leg down to the dorsum of the foot, the pain is usually described as a burning pain.

Claudication – Intense feeling if tightness and cramp like sensation
Paraesthesia – Feeling of numbness