Tibialis Anterior Compartment Syndrome – Some Thoughts.
Just what is compartment syndrome? Each muscle in your body is surrounded by a sheath that holds the muscle together. Think of a sausage being held in place by its surrounding skin. Over work the muscle, and the now larger, swollen muscle takes up too much space and hence, gets squeezed by the surrounding sheath. Venous blood, (that’s blood that has to make its way back to your heart against gravity) finds it more difficult to flow freely, and so adds to the volume of the muscle.
Your tibialis anterior muscle is one of those muscles more prone to compartment syndrome. Get your hand just to the outside of your shin and pull your foot up toward your shin. That muscle that you feel engaging is your tibialis anterior muscle.
Here are some options.
1. Stop running.
Truth be told, any runner will tell you that running is so much fun that this would be the last bit of advice they would follow. Telling a runner not to run is for the most part a total waste of time. This is the typical look that you get from them –
2. Go for surgery.
This is a viable option and your injury might just come to that. The surgery is fairly simple with cuts being made in the sheath, thereby giving the muscle a bit more space.
3. Get those tissues released.
Myofascial release, especially with the use of mobility bands can be of huge benefit. The mobility band is wrapped tightly over the area thus allowing one to cross friction through the calf complex more effectively.
4. Work on your running gait.
Overstriding means that you tend to land way forward of your centre of gravity instead of getting your foot to land closer to your centre of gravity. You’ve seen the Johnny Walker ads. Look at that leading foot shot purposefully forward.
That’s what I mean by overstriding. What typically happens is that you also tend to pull your foot upwards as you do that, and the muscle that works particularly hard – you guessed it, is your Tibialis Posterior. Some studies have suggested that you should adopt a forefoot landing pattern instead. There is adequate scientific proof that this will help with your injury. Diebal et al, reported the following in a study they did. “After 6 weeks of forefoot run training, mean postrun anterior compartment pressures significantly decreased from 78.4 ± 32.0 mm Hg to 38.4 ± 11.5 mm Hg. Running distance significantly increased from 1.4 ± 0.6 km before intervention to 4.8 ± 0.5 km 6 weeks after intervention. Two-mile run times were also significantly faster than preintervention values. No patient required surgery.”
My issue with that is that you will increase your chances of picking up foot and calf injuries thereby trading one injury for the other. So I would never suggest landing on your toes as an alternative. However, getting closer to your centre of gravity with your landing foot will go along way in reducing the workload of your tibialis anterior.
5. Stretch the muscle out.
The way to do this is to incorporate this muscle as you stretch out your quads. Grab your foot versus your ankle as you perform a typical quad stretch. You will also be getting a stretch through your superficial front line of fascia which should be of benefit.
6. Learn to rapidly shorten your stride on hills.
Short and quick steps are the way to go when it comes to hills. Shortening your stride will decrease the amount of work your tib ant muscle will have to do. This is going to be particularly important for Comrades up runners, although having said that, even the down run has enough up hills in it to make you think that the race organisers threw in Mt Everest just for the fun of it.
7. Make sure that your running shoe has enough support.
The tibialis posterior muscle does not just lift the foot (or bring the toes closer to your shin), it also rotates the foot inwards. Any shoe that allows too much pronation will overwork the muscle.
8. You can also look at running in a shoe with a lower drop.
It’s worth getting these functions properly assessed. Again, we want to avoid replacing one injury with another. I can always pop you on the treadmill and have a look at how your shoes are functioning on you.
I really hope that this helps and that it brings you one step further toward sorting your injury out. Contact us if you feel that I can help in any way.
Regards,
Mike Roscoe.
