comparison of features of chronic exertional compartment syndrome and medial tibial stress syndrome (shin splints)

Last reviewed 01/2018

Comparison of features of chronic exertional compartment syndrome and medial tibial stress syndrome (shin splints)

chronic exertional compartment syndrome (CECS) medial tibial stress syndrome (MTSS)
Nature of pain Aching, burning or cramping pain Diffuse pain of variable intensity
Relieving and exacerbating factors

Pain due to chronic exertional compartment syndrome typically follows this pattern:

  • begins after a certain time, distance or intensity of exertion after you start exercising
  • progressively worsens as you exercise
  • subsides within 10 to 20 minutes of stopping the activity
  • over time, recovery time after exercise often increases
Exacerbated by exercise, relieved by rest
Most common location of pain Anterior compartment of the lower leg is the most commonly affected Middle to distal posteromedial border of the tibia
Unilateral or bilateral Bilateral more common Bilateral more common
Neurovascular changes Paraesthesia and/or numbness of leg and foot reported on exertion None
Associations
  • diabetes mellitus
  • recent change in footwear or exercise regimen
  • wearing of high heels
  • pes planus
  • often pain worse in the morning
  • improper footwear
  • exercising on a hard surface, uneven terrain
  • pes planus
Physical examination
  • examination normal at rest
  • during and immediately after exercise
    • affected area may bulge with paraesthesia and numbness of the compartment or the foot
  • pitting oedema may be present over the affected area
  • pain on palpation during both rest and exertion
    • periosteal tenderness at the distal 1/3 to 1/2 of the anteromedial tibial surface

Related pages:

shin splints

medial tibial stress syndrome (MTSS)

chronic exertional compartment syndrome (CECS)