One should be aware that a compartment syndrome can occur here. This is usually chronic and repetitive and in some respects different from the acute compartment syndrome seen after serious muscle injuries. It is vital to seek evaluation and treatment, if this is suspected. It is caused by the muscles swelling within a closed compartment with a resultant increase in pressure in the compartment. The blood supply can be compromised and muscle injury and pain may occur.
Definitive evaluation is done by measuring the pressure in the compartment with a atheter.
The normal compartment pressure is 8 to 10 mm Hg at rest. During exercise the pressure may rise to 50 mm Hg, but rapidly, within 5 minutes, should return to normal. It is clearly abnormal if the pressure exceeds 75 mm Hg during exercise or remains above 30 mm Hg after cessation of exercise. This may require surgical decompression of the compartment. The usual runners at risk for anterior shin splints are beginning runners.