Periostitis causes mechanical pain painful at the postero-internal edge of the tibia, and more particularly on the middle third of the bone. These pains are felt intensely when running, or when performing jumps, but are non-existent at rest.

Periostitis can sometimes be revealed on x-ray but most of the time, a simple clinical examination is sufficient: palpation often reveals one or more nodules, rarely swelling or an increase in skin temperature. It also exacerbates pain in characteristic areas. We can also highlight ” improper use of the forefoot and toes during propulsion, sagging of the internal arch, and hypotonia of the posterior compartment (1). »

It should not be confused with the stress fracture of the tibial shaft.

Periostitis classically occurs as a result of excessive traction of the muscles inserted on the membrane of the tibial periosteum. There are two major causes:

• Direct trauma to the front part of the leg. It therefore preferentially affects skiers and footballers.
• Multiple microtraumas, after overworking the anti-valgus muscles of the foot. Almost 90% of periostitis is explained in this way. Bad shoes or a training ground unsuitable for sporting activity (too hard or too soft) could, in the long term, cause periostitis.

The recovery time from periostitis varies between 2 and 6 weeks.

Treatment begins immediately, while the first two weeks are often spent resting. Here are the treatments physiotherapy possible:

• Icing the painful area. For anti-inflammatory and analgesic purposes, and for at least 30 minutes.
• Massages of contractured muscle compartments. Except in the presence of a hematoma.
• Passive stretching.
• Strapping contensif.
• Orthotics wearing.

It is generally recommended to resume running, jogging on grass and jumping rope from the 5th week.