The tibia (Latin tibia) and fibula (Latin fibula) make up the bone of the shin. The more robust of the two tibia is the second longest bone in the human skeleton after the femur (Latin femur). Its front edge lies close to the skin, making it particularly vulnerable to painful bruises and fractures. Therefore, it is recommended to use shin pads during sports competitions, especially in contact disciplines.

The tibia (Latin tibia) iseven long bone . It lies along the fibula with which it connects at the top and bottom.Contributes to the knee and ankle joints . It is also asite of attachment for numerous musclesof the lower limb. The most common ailments associated with it are post-exercise pain in the tibia, as well ascontusionandtibia fracture .

Tibia - structure

The tibia is a long, massive bone that lieson the medial side of the lower legand forms the rigid connection of the knee joint to the ankle joint. It has a triangular shape in cross section. At the top, where it forms the knee joint, it is much thicker. Then it narrows downwards to thicken again at the end, although to a lesser extent than at the top. The tibia consists of a shaft and two clearly marked ends.

Shaft of the tibiamathree edges :

  • anterior- the most prominent, starts at the top with the tuberosity of the tibia and runs in the shape of an elongated S. In the upper part it is sharply marked under the skin, so it is easy to break and cut here the skin from the inside;
  • lateral( interosseous ) - thin and prominent, especially in the middle part. The interosseous membrane of the shin is attached to it;
  • medial- it is smooth and rounded.

Theshank of the tibiaalso consists ofthree surfaces :

  • medial- smooth, wider at the top than at the bottom. Slightly below and medially from the tuberosity of the tibia, covered with tendonsof the tailor's, slender and semi-tendinous muscles that stick here . The entire medial surface lies subcutaneously and is easily perceptible;
  • lateral- narrower than the medial one. upperpart forms a shallow groove to whichattaches the tibialis anterior muscle . The lower part is smooth and covered with tendonsof the anterior tibial, long toe extensor, and long toe extensor muscles ;
  • posterior- in the upper part of the posterior surface runs downwardsthe rough edge of the soleus muscleto which this muscle is attached. Above is the attachment of thepopliteal muscle , and below theof the posterior tibial and long flexor muscles .

The proximal end of the tibiais significantly thickened and has two concave surfaces on its surfaceupper articular surfacescovered with hyaline cartilage . They rest on two prominent and wideknuckles - the medial and lateral . There is a rough indentation between the articular surfaces, which is separated in the middle byby the intercondylar eminence . In front of the eminence there is theanterior intercondylar fieldto which theanterior cruciate ligament (ACL)is attached, and at the back of the eminence isposterior intercondylar areato which theposterior cruciate ligament (PCL)attaches. In the extension of the anterior edge of the tibia there is atibial tuberosityto which thepatellar ligamentattaches. The following muscles also have the following muscles in the proximal end of the tibia:semimembranous, long extensor of fingersandiliotibial band .

Further end( distal )of the tibiais smaller and has five faces:

  • the lateral surfaceis concave and its lower part calledsagittal indentationis used forconnection with the fibula;
  • the anterior surfaceis smooth, only on its lower edge there is a transverse groove for attachment of an upper ankle joint capsule;
  • medial surfaceextends downwardly into the medial malleolus. The lateral surface of the ankle is a slightly concave articular surface that connects to the ankle bone;
  • posterior surfacehas a shallow oblique groove in which the flexor tendon of the big toe is located;
  • inferior surfaceforms the inferior articular surface that extends to the medial surface of the ankle. Both these surfaces, more or less at right angles to each other, form the upper ankle joint, which allows the foot to move up and down (dorsiflexion andsole), for example for walking on toes and heels.

Tibia and fibula

The tibia is directly adjacent to the thin lateral fibula with which it forms the skeleton of the shin. There are two types of connections for the fibula and tibia.

The closer ends of these bones are connected bytibiofibular joint , which is located just below the knee. However, it is not part of the knee joint and does not participate in its movements.

The distal ends of the fibula and tibia are connected by the so-calledinterosseous membrane , which turns downwardly intotibiofibular ligament . This membrane is made of very durable connective tissue. Thanks to it, the tibia and fibula bones are connected along their entire length.

The tibiofibular joint and the interosseous membrane of the shin aretight connection of the two bonesand protect them against independent, independent displacement. The two bones usually move together as one structure.

Tibia - Features

The tibia is the most important component of the shin skeleton - it carries the vast majority of the load on the lower limb and forms two joints that are essential for human locomotion: the knee joint and the upper ankle joint.

The tibia also acts as an ankle stabilizer via the medial ankle. It also serves as an attachment site for numerous muscles in the lower leg.

Shin pain

Due to the fact that large fragments of the tibia are not covered with fat and muscle tissue, it is especiallyvulnerable to injuries and microdamagesthat cause tibia pain, as well as visible swelling or hematomas on its surface. The tibia's location also makes it easy to bruise and even break. Shin pain is an obstacle to practicing sports and even makes it difficult to move around.

Shin pain is often caused byincorrect footwear, no warm-upbefore training or no cooling-down phase after training, andadequate recoverythereafter period. The tibia pain may also be caused byrunning on hard surfacesorbad running technique .

Sterile Tibial Tuberosity Necrosis

This disease is most common in boys aged 10-14. They are characterized by pain in the knee area, which preventsfrom practicing sports related to running . A common cause of this adolescent disease is playing the ball too much

This condition can be diagnosed not only by pain, but also by palpating the tibial tuberosity. In the presence of aseptic necrosis of the tibial tuberosity, this structure, located just below the patella, will be thickened.

Vascular disorders (e.g. as a result of vitamin A deficiency) and overloading of the patellar ligament (mainly caused by too intense training) often contribute to the appearance of this disease.

Shin splints

Shin splints is one of the popular diseases amongphysically active people , especially among those who train dynamicrunning and jumping disciplines .

They are characterized by tibia pain along the anterior edge of the bone, which is caused by the overlappingof microtraumas in the muscle tissue . It can also become periostitis, which means that not only does the muscles hurt, but also the bone itself.

Pain usually occurs shortly after the end of physical activity, although it can also occur during training. In the case of the advanced form of the disease, the symptoms do not disappear even during a longer resting period. At first,relieves cooling, stretching and resting , but in the long run it is better to consult a specialist who will lead the treatment.

Fractures of the tibia

Medicine has divided the fractures of the tibia according to their location into the fractures: shaft, proximal epiphysis and distal epiphysis. Fracture of the tibia can be very painful and manifests itself with increased pain while moving, tenderness, swelling, a bruise or a hematoma.

People who practice football, running, basketball, athletics and tennis are the most vulnerable to tibia fractures. But often damage to the tibia also occurs as a result of traffic accidents and other mechanical injuries of a random nature.

According to the AO ASIF classification, the following are distinguishedtypes of fractures of the proximal end of the tibia :

  • extra-articular;
  • partially covering the articular surface;
  • completely covering the articular surface.

These fractures are a consequence of mechanical injuries. To restore the full function, it is necessary to adjust it (sometimes operative), stiffen it, relieve it, and then improve physiotherapy. Without it, the functioning of the entire limb may be disturbed.

Fracture of the shank of the tibiais one of the most common fractures in the human body. It can be caused by both direct injury and overstrain.

Whereasfracture of the distal epiphysis( Pilon type )of the tibiausually results from a compression force in conjunction with rotation.

Other causes of tibia pain

Pain in the area of ​​the lower leg is also caused by diseases such as: osteitis, tibia cyst, osteomyelitis or tibia cancer.

The soreness of the tibia may also be affected by defects in the position of the foot, such as: excessive pronation, supination or flat feet.

The causes of tibia soreness also include: shin muscle contractures, overtraining, incorrect posture, inappropriate footwear or work that contributes to overloading the lower limbs.

Treatment of the tibia

Management of tibia injuries depends on the type and extent of the damage, the type of condition that caused the pain in the tibia, and the factors that cause strain, inflammation, and other ailments.

Treatment is most often based on:

  • pharmacotherapy - the use of analgesic, anti-swelling and anti-inflammatory ointments and gels,
  • physical therapy - performing procedures such as magnetotherapy or laser therapy,
  • massage and manual techniques to reduce excessive muscle tension,
  • kinesiotaping (slicing).

Sometimes it is necessary to apply a cast or some other kind of immobilization of the painful lower limb, or even an operation.

During recovery from a tibia injury, the following are important:

  • taking care of the correct body posture and alignment of the knees,
  • use of physical activity that does not lead to overload
  • performing personalized exercises and training.

The treatment should be carried out by a doctor or physiotherapist after diagnosis.

Bibliography

Bochenek A., Reicher M., "Human Anatomy", volume I, PZWL Medical Publishing, Warsaw 2012.

Czerniak P., "Shin splints - non-specific pain in the tibia associated with physical activity", Fizjoterapia & Rehabilitacja, 100/2018.

Category:

Anatomy