Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia

Objectives: Shin pain is a broad term used to describe lower leg pain. It is commonly seen in the athletic/sports population. Various conditions have been claimed to produce leg pain, and muscle herniation is one of these conditions. Muscle herniation is the protrusion of muscle through a defect in...

Full description

Bibliographic Details
Main Authors: Muhammed Minhaj, Binoy Mathew
Format: Article
Language:English
Published: Negah Institute for Scientific Communication 2021-12-01
Series:Iranian Rehabilitation Journal
Subjects:
Online Access:http://irj.uswr.ac.ir/article-1-1362-en.pdf
_version_ 1827802857030549504
author Muhammed Minhaj
Binoy Mathew
author_facet Muhammed Minhaj
Binoy Mathew
author_sort Muhammed Minhaj
collection DOAJ
description Objectives: Shin pain is a broad term used to describe lower leg pain. It is commonly seen in the athletic/sports population. Various conditions have been claimed to produce leg pain, and muscle herniation is one of these conditions. Muscle herniation is the protrusion of muscle through a defect in the overlying fascia. Although such herniation is common, it is often an underdiagnosed condition in the lower extremity. It usually occurs in athletes, especially in the anterior compartment of the leg, as a result of trauma or due to muscle hypertrophy secondary to strenuous exercise. Herniation diagnosis depends on its clinical presentation as it appears as a palpable soft tissue bulge through a fascia defect; radiological findings are used to confirm the diagnosis. Conservative treatment should be the initial approach, and surgery can be performed if conservative treatment fails. Methods: We present a case of symptomatic anterior lower leg pain, initially diagnosed as a psychosomatic disorder by two orthopedic physicians. However, tibialis anterior hernia in this patient was confirmed after physical examination by a physiotherapist and subsequent referral for ultrasonographic evaluation to a radiologist. The patient underwent an 8-week course of conservative treatment under the supervision of a physiotherapist. This treatment significantly improved the patient’s pain and function. Results: After eight weeks of conservative treatment using Minhaj protocol for Tibialis Anterior hernia, the patient has reported improvement in pain (reduction of score from eight to two on the NPRS scale) and function. The patient returned to his previous level of physical activity following eight weeks of rehabilitation. Discussion: Tibialis anterior hernia should be considered a differential diagnosis in chronic leg pain with palpable soft tissue protrusion. Conservative treatment can be chosen as the primary approach.
first_indexed 2024-03-11T20:47:03Z
format Article
id doaj.art-1690cecd0571401e851bedb2b00b599e
institution Directory Open Access Journal
issn 1735-3602
1735-3610
language English
last_indexed 2024-03-11T20:47:03Z
publishDate 2021-12-01
publisher Negah Institute for Scientific Communication
record_format Article
series Iranian Rehabilitation Journal
spelling doaj.art-1690cecd0571401e851bedb2b00b599e2023-10-01T07:33:32ZengNegah Institute for Scientific CommunicationIranian Rehabilitation Journal1735-36021735-36102021-12-01194465472Missing the Bull’s Eye: A Case Report of Tibialis Anterior HerniaMuhammed Minhaj0Binoy Mathew1 Department of Sports Physiotherapy, Jamia Millia Islamia University, New Delhi, India. Department of Physiotherapy, Composite Regional Centre for Skill Development Rehabilitation and Empowerment of Persons with Disabilities, Kozhikode, India. Objectives: Shin pain is a broad term used to describe lower leg pain. It is commonly seen in the athletic/sports population. Various conditions have been claimed to produce leg pain, and muscle herniation is one of these conditions. Muscle herniation is the protrusion of muscle through a defect in the overlying fascia. Although such herniation is common, it is often an underdiagnosed condition in the lower extremity. It usually occurs in athletes, especially in the anterior compartment of the leg, as a result of trauma or due to muscle hypertrophy secondary to strenuous exercise. Herniation diagnosis depends on its clinical presentation as it appears as a palpable soft tissue bulge through a fascia defect; radiological findings are used to confirm the diagnosis. Conservative treatment should be the initial approach, and surgery can be performed if conservative treatment fails. Methods: We present a case of symptomatic anterior lower leg pain, initially diagnosed as a psychosomatic disorder by two orthopedic physicians. However, tibialis anterior hernia in this patient was confirmed after physical examination by a physiotherapist and subsequent referral for ultrasonographic evaluation to a radiologist. The patient underwent an 8-week course of conservative treatment under the supervision of a physiotherapist. This treatment significantly improved the patient’s pain and function. Results: After eight weeks of conservative treatment using Minhaj protocol for Tibialis Anterior hernia, the patient has reported improvement in pain (reduction of score from eight to two on the NPRS scale) and function. The patient returned to his previous level of physical activity following eight weeks of rehabilitation. Discussion: Tibialis anterior hernia should be considered a differential diagnosis in chronic leg pain with palpable soft tissue protrusion. Conservative treatment can be chosen as the primary approach.http://irj.uswr.ac.ir/article-1-1362-en.pdfathletic injuriesherniamusclesdiagnostic errorslower extremityultrasonography
spellingShingle Muhammed Minhaj
Binoy Mathew
Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia
Iranian Rehabilitation Journal
athletic injuries
hernia
muscles
diagnostic errors
lower extremity
ultrasonography
title Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia
title_full Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia
title_fullStr Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia
title_full_unstemmed Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia
title_short Missing the Bull’s Eye: A Case Report of Tibialis Anterior Hernia
title_sort missing the bull s eye a case report of tibialis anterior hernia
topic athletic injuries
hernia
muscles
diagnostic errors
lower extremity
ultrasonography
url http://irj.uswr.ac.ir/article-1-1362-en.pdf
work_keys_str_mv AT muhammedminhaj missingthebullseyeacasereportoftibialisanteriorhernia
AT binoymathew missingthebullseyeacasereportoftibialisanteriorhernia