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Related Experiment Video

Updated: Jun 16, 2026

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
09:38

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Published on: April 14, 2016

Exercise-induced leg pain: sifting through a broad differential.

M Korkola1, A Amendola

  • 1Fowler/Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, N6A 3L8, CAN. amendola@uwo.ca.

The Physician and Sportsmedicine
|January 21, 2010
PubMed
Summary

Diagnosing exertional leg pain, often from repetitive stress, requires identifying conditions like tibial stress syndrome and compartment syndromes. A thorough history, physical exam, and targeted tests are key for accurate diagnosis and effective treatment.

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Area of Science:

  • Sports Medicine
  • Orthopedics
  • Exercise Physiology

Background:

  • Exertional leg pain is a common complaint in athletes and active individuals.
  • The underlying causes are frequently multifactorial, often related to repetitive stress injuries.
  • Differential diagnosis can be challenging due to overlapping symptoms.

Purpose of the Study:

  • To outline the common causes of exertional leg pain.
  • To describe the characteristic signs and symptoms of various conditions.
  • To emphasize the importance of a systematic diagnostic approach.

Main Methods:

  • Review of common etiologies of exertional leg pain.
  • Description of clinical presentation for conditions including medial tibial stress syndrome, tibial stress fractures, compartment syndromes, fascial hernias, peripheral neuropathy, and vascular entrapments.
  • Emphasis on integrating patient history, physical examination, and diagnostic investigations.

Main Results:

  • Repetitive stress is a primary contributor to exertional leg pain.
  • Specific conditions like medial tibial stress syndrome (MTSS), tibial stress fractures, and exertional compartment syndromes present with distinct clinical features.
  • Peripheral neuropathy and vascular entrapments represent less common but significant differential diagnoses.

Conclusions:

  • Accurate diagnosis of exertional leg pain relies on a comprehensive evaluation.
  • Clinical history and physical examination are foundational for identifying potential causes.
  • Judicious use of adjunctive investigations aids in confirming diagnoses and guiding treatment strategies.