Pathologie : Les Periostites Tibiales

par

Quelles sont les causes des périostites? comment les éviter? Comment les prendre en charge ?

La périostite est une inflammation à caractère dégénératif affectant le périoste. Elle touche aujourd’hui, 10 % d’entre nous.

La survenue de cette pathologie provient directement d’une trop grande tension des insertions musculaires et aponévrotiques fixées au périoste. Elle peut aussi être la relation de cause à effet d’un grand nombre de choc répétés, entre autres lors de la pratique de certain sports fractionnés, tel que l’athlétisme ou la danse classique par exemple.

Etiologie(s) :
C’est une pathologie, complexe est multifactorielle. En effet, il n’y a pas une cause responsable de cette inflammation, mais un ensemble de facteurs, qui feront que la pathologie se soignera plus ou moins bien avec le temps. La cause de cette blessure réside dans l’excès de traction des muscles sur l’attache osseuse.

On notera à titre exhaustif, les facteurs suivants:

La Chaussure/ Le Terrain :
Le chaussant non adapté; ou chaussures usées; en fait tout sportif doit au minimum prendre la précaution d’acheter sa paire (ou ses paires) de chaussures dans un magasin spécialisé où un vendeur lui apportera les bons conseils. Le mieux c’est de consulter un podologue afin de mieux choisir le modèle de chaussure en fonction de son utilisation et de nos caractéristiques.

De même, si le terrain, n’est pas propice à la pratique sportive, ce genre d’inflammation peuvent survenir plus rapidement. C’est pour ça qu’en plus de chaussures adaptées au sport pratiqué, il faut qu’elles soient également, au terrain sur lequel aura lieu l’activité.

L’Hygiène du sportif :
L’Hydratation est une chose évidement, mais à toujours recommander. Il faut boire, avant, pendant et après l’effort.
Il faudra éviter les éviter les aliments acides, privilégier les aliments alcalins .

L’Etat de santé général du patient :
Un bilan sanguin pourra rechercher des facteurs qui peuvent favoriser un climat propice aux tendinites et périostites : acide urique élevé, cholestérol, triglycérides ; mon expérience m’amène également à toujours rechercher une carence en fer chez un sportif qui présente une tendinite ou une périostite rebelles.

Un surpoids bien sûr, qui de plus aggravera peut-être les troubles plantaires statiques et dynamiques ; il ne faut pas hésiter à s’entourer de conseils dispensés par un professionnel de la santé.

La Surcharge d’entrainement :
Une surcharge d’entraînements : c’est très souvent la cause principale ; fréquemment il s’agit aussi d’une personne qui se « remet » au sport ; tout comme il peut s’agir d’un cycliste ou autre sportif non coureur à pied qui pendant son intersaison va se mettre au footing.

Tableau Clinique :
Son apparition est progressive. Elle peut être unilatérale ou bilatérale, touche la face interne du tibia, à la jonction tiers inférieur et tiers moyen. On constate parfois que la douleur, présente en début de séance, diminue progressivement pour réapparaître en fin de séance. Face à de tels symptômes, il n’est pas nécessaire de consultation. En revanche, elle peut être beaucoup plus intense et permanente, même hors course à pied. L’impotence fonctionnelle porte alors à consulter.

 

Une simple palpation de la zone douloureux, pourra mettre en évidence le diagnostique.

Il faut palper la face interne du tibia, avec et sans contractions musculaires. Sous contractions musculaires, la douleur doit être plus vive que sans. Il suffit de mettre le doigt sur la zone douloureuse, appuyer et faire une dorsi-flexion du pied sans enlever le doigt.

Traitement(s) :
En première intention, il y aura bien évidement, le Glaçage et le Repos, pouvant être couplé à un traitement anti-inflammatoire.

De même un traitement homéopathique à base de « Curcuma », d’ « Arnica », peut être également utiliser pour soulager des douleurs.

La kinésithérapie choisira parmi plusieurs techniques : physiothérapie, massage transverse profond, entre autres.

La pose de K TAPING, peut également, faire diminuer (voir disparaître) les douleurs, en cas d’échéances importantes.

Le traitement Podologique lui consiste à limiter la traction de ces muscles pendant la course par des orthèses plantaires moulées corrigeant la pronation et /ou le manque « d’élasticité » du mollet.

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