Dear Mr. Jensen,

I will humbly give my opinion as a 4th year Osteopathy student, for treatment options. If there is recurrent pain and swelling without direct trauma to the area then I would imagine that there is some bio-mechanical issue happening in the leg. This would necessitate to examine at the whole limb and foot. Osteopathically The superior tibia fibular joint is considered to act as as part of the ankle joint complex so the talo crual , subtalar and mobility of the mid and fore foot could be assesed to make sure that forces from foot fall are being directed correctly through these structures to the lower leg. Also the position of the hip joint would need to be asessed to see if there was torsion of the femur on the tibia which would mean that the fibula was being compressed or pulled out of the normal resting position and stressing the ligaments and synovial capsule of the tib-fib joint. This could also be a consequence of muscle tone imbalance of the hamstrings, quadriceps or any muscle that spans the hip and knee joint.As for treatment locally, effleurage massage techniques to the area to drain the swelling and articulation of the joint may be beneficial or a manipulative technique to the joint. This would help reposition the articular surfaces and give input to the motor and sensory nerves in the area. I hope that this give you some idea of why treatment might depend on the assesment of the underlying issue as to why this is an recurrent injury. However as per your question manipulation/ articulation of the joint would indeed probably help and there is lots of research articles available about teh effects of this technique.

Best wishes,

Siobhan Wilson ( future Osteopath)

Thank you for your very extensive answer. What you said is surely all correct. The whole foot-leg-hip apparatus plays an important role. Strengthening M. gluteus medius, stretching the ITB etc. may help some studies show, but I could not find a larger study looking at the different approaches.