Statement of Principles
concerning
SHIN SPLINTS
No. 49 of 2006
for the purposes of the
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and
Compensation Act 2004
Title
1.
This Instrument may be cited
as Statement of Principles concerning shin splints No. 49 of 2006.
Determination
2.
This Statement of Principles
is determined by the Repatriation Medical Authority under subsection 196B(2)
of the Veterans’ Entitlements Act 1986 (the VEA).
Kind of injury, disease
or death
3. (a) This Statement of Principles is
about shin splints and death from shin splints.
(b)
For the purposes of this Statement
of Principles, "shin splints" means
medial tibial stress syndrome and chronic exertional compartment syndrome of
the lower leg. Medial tibial stress syndrome is characterised by
exercise-induced pain along the posteromedial aspect of the distal two-thirds
of the tibia. Chronic exertional compartment syndrome of the lower leg is
characterised by exercise-induced pain and tightness originating in the calf or
shin due to raised intracompartmental pressure. The pain of both conditions
typically resolves or reduces with rest but may recur with exercise. This
definition excludes fracture, stress fracture, bursitis, infections, tumours,
vascular insufficiency, entrapment of nerves or arteries, acute strains and
acute sprains.
Basis for determining the
factors
4. The Repatriation Medical Authority is of the view that there
is sound medical-scientific evidence that indicates that shin splints and
death from shin splints can be related to relevant service rendered by
veterans, members of Peacekeeping Forces, or members of the Forces under the
VEA, or members under the Military Rehabilitation and Compensation Act 2004
(the MRCA).
Factors that must be
related to service
5. Subject to clause 7, at least one of the factors set out in
clause 6 must be related to the relevant service rendered by the person.
Factors
6. The factor that must as a minimum exist before it can be said
that a reasonable hypothesis has been raised connecting shin splints or
death from shin splints with the circumstances of a person’s relevant
service is:
(a)
having a sudden increase
in the frequency, duration, or intensity of weight bearing exercise involving
the affected lower limb, at the time of the clinical onset of shin splints; or
(b)
undertaking weight bearing exercise involving the affected lower limb
at a rate greater than six METs for at least one hour per day on more days than
not over a period of at least the three months, before the clinical onset of
shin splints; or
(c)
for
medial tibial stress syndrome only, having an injury that has resulted in
excess pronation of the foot of the affected limb before the clinical onset of
shin splints; or
(d)
having a sudden
increase in the frequency, duration, or intensity of weight bearing exercise
involving the affected lower limb, at the time of the clinical worsening of
shin splints; or
(e)
undertaking weight bearing exercise involving the affected lower limb
at a rate greater than six METs for at least one hour per day on more days than
not over a period of at least the three months, before the clinical worsening
of shin splints; or
(f)
for
medial tibial stress syndrome only, having an injury that has resulted in
excess pronation of the foot of the affected limb before the clinical worsening
of shin splints; or;
(g)
inability to obtain appropriate clinical
management for shin splints.
Factors that apply only
to material contribution or aggravation
7. Paragraphs 6(d) to 6(g) apply only to material
contribution to, or aggravation of, shin splints where the person’s shin
splints were suffered or contracted before or during (but not arising out of)
the person’s relevant service.
Inclusion of Statements
of Principles
8. In this Statement of Principles if a relevant factor applies
and that factor includes an injury or disease in respect of which there is a
Statement of Principles then the factors in that last mentioned Statement of
Principles apply in accordance with the terms of that Statement of Principles
as in force from time to time.
Other definitions
9.
For the purposes of this
Statement of Principles:
"death from shin splints" in relation to a person includes death from a terminal
event or condition that was contributed to by the person’s shin splints;
"excess
pronation of the foot" means a positional deformity of the foot such that
there is excessive dorsiflexion, eversion and abduction (inward roll) of the
foot when the foot is in a fixed position or in dynamic motion;
"MET" means a unit of measurement of
the level of physical exertion. 1 MET = 3.5 ml of oxygen/kg of body weight per
minute or, 1.0 kcal/kg of body weight per hour, or resting metabolic rate;
"relevant service" means:
(a)
operational service under the VEA;
(b)
peacekeeping service under the VEA;
(c)
hazardous service under the VEA;
(d)
warlike service under the MRCA; or
(e)
non-warlike service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and
includes:
(a)
pneumonia;
(b)
respiratory failure;
(c)
cardiac arrest;
(d)
circulatory failure; or
(e)
cessation of brain function.
Date of effect
10. This Instrument takes effect from 30 August 2006.
Notes to Statement of Principles concerning shin
splints (Instrument No. 49 of 2006)
The Statement of Principles concerning shin splints
(Instrument No. 49 of 2006) in force under section 196B(2) of the Veterans’
Entitlements Act 1986, as shown in this compilation is amended as indicated
in the Tables below.
Table
of Instruments
|
Title
|
Date of notification
in Gazette or FRLI registration
|
Date of
commencement
|
Application, saving or
transitional provisions
|
|
Statement
of Principles concerning shin splints (Instrument No. 49 of 2006)
|
23 August 2006
|
30 August 2006
|
|
|
Amendment
of Statement of Principles concerning shin splints (Instrument No. 105 of
2007)
|
13 September 2007
|
19 September 2007
|
|
Table of Amendments
|
ad. = added or inserted am. = amended
rep. = repealed rs. = repealed and substituted
|
|
Provision affected
|
How affected
|
|
Clause 6 – paras (d), (e) & (f).........................................
|
ad. Instrument No.105 of 2007
|