Lower Leg, Ankle & Foot
Shin Splints:
They're common in people who do a lot of running or other activities that involve repeatedly putting weight on the legs, such as tennis or basketball. Shin splints are caused due to irritation / aggravation/ swelling of the soft tissue structures and bone.
Symptoms:
• Onset soon after starting exercise
• Affect both shins
• Be felt over a large part of the shin (an area over 5cm across) – pain in a small area may be caused by a stress fracture instead
• Sometimes there may also be some swelling.
Causes:
• A sudden change in your activity level or repetitive running
• Running on hard or uneven surfaces
• Wearing poorly fitting or worn-out trainers that don't cushion and support your feet properly
• Being overweight
• Having flat feet or feet that roll inwards (known as over-pronation)
• Having tight calf muscles, weak ankles, or a tight Achilles tendon (the band of tissue connecting the heel to the calf muscle)
Treatment:
• Rest – stop or reduce activity
• Ice
• Pain relief
• Massage
• Mobilisation techniques
• Stretching
• Taping
• Exercises rehabilitation
• Correct footwear
• Weight loss
• Warm up before exercises
• Improve overall flexibility
They're common in people who do a lot of running or other activities that involve repeatedly putting weight on the legs, such as tennis or basketball. Shin splints are caused due to irritation / aggravation/ swelling of the soft tissue structures and bone.
Symptoms:
• Onset soon after starting exercise
• Affect both shins
• Be felt over a large part of the shin (an area over 5cm across) – pain in a small area may be caused by a stress fracture instead
• Sometimes there may also be some swelling.
Causes:
• A sudden change in your activity level or repetitive running
• Running on hard or uneven surfaces
• Wearing poorly fitting or worn-out trainers that don't cushion and support your feet properly
• Being overweight
• Having flat feet or feet that roll inwards (known as over-pronation)
• Having tight calf muscles, weak ankles, or a tight Achilles tendon (the band of tissue connecting the heel to the calf muscle)
Treatment:
• Rest – stop or reduce activity
• Ice
• Pain relief
• Massage
• Mobilisation techniques
• Stretching
• Taping
• Exercises rehabilitation
• Correct footwear
• Weight loss
• Warm up before exercises
• Improve overall flexibility
Achilles Tendonitis:
Achilles tendonitis (also known as Achilles tendinopathy or Achilles tendinosis) is an overuse injury causing pain, inflammation or degeneration of the Achilles tendon at the back of the ankle. Symptoms include pain and stiffness in the Achilles tendon. Treatment involves reducing pain and inflammation, massage, taping, stretching and eccentric strengthening exercises.
Symptoms:
Symptoms of Achilles tendonitis consist of pain and stiffness in the Achilles tendon at the back of the ankle. Symptoms will most likely have developed gradually over time and will often be worse first thing in the morning. Achilles tendonitis can be either acute or chronic.
• Stiffness
• Pain on walking, running
• Tender to touch
• Swelling
Causes:
• Trauma / injury to the tendon
• Over use – running, walking, training
• Poor foot biomechanics
• Incorrect footwear / high heels
• Over training / up heel training
Treatment:
• Massage
• Ultrasound
• Mobilisation techniques
• Acupuncture
• Reduce / stop training
• Corrective exercises / stretches (Hakan Alfredson's heel drop protocol)
• Corrective footwear
Achilles tendonitis (also known as Achilles tendinopathy or Achilles tendinosis) is an overuse injury causing pain, inflammation or degeneration of the Achilles tendon at the back of the ankle. Symptoms include pain and stiffness in the Achilles tendon. Treatment involves reducing pain and inflammation, massage, taping, stretching and eccentric strengthening exercises.
Symptoms:
Symptoms of Achilles tendonitis consist of pain and stiffness in the Achilles tendon at the back of the ankle. Symptoms will most likely have developed gradually over time and will often be worse first thing in the morning. Achilles tendonitis can be either acute or chronic.
• Stiffness
• Pain on walking, running
• Tender to touch
• Swelling
Causes:
• Trauma / injury to the tendon
• Over use – running, walking, training
• Poor foot biomechanics
• Incorrect footwear / high heels
• Over training / up heel training
Treatment:
• Massage
• Ultrasound
• Mobilisation techniques
• Acupuncture
• Reduce / stop training
• Corrective exercises / stretches (Hakan Alfredson's heel drop protocol)
• Corrective footwear
Plantar Fasciitis:
In most cases, only one heel is affected, although it can effect both heels
The pain is usually worse first thing in the morning, but can ease off after a few steps. Walking generally eases pain, but standing or sitting can make pain worse
Some people can limp, or walk differently as its painful to walk on the effected foot. This can cause other issues such as knee, ankle, hip and back pain.
The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot, this can become thicken and damaged over time.
Causes:
• Trauma or sudden damage
• Mircotears to the plantar fascia can occur over months or even years meaning the tissues can become inflamed
Treatment:
• Rest – avoid walking long distance, running or standing for long periods of time
• Massage
• Mobility techniques
• Ultrasound therapy
• Acupuncture
• Ice
• Pain relief
• Stretches
• Exercises rehabilitation
• Straps / supports / taping
In most cases, only one heel is affected, although it can effect both heels
The pain is usually worse first thing in the morning, but can ease off after a few steps. Walking generally eases pain, but standing or sitting can make pain worse
Some people can limp, or walk differently as its painful to walk on the effected foot. This can cause other issues such as knee, ankle, hip and back pain.
The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot, this can become thicken and damaged over time.
Causes:
• Trauma or sudden damage
• Mircotears to the plantar fascia can occur over months or even years meaning the tissues can become inflamed
Treatment:
• Rest – avoid walking long distance, running or standing for long periods of time
• Massage
• Mobility techniques
• Ultrasound therapy
• Acupuncture
• Ice
• Pain relief
• Stretches
• Exercises rehabilitation
• Straps / supports / taping
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Calf strain
What is a calf strain?
A calf strain is a common injury and can often caused by overstretching or excess force going through the calf muscles at the back of the lower leg. This causes the muscle fibres to be stretched and weakened, which results in bleeding into the muscles.
What are the symptoms?
• Mild ache when resting
• Moderate pain when using the affected lower leg
• Swelling
• A change in the colour of your skin over your calf area - redness or bruising
• Difficulty in rising up onto your toes
• Difficulty pushing off from your foot
Causes:
• Overstretching or excess force going through the calf muscles at the back of the lower leg
Treatment:
• The first treatment is to calm the inflammation and to control the swelling and pain. This can be managed with the PRICE principles - Protection, Rest, Ice, Painkillers and Elevation.
• As healing gets underway, it is important you begin a series of exercises to gently stretch the calf muscle. This will help your knee and ankle joints to get back into their normal position. This also helps to reduce the risk of further injury. A sports therapist will be able to make a rehabilitation plan to help you to return to full strength
• Healing of muscles usually takes around six weeks, although some people will recover faster, and some slower, than this. The speed at which your muscles will heal depends on how severe your injury is, as well as your existing health.
What is a calf strain?
A calf strain is a common injury and can often caused by overstretching or excess force going through the calf muscles at the back of the lower leg. This causes the muscle fibres to be stretched and weakened, which results in bleeding into the muscles.
What are the symptoms?
• Mild ache when resting
• Moderate pain when using the affected lower leg
• Swelling
• A change in the colour of your skin over your calf area - redness or bruising
• Difficulty in rising up onto your toes
• Difficulty pushing off from your foot
Causes:
• Overstretching or excess force going through the calf muscles at the back of the lower leg
Treatment:
• The first treatment is to calm the inflammation and to control the swelling and pain. This can be managed with the PRICE principles - Protection, Rest, Ice, Painkillers and Elevation.
• As healing gets underway, it is important you begin a series of exercises to gently stretch the calf muscle. This will help your knee and ankle joints to get back into their normal position. This also helps to reduce the risk of further injury. A sports therapist will be able to make a rehabilitation plan to help you to return to full strength
• Healing of muscles usually takes around six weeks, although some people will recover faster, and some slower, than this. The speed at which your muscles will heal depends on how severe your injury is, as well as your existing health.
Compartment Syndrome
Compartment syndrome is a painful and potentially serious condition, which can affect the lower leg. It is caused by bleeding or swelling within an enclosed bundle of muscles, which is known as a muscle compartment. There are four ‘compartments’ in the lower leg.
Two types of compartment syndrome:
Acute compartment syndrome:
• Occurs suddenly, usually after a severe injury
• Requires urgent treatment and is considered a medical emergency
• If is is not treated quickly is can lead to irreversible muscle damage
Symptoms of acute compartment syndrome:
• Very intense pain, particularly when the muscle is stretched. This pain can seem more extreme than would usually be expected for the injury
• Tenderness in the affected area
• Muscle tightness in the affected area
• A burning or tingling sensation
• In severe cases there can be numbness or weakness, although these are signs of permanent damage
Chronic compartment syndrome:
• Occurs gradually, often brought on during and straight after repetitive exercise
• Is not a medical emergency and does not cause permanent damage
• Usually fades shortly stopping the activity
Symptoms of chronic compartment syndrome:
• Cramping during exercise, usually in the legs
• Swelling or a bulging muscle
• Tingling
• The affected area turning pale and cold
• In severe cases there can be difficulty when moving the affected body part
Treatments:
Acute compartment syndrome:
• Acute compartment syndrome needs to be treated in hospital using a surgical procedure called an emergency fasciotomy.
• An incision is made in the skin and fascia surrounding the muscles. This enables the doctor or surgeon to immediately relieve the pressure inside the muscle ‘compartment’
Chronic compartment syndrome:
• Stop the exercise that triggers the problem and seek advice from a sports therapist
• Shoe inserts (orthotics) and non-steroidal anti-inflammatory medicines may help
• Surgery will only be considered if your symptoms persist despite these measures. In these cases, you'll go on a waiting list, as chronic compartment syndrome is not a medical emergency
Compartment syndrome is a painful and potentially serious condition, which can affect the lower leg. It is caused by bleeding or swelling within an enclosed bundle of muscles, which is known as a muscle compartment. There are four ‘compartments’ in the lower leg.
Two types of compartment syndrome:
Acute compartment syndrome:
• Occurs suddenly, usually after a severe injury
• Requires urgent treatment and is considered a medical emergency
• If is is not treated quickly is can lead to irreversible muscle damage
Symptoms of acute compartment syndrome:
• Very intense pain, particularly when the muscle is stretched. This pain can seem more extreme than would usually be expected for the injury
• Tenderness in the affected area
• Muscle tightness in the affected area
• A burning or tingling sensation
• In severe cases there can be numbness or weakness, although these are signs of permanent damage
Chronic compartment syndrome:
• Occurs gradually, often brought on during and straight after repetitive exercise
• Is not a medical emergency and does not cause permanent damage
• Usually fades shortly stopping the activity
Symptoms of chronic compartment syndrome:
• Cramping during exercise, usually in the legs
• Swelling or a bulging muscle
• Tingling
• The affected area turning pale and cold
• In severe cases there can be difficulty when moving the affected body part
Treatments:
Acute compartment syndrome:
• Acute compartment syndrome needs to be treated in hospital using a surgical procedure called an emergency fasciotomy.
• An incision is made in the skin and fascia surrounding the muscles. This enables the doctor or surgeon to immediately relieve the pressure inside the muscle ‘compartment’
Chronic compartment syndrome:
• Stop the exercise that triggers the problem and seek advice from a sports therapist
• Shoe inserts (orthotics) and non-steroidal anti-inflammatory medicines may help
• Surgery will only be considered if your symptoms persist despite these measures. In these cases, you'll go on a waiting list, as chronic compartment syndrome is not a medical emergency
Sever's Disease
Sever’s disease (also known as calcaneal apophysitis) is inflammation of the growth plate of the heel and is common in children. Repetitive stress during a growth spurt can cause this condition. Children who also participate in sports which involve running, jumping and twisting can also worsen the condition, however the condition can still be seen in children who are less active, but wear flat shoes.
Symptoms:
• Heel pain and tenderness
• Swelling at the heel
• Pain and stiffness in the mornings and after exercise
Treatment:
• Rest / reduction activity
• Corrective footwear (avoid flat shoes)
• Correct muscle imbalances (rehab)
• Massage
• Ultrasound
• Taping / strapping
Sever’s disease (also known as calcaneal apophysitis) is inflammation of the growth plate of the heel and is common in children. Repetitive stress during a growth spurt can cause this condition. Children who also participate in sports which involve running, jumping and twisting can also worsen the condition, however the condition can still be seen in children who are less active, but wear flat shoes.
Symptoms:
• Heel pain and tenderness
• Swelling at the heel
• Pain and stiffness in the mornings and after exercise
Treatment:
• Rest / reduction activity
• Corrective footwear (avoid flat shoes)
• Correct muscle imbalances (rehab)
• Massage
• Ultrasound
• Taping / strapping
