Lower Leg and Ankle Injuries.ppt

Lower Leg and Ankle Injuries Shin Splints Medial Anterior Medial Tibial Stress Syndrome Tenderness is usually found between 3 and 12 centimeters above the tip of the medial malleolus at the posterio-medial aspect of the tibia. Inflammation of the periostium (periostitis) Most frequently involved is the Tibalis Posterior tendon and muscle, but the Flexor Digitorum Longus and Flexor Hallucis Longus may also be involved. Stress fractures can also occur in this area. Anterior Compartment Syndrome Soft tissue injuries at the muscular origin and bony or periosteal interface of the bone and muscle origin. Due to micro tears of the Tibialis Anterior either at the origin or in the fibers themselves. Or microtrauma to the bone structure itself. Stress fractures can also occur in this area. Exertional Compartment Syndrome Caused by the muscles swelling within a closed compartment with a resultant increase in pressure in the compartment. The blood supply can be compromised and muscle injury and pain may occur. Abnormal compartment pressure: A resting pressure greater than 20 mm Hg; or An exertional pressure greater than 30 mm Hg; or A pressure of 25 mm Hg or higher 5 minutes after stopping exercise. This may require surgical decompression of the compartment. Key Causes Tight posterior muscles Imbalance between the posterior and anterior muscles Running on concrete or other hard surfaces Improper Shoes - inadequate shock protection Overtraining Treatment (FYI) Rest. The sooner you rest the sooner it will heal. Apply ice 10-15 minutes for 2-3x per day in the early stages when it is very painful. Anti inflammatory drugs Wear shock absorbing insoles in shoes. Maintain fitness with other non weight bearing exercises. Apply heat and use a heat retainer after the initial acute stage, particularly before training. Stress Fractures Bone remodeling Repetitive stress weakens the bone 10-20% of injuries to athletes Most common locations: tibia, fibula and metatarsa