Injuries to the Lower Leg, Injuries to the Lower Leg, Foot and AnkleFoot and Ankle

Lower Leg InjuriesLower Leg InjuriesCaution! Graphic PictureCaution! Graphic Picture

ContusionsContusions

Shin contusion Shin contusion

Compartment SyndromeCompartment Syndrome

Fasciotomy – surgical procedure in which the fascia is cut to relieve pressurehttp://www.youtube.com/watch?v=82QcxdHel0Q

Muscle StrainMuscle Strain

Calf is most affected (usually at Calf is most affected (usually at gastroc-achilles junction)gastroc-achilles junction)

Grade 1 Calf Strain: Grade 1 Calf Strain:

Grade 2 Calf Strain : Grade 2 Calf Strain :

Grade 3 Calf Strain:Grade 3 Calf Strain:

Achilles TendonitisAchilles Tendonitis

Inflammation of the Achilles Inflammation of the Achilles TendonTendon

MOI – overuse, microtearing of MOI – overuse, microtearing of tendontendon

Achilles Tendon TearAchilles Tendon Tear

ThompsonThompson’’s test for Achilles Tendon Ruptures test for Achilles Tendon Rupturehttp://www.youtube.com/watch?v=8kxPFjSJj0k

Muscle SpasmMuscle Spasm

Calf usually affectedCalf usually affectedMOI – fatigue, dehydrationMOI – fatigue, dehydrationTreatment – direct compression, Treatment – direct compression,

gradual stretch, ice, rehydrategradual stretch, ice, rehydrate

Leg FracturesLeg Fractures

Direct blows or indirect Direct blows or indirect traumatrauma

Stress FracturesStress Fractures

An incomplete break in a An incomplete break in a bone occurring after bone occurring after prolonged repetitive prolonged repetitive

exerciseexercise

Stress Fractures (conStress Fractures (con’’t)t)

Signs and Symptoms Signs and Symptoms

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Medial Tibial Stress Medial Tibial Stress SyndromeSyndrome

““shinsplintsshinsplints””

Pain along medial border of the Pain along medial border of the tibiatibia

Usually with novice runners – well Usually with novice runners – well conditioned runners usually due to conditioned runners usually due to mechanical abnormalitiesmechanical abnormalities

Causes: - running on hard Causes: - running on hard

surfaces surfaces

- Overuse- Overuse

- Muscle imbalance- Muscle imbalance

- Tight Achilles - Tight Achilles

Ankle InjuriesAnkle Injuries

Mechanisms of InjuriesMechanisms of Injuries InversionInversion

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Plantar FlexionPlantar Flexion

- Usually sprain ankle when in - Usually sprain ankle when in plantar flexion.plantar flexion.

- Ankle is unstable in this position- Ankle is unstable in this position

EversionEversion- usually due to a planted - usually due to a planted

foot that receives a lateral forcefoot that receives a lateral force- stepping in a hole- stepping in a hole- higher incidence of - higher incidence of

fractures fractures

Lateral Ligament SprainLateral Ligament Sprain

Most common ankle injuryMost common ankle injuryMOI = Inversion and plantar MOI = Inversion and plantar

flexionflexion

Anterior Talofibular Ligament Anterior Talofibular Ligament (ATF) is injured first. (mild sprain)(ATF) is injured first. (mild sprain)

The Calcaneofibular Ligament The Calcaneofibular Ligament (CF) is injured in more severe (CF) is injured in more severe sprainssprains

INVERSION ANKLE SPRAININVERSION ANKLE SPRAIN

Ankle inversionAnkle inversionhttp://www.youtube.com/watch?v=dP17ZY3zxa4&feature=related

http://www.youtube.com/watch?v=8Kc1CEAk1ao&feature=fvwrel

Medial Ligament SprainMedial Ligament Sprain(Deltoid Ligament)(Deltoid Ligament)

Often associated with fractures Often associated with fractures of lateral malleolusof lateral malleolus

The Deltoid LigamentThe Deltoid Ligament

Peroneal Tendon InjuryPeroneal Tendon InjuryCan occur when lateral ankle Can occur when lateral ankle

ligaments are injuredligaments are injured