Athletic Injuries to the Lower Athletic Injuries to the Lower Leg Leg

By: Juliann PlimptonBy: Juliann Plimpton

Peroneal TendonitisPeroneal TendonitisPersonal tendonitis is an Personal tendonitis is an

inflammatory condition of the inflammatory condition of the peroneal tendon, which runs peroneal tendon, which runs along the outside of the lower along the outside of the lower leg, behind the ankle and leg, behind the ankle and under the foot.under the foot.

Located behind the lateral Located behind the lateral malleolusmalleolus

MOIMOIMost commonly found in Most commonly found in those that have pes cavusthose that have pes cavus

Includes the peroneal brevis Includes the peroneal brevis and longusand longus

Also aging of the tendons Also aging of the tendons elasticityelasticity

MOI continuedMOI continuedA sudden increase in the intensity of training A sudden increase in the intensity of training

A rapid increase in the frequency of training. A rapid increase in the frequency of training.

Repeated training on rigid surfaces. Repeated training on rigid surfaces.

Poor core strength.Poor core strength.

Genetic abnormalities.Genetic abnormalities.

Due to excessive supination, which causes weight bearing Due to excessive supination, which causes weight bearing on the outside of the foot thus placing stress on the on the outside of the foot thus placing stress on the peroneal. peroneal.

Often an overuse injury (#1 cause)Often an overuse injury (#1 cause)

Signs and SymptomsSigns and SymptomsSymptoms of peroneal tendonitis include:Symptoms of peroneal tendonitis include:

_Pain and tenderness along a tendon, usually in _Pain and tenderness along a tendon, usually in proximity to the ankle or foot. proximity to the ankle or foot. _ Pain is worse with movement or activity. _ Pain is worse with movement or activity. _ Pain at night. _ Pain at night. _ Tenderness and swelling over the bit where the _ Tenderness and swelling over the bit where the tendon inserts onto the ankle or foot. tendon inserts onto the ankle or foot. _ Pain when you try to bend the ankle or foot against _ Pain when you try to bend the ankle or foot against resistance. resistance. _ Stiffness after exercise. _ Stiffness after exercise.

TREATMENTTREATMENT

RICE always worksRICE always worksNon steroidal anti- Non steroidal anti- inflammatoryinflammatory Flexibility and strength Flexibility and strength trainingtraining Ice massageIce massageStretching calf, Stretching calf, peroneals, and Achilles peroneals, and Achilles

Leg Cramp and SpasmsLeg Cramp and Spasmsmuscle cramps are painful muscle cramps are painful spasms that occur during or spasms that occur during or

immediately after activityimmediately after activity the muscle goes into a hard the muscle goes into a hard and contracted state that you and contracted state that you

cannot voluntarily relaxcannot voluntarily relax muscle cramps may well cause muscle cramps may well cause an athlete to temporarily stop an athlete to temporarily stop what they are doing, but what they are doing, but cramps generally have no cramps generally have no serious long-term serious long-term consequences consequences

MOIMOI

overexertion overexertion

failing to stretch adequately before failing to stretch adequately before exercise exercise

extreme hot or cold extreme hot or cold

dehydration dehydration

salt imbalances after sweating salt imbalances after sweating

low blood sugar low blood sugar

Symptoms and signsSymptoms and signs

Hard muscle tissue (bulge)Hard muscle tissue (bulge)

Pain with the tonic contraction of the Pain with the tonic contraction of the calf musclecalf muscle

Tender to touchTender to touch

Other contributing factor is have one Other contributing factor is have one leg longer than the otherleg longer than the other

Tight musclesTight muscles

TreatmentTreatmentgently stretch the cramped gently stretch the cramped muscle - this is the muscle - this is the quickest and easiest quickest and easiest method of relieving a method of relieving a muscle cramp. By muscle cramp. By stretching the contracted stretching the contracted muscle, the pressure on muscle, the pressure on the muscle will be the muscle will be reduced, causing reduced, causing temporary relief temporary relief

gently massage the gently massage the muscle muscle

apply ice that is wrapped apply ice that is wrapped in a soft material - this can in a soft material - this can be used along with be used along with stretching, as this will stretching, as this will numb the area and cause numb the area and cause an increase in circulation an increase in circulation once the ice is removed once the ice is removed

start replacing lost fluids start replacing lost fluids

Muscle ContusionMuscle Contusion

Muscle contusion indicates a direct, Muscle contusion indicates a direct, blunt, compressive force to a muscle. blunt, compressive force to a muscle. Contusions are one of the most Contusions are one of the most common sports-related injuries. common sports-related injuries.

Second common injury compared to Second common injury compared to the strainthe strain

Symptoms and signsSymptoms and signsBruise in the areaBruise in the area

May have limited May have limited mobility (partial loss of mobility (partial loss of limb) limb)

Pain, weaknessPain, weakness

Palpation may reveal Palpation may reveal a hard, rigid, and a hard, rigid, and somewhat inflexible somewhat inflexible area do to area do to hemorrhage hemorrhage

TreatmentTreatmentStretch immediately to prevent spasmsStretch immediately to prevent spasms

Apply a compression and iceApply a compression and ice

Can use ultra sound if the cold therapy or Can use ultra sound if the cold therapy or whirlpool don’t( 3 days)whirlpool don’t( 3 days)

Elastic wrap or tape can give support Elastic wrap or tape can give support

Gastrocnemius Strain Gastrocnemius Strain

A strained calf A strained calf muscle is a partial muscle is a partial tear of the small tear of the small fibers of the calf fibers of the calf muscles. The calf muscles. The calf muscles are located muscles are located in the back of your in the back of your lower leg lower leg

MOIMOISports that have quick starts, stops or occasional Sports that have quick starts, stops or occasional jumpingjumping (quick stops with the foot planted flat and suddenly (quick stops with the foot planted flat and suddenly extents the knee, placing stress on the medial heard of extents the knee, placing stress on the medial heard of gastracnemius)gastracnemius)

Stretching the calf muscles beyond the amount of Stretching the calf muscles beyond the amount of tension that they can withstand tension that they can withstand

Suddenly putting stress on the calf muscles when Suddenly putting stress on the calf muscles when they are not ready for the stress they are not ready for the stress

Using the calf muscles too much on a certain day Using the calf muscles too much on a certain day

A direct blow to the calf musclesA direct blow to the calf muscles

MOI continueMOI continueFatigue Fatigue Tight calf muscles Tight calf muscles Overexertion Overexertion Cold weather Cold weather

Side note Sports most Side note Sports most common:common:Running Running Hurdles Hurdles Long jump Long jump Basketball Basketball Soccer Soccer Football Football Rugby Rugby

Signs and Symptoms Signs and Symptoms Pain and tenderness in the calf Pain and tenderness in the calf

Stiffness in the calf muscles Stiffness in the calf muscles

Weakness of the calf muscles Weakness of the calf muscles

Pain when pushing off the foot or standing on Pain when pushing off the foot or standing on tiptoe tiptoe

Bruising on the calf (if blood vessels are broken) Bruising on the calf (if blood vessels are broken)

Popping sensation as the muscle tears (possibly)Popping sensation as the muscle tears (possibly)

(described by the athlete as being “ hit in the (described by the athlete as being “ hit in the calf with a stick)calf with a stick)

TreatmentTreatment

All depends on the severity on the All depends on the severity on the strainstrain– RICE, NSAIDSRICE, NSAIDS– Heat ( but not on the first 3 to 5 daysHeat ( but not on the first 3 to 5 days– Stretching muscles (when acute pain is gone)Stretching muscles (when acute pain is gone)– Strengthen muscleStrengthen muscle

References References BUPA. “Exercise- induced Muscle Cramps”. BUPA. “Exercise- induced Muscle Cramps”. http://www.bupa.co.uk/health_information/html/healthy_living/lifestyle/http://www.bupa.co.uk/health_information/html/healthy_living/lifestyle/exercise/running/cramps.html exercise/running/cramps.html

LaRusso, Laurie. Health Library. LaRusso, Laurie. Health Library. http://www.healthlibrary.epnet.com/GetContent.aspx?token=94ehttp://www.healthlibrary.epnet.com/GetContent.aspx?token=94e

““Peroneal Tendonitis.” Peroneal Tendonitis.” http://www.arthritis-pain-cure.com/article_info.php/articles_id/297http://www.arthritis-pain-cure.com/article_info.php/articles_id/297

Prentice, E. William: “Musculoskeletal Conditions. Arnheim’s Principles of Prentice, E. William: “Musculoskeletal Conditions. Arnheim’s Principles of Athletic Training 12Athletic Training 12thth ed.: 585, 2005. ed.: 585, 2005.

““Top 10 Most Common Sports Injuries and Treatments”. Top 10 Most Common Sports Injuries and Treatments”. www.cellhealthmakeover.com/most-common-sports-injuries.htmlwww.cellhealthmakeover.com/most-common-sports-injuries.html