Lower Leg Injuries
mvpboxing  |   May 04, 2017, 12:05PM

Calf Strain
  1. Definition and Occurrence
    1. The calf muscles are a group of large muscles at the back of the lower leg that come together to form the Achilles tendon. They are very powerful muscles that are used to propel the leg forward during the late stance phase of walking and running. They are placed under a large amount of stress when landing on a dorsiflexed foot or with repetitive running and cycling activities. The muscle group often becomes irritated at its Achilles tendon insertion, leading to pain, inflammation, and sometimes rupture.
  2. Signs and Symptoms
    1. Pain with passive dorsiflexion of the ankle joint or active plantarflexion (standing on tiptoes)
    2. Swelling
    3. Popping sound is often heard if the tendon is torn from the bone
  3. Treatment
    1. Initially, rest, ice, elevation, and pain control
    2. If the Achilles tendon is torn, it will most likely need to be surgically re-attached.
      1. Following surgery, a rehabilitation program will be initiated consisting of gradual increases in ROM followed by strengthening.
      2. Care needs to be taken to protect the surgical reattachment
    3. Rehab of a strained calf muscle will consist of gentle stretching and eccentric strengthening exercises
    4. Once pain subsides, more involved strengthening exercises will be initiated to help strengthening the Achilles tendon and avoid future exacerbations
  4. Prehab (prevention)
    1. Calf stretching and strengthening
    2. Ankle stability training
Shin Splints
  1. Definition and Occurrence
    1. Shin splints or medial tibial stress syndrome is an inflammation of the muscular attachments on the front and outside part of the lower leg. As the muscles are overused, they pull on the bones of the lower leg, leading to inflammation. The cause of shin splints is varied. They can be caused by over pronation of the foot during walking and running, or running too much on the toes or heels, leading to overuse of the involved muscles. This condition is classified as an overuse injury due to most commonly being seen in runners who increase their training regimen too rapidly. Overuse musculotendinous injury that can be caused by abnormal biomechanics, poor conditioning, and improper training.
    2. Pain can manifest in two locations:
      1. anterior
      2. posterior
  2. Signs and Symptoms
    1. Pain on the middle and outside part of the lower leg. The pain usually starts out dull and worsens during activity
    2. Pain with active dorsiflexion of the ankle joint and passive plantar flexion
  3. Treatment
    1. Ice, rest, NSAIDs to control inflammation during rest period
    2. Cross training during rest period (swimming and cycling)
    3. Stretching and massage of involved muscles
    4. Correction of improper foot biomechanics that could be contributing to the problem
  4. Prehab (prevention)
    1. Avoid increasing training regiment too rapidly
    2. Avoid prolonged hill running, as this forces you to constantly use the muscles involved with this injury
    3. Wear proper footwear
    4. Strengthen muscles inside the foot

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