Leg Injuries
Hamstring injuries are a common problem that affects many athletes. These injuries can be slow to heal with a very high rate of recurrence or re-injury. Hamstring injuries are often associated with sports that require fast acceleration and deceleration such as running (intervals), football, soccer, and rugby. Among medical researchers, there is a considerable lack of consensus regarding what precipitates a hamstring injury. Some of the more common theories are lack of strength, flexibility, muscle imbalances, and not warming up before an athletic event. However, it is agreed upon that hamstring injuries are usually not the result of a direct trauma, referred to as a “Non Contact Event”.
Hamstring Anatomy
The hamstrings are called bi-articular muscles because they cross both the hip and knee joints. This is an important consideration because a hamstring injury can affect your hips, low back, knees, and the motion patterns of the entire lower extremity. If we consider fascial connections (posterior line), we will see that a hamstring injury can affect a very large area.
Iliotibial Tibial Band Syndrome (ITBS) is a common injury that affects triathletes, runners and cyclists. Using conventional treatments, this condition never completely resolves since these treatments typically do not address all of the key structures involved in the injury.
ITBS presents as:
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A sharp or burning pain on the lateral aspect of the knee.
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Pain radiating up the side of the hip or thigh.
ITBS is an overuse injury caused by the repetitive action of the iliotibial band as it moves across the lateral femoral epicondyle.
The primary functions of the Iliotibial Band are to:
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Provide static stability to the lateral (outer) aspect of the knee.
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Control adduction (inward motion) and deceleration of the thigh.
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During a run, the ITB performs this function about 90 times per minute, or 22,000 times during a four-hour marathon.
Sciatica is a nerve compression syndrome that can be extremely painful and difficult to manage for both the patient and practitioner. Sciatic pain often affects the lower back, gluteal region, and various areas of the leg and foot. Often, the symptoms effect only on one side of the body.
Sciatica can be caused by a disc herniation, compression of the lumbar nerve roots, spinal stenosis, and/or entrapment of the sciatic nerve along its path from the lumbar spine down the leg.
Most cases of sciatica are mechanical in nature (98%) and are not secondary to some other pathological process (Infections, tumors, blood clots).
What Are Typical Sciatica Symptoms?
The sciatic nerve is a very long nerve that extends from the hips down the back of the leg, to the heels. Sciatica symptoms vary depending on just where the sciatic nerve is impinged or restricted. Symptoms include:
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Pain when you sneeze or cough
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Pins and needles in your legs
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Burning or tingling down the leg
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Pain in the rear of the leg that gets worse when sitting
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A continuous, constant pain on one side of the buttocks and leg
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Weakness, numbness or difficulty moving the leg or foot
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A shooting pain that makes it difficult to stand up
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Pain that feels like a bad leg cramp, but which can last for weeks
One of the most common running injuries we treat in our clinic is shin splints or Medial Tibial Stress Syndrome (MTSS). Shin splints cause one in five athletes to stop running. In addition to running, engaging in soccer, rugby, basketball, volleyball, or any sport that involves running or jumping can cause shin splints.
Symptoms
Most people would describe the initial pain of shin splints as a dull ache along the inside of the the lower leg (tibia). Shin splint pain is often felt at the beginning of a run and then diminishes as the run continues, only to return near the end of the run.
In this initial stage the pain from shin splints will often dissipate completely with rest. If the shin splints progress, the pain will often be present with both activity and rest. Once shin splints reach the stage of constant pain, a medical professional should be seen to determine if additional injuries are present (stress fractures or compression syndrome).
The exact location of shin splints is often hard to find, because it is usually more of a diffused pain in the soft tissue (fascia, tendon, muscle) rather than on the bone (tibia) itself.
Preventing Stress Fractures
Stress fractures are one of the most common, and potentially serious, overuse injuries. A stress fracture is an incomplete fracture that can occur anywhere in the body, and are typically caused by repetitive forceful actions. In contrast, most other types of fractures are caused by a single, direct, traumatic impact.
Stress fractures usually occur in weight-bearing bones, and are commonly seen in the metatarsals of the foot, bones of the ankle, shins (tibia), knees, and hips (the neck of the femur is one the worst stress fractures). Stress fractures are often caused by repetitive activities such as running, dancing, soccer, or any sport that involves high levels of repetitive actions. Stress fractures can eventually lead to a complete fracture.
Causes of Stress Fractures
Your body is continually remodeling your skeletal system based on the stresses that are placed upon it. This remodeling process gives your body the ability to handle increased loads without further injury. The problem arises in that your body can only adapt to these stresses at a certain rate, and there is a finite limit to the amount of stress to which it can adapt. Injuries to the bone (microscopic fractures) occur when increased stress is placed upon your body too quickly, or when too much load is applied.
