The Lower Leg
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Transcript The Lower Leg
The Lower Leg
ANATOMY
Bones
Tibia
Fibula
MUSCLES
The
muscles are in four compartments
with 2-4 muscles in each compartment
Compartments are held together by
fascia
MUSCLE COMPARTMENTS
1.
2.
3.
4.
LATERAL – everts the ankle
ANTERIOR – dorsiflexes the ankle
DEEP POSTERIOR – plantarflexes the
ankle (the calf muscle)
POSTERIOR MEDIAL – inverts and
plantarflexes the ankle
Page
317 and 318
Major Muscles and Actions
Anterior
Tibialis - dorsiflexor
Peroneals - evertors
Gastrocnemius – plantarflexor
Soleus – plantarflexor
Posterior Tibialis – invertor
INJURIES
Muscle
Cramps
Sudden,
violent contraction of the calf
muscles
Causes:
Fatigue, overtraining, dehydration, poor
nutrition, injury, poor flexibility
– sharp pain in the calf, toe is pointed
Tx: gentle stretch, ice, hydrate, can return
to play if subsides and does not continue
S/S:
INJURIES
STRESS FRACTURE
Cause: Repetitive pounding with training
S/S: Hurts more with and after activity,
pain on one spot on bone
Tx: Requires x-ray, possibly a bone scan
If positive, no weight bearing for at least
2 weeks, no running for 4-6 weeks
INJURIES
MEDIAL
‘SHIN
TIBIAL STRESS SYNDROME
SPLINTS’
Occurs in distal 2/3 of posterior/medial tibia
Causes: pronation, lack of flexibility in the
lower legs, hard surfaces, hills, muscle
weakness, poor shoes
INJURIES
MEDIAL
S/S:
TIBIAL STRESS SYNDROME
resisted plantar flexion and inversion
should hurt, pain is just off the tibia
Treatment : prevention (shoes, arch
support), strengthening, stretching, ice
massage, contrast bath, tape arches
Refer to MD if no improvement to rule out
stress fracture
INJURIES
COMPARTMENT
Occurs
SYNDROME
when pressure increases in
compartment and shuts off blood and
nerve supply to the foot
Most often occurs in the anterior and deep
posterior compartment
THREE TYPES
Acute
Acute Exertional
Chronic
INJURIES
ACUTE
COMPARTMENT SYNDROME
Medical
emergency
Causes: direct blow to the lower leg
Usually in the anterior lower leg
Symptoms come about several hours later
S/S:
compartment is tense, warm, red and
shiny; complains of (c/o) deep aching pain;
circulation and sensory problems in foot
Tx: ice, elevation – refer to ER immediately
INJURIES
ACUTE
EXERTIONAL/CHRONIC
COMPARTMENT SYNDROME
Cause:
running and jumping activities
S/S: With activity, foot goes to sleep,
crampy pain, and tingling. When activity
stops, it goes away. Consistent as to when
it comes on with activity
Tx: ice, activity modification, stretching,
massage, and referral to the doctor
(possible surgery)
INJURIES
ACHILLES
Chronic,
TENDINITIS
overuse condition that comes
about gradually
Causes: running and jumping, repetitive
stress, running up hills, poor flexibility
S/S: achy type pain, Achilles is tender on
palpation, pain with standing plantarflexion,
may have crepitus, hurts to warm up and to
cool down
INJURIES
ACHILLES
TENDINITIS
TREATMENT
If there is crepitus, no running for 1-2 weeks
Stretch!
Heel lift in both shoes
Orthodics
Heat and/or ice
INJURIES
ACHILLES
Achilles
TENDON RUPTURE
in largest tendon in body
For Gastronemius and Soleus muscles
Most
common tearing spot is 1” above its
insertion on the calcaneus
Causes: Sudden, forceful plantar flexion and
extension of the knee, age, previous tendinitis
S/S: Feel and hear a snap, “kicked in the leg”,
very weak plantarflexion, no Achilles observed
Tx: Immobilization to ER, surgery?
TEST FRIDAY, FEB 20th
FOOT
ANKLE
LOWER
LEG
ANATOMY
INJURIES
Causes
Signs
and Symptoms
Treatments