Brief Outline of Calf Strain

Failing to warm-up properly can lead to muscle strains. The calf muscles are used when taking off during a sprint, when jumping, changing directions, or when coming out of the bottom of a deep squat. These are usually explosive movements requiring forceful contractions of the calf muscles, which can lead to a muscle strain. Strains can result from incorrect foot positioning during an activity or an eccentric contraction beyond the strength level of the muscle.

Anatomy and Physiology of Calf Strain

The muscles of the calf include the gastrocnemius, plantaris and soleus, known as the triceps surae. These muscles attach to the foot through the Achilles tendon. The popliteal foassa at the back of the knee is formed inferiorly by the bellies of gastrocnemius and platnaris, laterally by the tendon of biceps femoris, and medially by the tendons of semimembranosus and semitendinous. The calf muscles are responsible for extending the foot, and rising up on the toes. When taking off or changing direction, the calf muscle must contract forcefully. This contraction can cause tearing of the muscle at the attachment of the tendon. An eccentric contraction, a contraction while the muscle stretches, such as when landing from a jump, can also cause a tear if the muscle is fatigued or not strong enough to handle it.

Cause of Calf Strain

Forceful contraction of gastrocnemius or soleus muscle. Forceful eccentric contraction. Improper foot position when pushing off or landing.

Signs and Symptoms of Calf Strain

Pain in the calf muscle, usually mid-calf. Pain when standing on tiptoes, and sometimes pain when bending the knee. Swelling or bruising in the calf.

Complications If Left Calf Strain Unattended

Any strain left unattended can lead to a complete rupture. The calf muscle is used when standing and walking, so the pain could become disabling. A limp or change in gait due to this injury could lead to injury in other areas.

Immediate Treatment of Calf Strain

R.I.C.E. Anti-inflammatory medication. Then Shockwave Therapy to promote blood flow and healing.

Rehabilitation and Prevention of Calf Strain

As the pain subsides, a program of light stretching may help facilitate healing. When the pain has subsided, strengthening and stretching will help to prevent future injury. Proper warm-up before activities will help protect the muscle from tears. Strong flexible muscles resist strains better and recover more quickly.

Long-term Prognosis for Calf Strain

Muscle strains, when treated properly with rest and therapy, seldom have any lingering effects. In very rare cases where the muscle detaches completely, surgery may be required to re-attach the muscle.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to see our orthopaedic specialist to Treat Calf Strain Today.

Brief Outline of Shin Splints

Shin splints are a common complaint of runners and other athletes who have just taken up running. Shin splints are actually a term used to cover all pain in the anterior shin area. There are several possible causes. Medial tibial pain syndrome, the most common cause of shin pain, refers to pain felt over the shin bone from irritation of the tendons that cover the shin and their attachment to the bones. Changes in duration, frequency or intensity of running can lead to this condition.

Anatomy and Physiology for Shin Splints

Shin Splints

The tibialis anterior muscle originates from the lateral condyle of the tibia, and inserts into the medial and plantar surfaces of the medial cunneiform bone. Tibialis anterior is responsible for dorsiflexing and inverting the foot and is used frequently during running to toe up with each step. When the muscle and tendon becomes inflamed and irritated through overuse or improper form, it will cause pain in the front of the shin. Repetitive pounding on the lower leg, such as with running, can also lead to pain in the shin.

Cause of Shin Splints

Repetitive stress on the tibialis anterior muscle leading to inflammation. Repetitive pounding force on the tibia, as with running and jumping.

Signs and Symptoms of Shin Splints

Dull, aching pain over the inside of the tibia. Pain is worse with activity. Tenderness over the inner side of the tibia with possible slight swelling.

Complications If Left Shin Splints Unattended

If left shin splints unattended, shin splints can cause extreme pain and cause cessation of running activities. The inflammation can lead to other injuries, including compartment syndrome.

Immediate Treatment for Shin Splints

R.I.C.E. Anti-inflammatory medication. Then shockwave therapy to promote blood flow and healing.

Rehabilitation and Prevention of Shin Splints

It is important to use low impact activities, such as swimming or cycling, to maintain conditioning levels while recovering. Stretching of the tibialis anterior muscle will help with recovery. To prevent this condition from developing, try alternating high impact activity days with lower impact days. It is also important to strengthen the muscles of the lower leg to help absorb the shock of impact activities.

Long-term Prognosis for Shin Splints

Medial tibial pain syndrome can be effectively treated with no long-term effects. Only in rare cases does the condition fail to respond to rest and rehabilitation, leading to chronic inflammation and pain. Surgery may be required to those rare cases.

Call (+65) 6471 2674 (24 Hour) to fix an appointment to see our orthopaedic specialist and treat your shin splints today.

Brief Outline of Stress Fracture to Lower Leg

Repetitive impact activities, such as running and jumping, can cause small cracks in the bone called stress fractures. These most often occur in the weight bearing bone, the tibia, of the lower leg. Athletes with lower bone density, due to dietary issues or genetic predisposition, are more susceptible, as are athletes who train on hard surfaces at increased distance and duration. Women are more susceptible to this injury than men due to bone density deficiency  conditions such as irregular or absent menstral cycles, eating disorders or osteoporosis.

Anatomy and Physiology of Stress Fracture of Lower Leg

The tibia (shin bone) is the larger and more medial of the bones in the lower leg. At the proximal end, the medial and lateral condyles articulate with the distal end of the femur to form the knee joint. The tibial tuberosity is a roughened area on the anterior surface of the tibia. The tibia is the weight bearing bone of the lower leg and therefore takes a large amount of the force of the impact during running and jumping activities. This force is transferred up the length of the bone. Bones are constantly repairing and rebuilding, leading to the robbing of calcium from one area of the bone to build another, causing a weak area. When the impact is transferred up the shaft and encounters a weak area, due to either calcium deficiency or a prior stress fracture, the bone will crack slightly. Overtime, this leads to a more serious crack or fracture. Fatigued muscles also contribute to the possibility of stress fractures. The muscles are meant to take some of the shock away from the bones but a fatigued muscle is a poor shock absorber.

Cause of Stress Fracture to the Lower Leg

Repetitive stress on the bone through impact activities such as running or jumping. Low bone density. Muscle fatigue leading to lower shock absorption by the muscles.

Signs and Symptoms to the Lower Leg

Pain with weight bearing, worsens with activity and diminishes with rest. Pain is most severe at the early stage of activity  subsiding in the middle and returning at the end. Point tenderness and some swelling possible.

Complications if Left Lower Leg Stress Fracture Unattended

If left unattended, a stress fracture can become a complete fracture and lead to complications such as bleeding and nerve compromise. The pain from an untreated stress fracture may lead to a complete cessation of activity and further injury to surrounding tissues.

Immediate Treatment to Lower Leg Stress Fracture

R.I.C.E.R. Anti-inflammatory medication. If any instability is noted in the lower leg, or inability to bear weight, our orthopaedic specialist professional can help you.

Clinic Treatment to Lower Leg Stress Fracture

Rehabilitation and Prevention of Stress Fracture to Lower Leg

During the recovery phase, it is important to maintain fitness levels by using low or non-impact activities such as swimming or biking. Strengthening the muscles of the lower leg will help add extra shock absorption. Warming-up properly and using cross training techniques to limit the impact of the bone will help prevent stress fractures.

Long-term Prognosis to Lower Leg Stress Fracture

Stress fractures generally heal completely with rest. Returning to activity too soon may cause a recurrence. Very rarely surgical intervention may be needed to strengthen the bone at the fracture site.

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Brief Outline of Peroneal Tendinitis

The peroneal tendon is involved in stabilising the foot and providing support to the ankle to prevent lateral rolling of the joint. When the foot pronates it causes the tendon to stretch leading to pain and inflammation. The tendon has to work harder to stabilise the foot during pronation. Runners who have excessive pronation often develop this condition.

Anatomy and Physiology Peroneal Tendinitis

The tendons of peroneus longus and peroneus brevis run from the peroneal muscles to the foot. They pass around the lateral malleolus (the bony prominence on the outside of the ankle) and attach just behind the big toe. These tendons, along with the peroneal muscles, help to stabilise the foot and assist the calf muscles to extend the foot. When the foot pronates causing the tendons to stretch, it puts extra stress on the tendons, leading to pain and inflammation. Running and jumping cause repetitive flexing of the peroneal muscles and can lead to inflammation of the tendons, especially with excessive pronation.

Cause of Peroneal Tendinitis

Over-pronation of the foot during running or jumping. Prior ankle injury leading to an incorrect path of travel for the tendons.

Signs and Symptoms of Peroneal Tendinitis

Pain and tenderness along the tendons. Pain is most severe at the beginning of the activity and diminishes as the activity continues. Gradual increase in pain overtime.

Complication If Left Peroneal Tendinitis Unattended

Unattended tendinitis can lead to a complete rupture of the tendons. Peroneal tendinitis can lead to subluxations. The chronic inflammation can also lead to damage to the ligaments surrounding the tendons.

Our Treatment for Peroneal Tendinitis

Anti-inflammatory injection. Shockwave therapy.

Long-term Prognosis for Peroneal Tendinitis

With proper treatment, peroneal tendinitis will usually heal completely with no lingering effects. In rare cases, the tendinitis may not respond to traditional treatment and may require surgical intervention to relive the pressure causing the inflammation.

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