Leg

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Fractures (Broken Bones)

Fractures may involve the outside or inside of the leg. The signs and symptoms of fractures are pain, swelling and bony deformities. X-rays are essential and rapid “reduction” (setting the bones close together for healing) is necessary. In extreme cases, open surgery is necessary to reduce the fracture. Often pins, plates and screws are used to maintain the reduction.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Improve Balance
  • Improve Function
  • Improve Muscle Strength and Power
  • Decrease Nerve Compression
  • Increase Oxygen to Tissues
  • Improve Range of Motion
  • Improve Safety
  • Self-care of Symptoms
  • Improve Wound Healing

Stress Fractures

These fractures result from repetitive submaximal loads applied to the foot, ankle, leg; they are usually the result of overuse (in athletes, over-training). They are common in long distance runners and female athletes.

Common stress fracture sites include the lower leg (in runners), calcaneus, talus, metatarsals in distance runners, and the big toe.

Pain and point tenderness, often relieved by rest, is typical. X-rays do not always show the fracture. Bone scans and MRI may be useful.

Most heal with rest, immobilization and cross training. Avoid high-impact workouts, and wear good shoes.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Function
  • Improve Muscle Strength and Power
  • Increase Oxygen to Tissues
  • Improve Safety
  • Self-care of Symptoms
  • Improve Tolerance for Prolonged Activities

Gastrocnemius/Calf Muscle Strain

This injury is commonly the result of quick sprints while running. With a muscle strain, there is localized tenderness or a “bulge” more commonly at the inner region of the back of the leg. The pain is aggravated by walking, descending stairs, or raising the heel of the affected leg off the ground.

Possible Treatments

  • Aerobic/Endurance Exercise
  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Gait or Walking Training
  • Isotonics
  • Ankle Active Range of Motion
  • Ankle Joint Mobilization
  • Ankle Passive Range of Motion
  • Ankle Resistive Range of Motion
  • Ice Massage
  • Stationary Cycling
  • Proprioception Exercises
  • Soft Tissue Mobilization
  • Ultrasound
  • Stretching/Flexibility Exercise

Possible Treatment Goals

  • Improve Balance
  • Improve ability to bear weight/stand on the leg(s)
  • Decrease Risk of Reoccurrence
  • Improve Function
  • Improve Muscle Strength and Power
  • Improve Proprioception
  • Improve Range of Motion
  • Improve Tolerance for Prolonged Activities
  • Fractures (Broken Bones)

    Fractures may involve the outside or inside of the leg. The signs and symptoms of fractures are pain, swelling and bony deformities. X-rays are essential and rapid “reduction” (setting the bones close together for healing) is necessary. In extreme cases, open surgery is necessary to reduce the fracture. Often pins, plates and screws are used to maintain the reduction.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Balance
    • Improve Function
    • Improve Muscle Strength and Power
    • Decrease Nerve Compression
    • Increase Oxygen to Tissues
    • Improve Range of Motion
    • Improve Safety
    • Self-care of Symptoms
    • Improve Wound Healing
  • Stress Fractures

    These fractures result from repetitive submaximal loads applied to the foot, ankle, leg; they are usually the result of overuse (in athletes, over-training). They are common in long distance runners and female athletes.

    Common stress fracture sites include the lower leg (in runners), calcaneus, talus, metatarsals in distance runners, and the big toe.

    Pain and point tenderness, often relieved by rest, is typical. X-rays do not always show the fracture. Bone scans and MRI may be useful.

    Most heal with rest, immobilization and cross training. Avoid high-impact workouts, and wear good shoes.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Function
    • Improve Muscle Strength and Power
    • Increase Oxygen to Tissues
    • Improve Safety
    • Self-care of Symptoms
    • Improve Tolerance for Prolonged Activities

    Resources

  • Gastrocnemius/Calf Muscle Strain

    This injury is commonly the result of quick sprints while running. With a muscle strain, there is localized tenderness or a “bulge” more commonly at the inner region of the back of the leg. The pain is aggravated by walking, descending stairs, or raising the heel of the affected leg off the ground.

    Treatments

    Aerobic/Endurance Exercise

    Stationary cycling is usually prescribed for improving the strength and/or range of motion of the hips, knees, ankles as well as cardio-vascular endurance.

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Gait or Walking Training

    The analysis of walking problems by visually examining the interaction of the low back and the joints of the thighs, legs, and feet during the various stages of walking, including, initial contact, loading response, mid stance, terminal stance, pre swing, mid swing, and terminal swing. Many back, thigh, leg, ankle, and foot problems may be caused by or manifest themselves in subtle gait abnormalities.

    Isotonics
    Ankle Active Range of Motion
    Ankle Joint Mobilization
    Ankle Passive Range of Motion
    Ankle Resistive Range of Motion
    Ice Massage
    Stationary Cycling

    Aerobic Exercise – The American College of Sports Medicine (ACSM) defines aerobic exercise as “any activity that uses large muscle groups, can be maintained continuously, and is rhythmic in nature.” Aerobic means in the presence of oxygen. In other words, your body is burning its fuel (glucose) in the presence of oxygen. It is performed at less than 85% of your maximum heart rate. An aerobically fit individual can work longer, more vigorously and achieve a quicker recovery at the end of the aerobic session. Jogging, cycling, swimming, aerobics classes, and rowing are examples of aerobic exercise.

    Proprioception Exercises

    Proprioception is the body’s ability to sense where it is in space. For example, close your eyes and touch your nose. How were you able to move your finger to your nose without seeing it? Proprioception exercises are used to help retrain your sensory system after the nerves have been damaged during a musculoskeletal injury. Your body uses its sensory system in the joints and muscles to know how they are moving. Balance and coordination both depend on your body’s proprioceptive skills.

    Soft Tissue Mobilization

    Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

    Ultrasound
    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Goals

    • Improve Balance
    • Improve ability to bear weight/stand on the leg(s)
    • Decrease Risk of Reoccurrence
    • Improve Function
    • Improve Muscle Strength and Power
    • Improve Proprioception
    • Improve Range of Motion
    • Improve Tolerance for Prolonged Activities

    Resources