Leg Pain & Injury
Article by John Miller
Areas of Leg Pain
Leg pain and injury are widespread. Most leg pain can occur as a result of sports injuries, work injuries or simply everyday use. Alternatively, leg pain can be referred from your lower back joints. Sciatica is a well-known source of referred leg pain. Leg pain can also be caused by blood clots (DVT’s), varicose veins or poor circulation.
How Do You Get Rid of Pain in the Leg?
It is important to make an accurate diagnosis of the cause of your leg pain or injury so that appropriate treatment can be directed at the cause. Your physiotherapist optimally treats musculoskeletal and sports injuries. If surgery is required, your doctor or physiotherapist may recommend that you seek the advice of an orthopaedic surgeon.
Referred pain from your lower back (e.g. sciatica) is also successfully treated by your trusted spinal healthcare practitioner, e.g. physiotherapist. A spinal surgeon assessment may be required to resolve your leg pain in a small percentage of patients.
Blood clots and vascular disorders may require the care of your doctor or a vascular surgeon. Untreated blood clots and DVT’s can have serious adverse health outcomes, including strokes or death. Prompt medical attention is strongly recommended.
Please do not delay consulting your doctor or physiotherapist if you experience leg pain. Some leg conditions can take many months or even years to heal when the diagnosis is incorrect, or treatment is neglected early.
Common Causes of Leg Pain
By Structure
- Joint (Arthritis)
- Bursa (Bursitis)
- Ligament
- Muscle
- Tendon (Tendinopathy-Tendinitis-Tendinosis)
Common Ankle Injuries
Sprained Ankles
The most common ankle injury is a sprained ankle, but ankle pain can have numerous sources.
Ankle Fractures
An ankle fracture occurs when there is a break in one or more of the bones. The most common ankle fractures are avulsion fractures of your distal fibula, which can be a side effect of an ankle sprain. All suspected fractures require medical investigation and professional management by your health professional to avoid long-term foot and ankle issues. If your healthcare professional suspects an ankle fracture, you will be referred for at least an X-ray and potentially an Orthopaedic Surgeon.
- Ankle Fracture (Broken Ankle)
- Stress Fracture
- Stress Fracture Feet
- Severs Disease
- Heel Spur
- Shin Splints
Ankle Tendinopathies
While muscle strains are more common in your legs, there are essential muscles that converge into tendons that wrap around your ankle to stabilise your ankle and foot to protect them from sprains and allow you to walk and run. These muscles and their tendon vitally provide you with a normal foot arch and avoid flat feet. Your muscles or tendons can become injured or inflamed as a result of overuse or trauma. The inflammation is called tendonitis. They can also tear, completely rupture, or sublux out of place. Medically tendon injuries are known as tendinopathies, and at the ankle may include:
- Achilles Tendinopathy
- Achilles Tendon Rupture
- Peroneal Tendinopathy
- Tibialis Posterior Tendinopathy
- FHL Tendinopathy
- Plantar Fasciitis
Ankle Arthritis
Your ankle pain and dysfunction can lead to degenerative conditions such as ankle osteoarthritis. While arthritis usually is a chronic deterioration of your ankle joint, it is crucial to slow ankle arthritis progression. Please seek the professional advice of your ankle and foot health practitioner, e.g. physiotherapist or podiatrist.
Biomechanical Conditions
Biomechanical disorders may result in foot deformation, painful weight-bearing and potentially nerve compression. In simple terms, this is where your foot and ankle do not have normal bone alignment and motion contr. Here are a few possible conditions related to poor ankle biomechanics.
- Anterior Ankle Impingement (Front of Ankle Pain)
- Posterior Ankle Impingement (Back of Ankle Pain)
- Pes Planus (Flat Feet)
- Tarsal Tunnel Syndrome
Muscle Injuries
Nerve-Related Ankle Pain
Children & Youth Conditions
Systemic Conditions that may cause Ankle Pain
Soft Tissue Inflammation
Other Useful Information
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What Can Cause Pain In Your Calf Muscle?
The most common sources of leg pain include calf muscle strain (torn calf), Achilles tendinopathy and leg cramps.
Other sources of calf pain can include the following:
Calf Muscle Strain
Other Muscular Conditions
Achilles Injuries
- Achilles Tendinopathy - (tendinitis/tendonitis)
- Achilles Tendon Rupture
- Retrocalcaneal Bursitis
Shin Pain
Systemic Conditions
Neurological Conditions
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Common Causes - Knee Pain
Knee pain can have many origins from local injury, referred pain, biomechanical issues and systemic issues. While knee pain can appear simple to the untrained eye, a thorough assessment is often required to ascertain the origin of your symptoms. The good news is that once a definitive diagnosis is determined, most knee pain quickly resolves with the correct treatment and rehabilitation.
Knee Ligament Injuries
- Knee Ligament Injuries
- ACL Injury
- PCL Injury
- MCL Sprain
- LCL Sprain
- Posterolateral Corner Injury
- Superior Tibiofibular Joint Sprain
Knee Meniscus Injuries
Kneecap Pain
- Chondromalacia Patella
- Fat Pad Syndrome
- Patella Dislocation
- Patellofemoral Pain Syndrome
- Osgood Schlatter’s Disease
- Sinding Larsen Johansson Syndrome
Knee Arthritis
Knee Tendon Injuries
Muscle Injuries
- Corked Thigh
- Thigh Muscle Strain
- Hamstring Strain
- ITB Syndrome
- Popliteus Syndrome
- Muscle Strain (Muscle Pain)
- Cramps
- DOMS – Delayed Onset Muscle Soreness
Knee Bursitis
Children’s Knee Conditions
Other Knee-Related Conditions
- Runner’s Knee
- Plica Syndrome
- Fibromyalgia
- Stress Fracture
- Overuse Injuries
- Restless Legs Syndrome
- Sciatica
Knee Surgery
For specific information regarding your knee pain, please seek the assistance of a healthcare professional with a particular interest in knee condition, such as your physiotherapist.
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Thigh Injuries
Muscle Injuries
- Corked Thigh
- Thigh Strain
- Hamstring Strain
- ITB Syndrome
- Muscle Strain (Muscle Pain)
- Cramps
- DOMS - Delayed Onset Muscle Soreness
Other Knee-Related Conditions
Tendinopathies
Referred Pain
Article by John Miller
Common Youth Leg Injuries
Why are Children's Injuries Different to Adults?
Adolescent injuries differ from adult injuries, mainly because the bones are still growing. The growth plates (physis) are cartilaginous (strong connective tissue) areas of the bones from which the bones elongate or enlarge. Repetitive stress or sudden large forces can cause injury to these areas.
Common Adolescent Leg Injuries
In the adolescent leg, common injuries include:
Osgood-Schlatter's Disease
Pain at the bump just below the knee cap (tibia tubercle). Overuse injuries commonly occur here. The tibia tubercle is the anchor point of your mighty quadriceps (thigh) muscles. Because of excessive participation in running and jumping sports, the tendon pulls bone off and forms a painful lump that will remain forever. This type of injury responds to reduced activity and physiotherapy.
More info: Osgood Schlatter's Disease
Sinding-Larsen-Johansson Disease
Pain at the lower pole of the knee cap (patella). Overstraining causes Sinding-Larsen-Johansson disease. Because of excessive participation in running and jumping sports, the tendon pulls bone off the knee cap. This type of injury responds to reduced activity and physiotherapy.
More info: Sinding Larsen Johansson Syndrome
Anterior Knee Pain
Anterior knee pain or patellofemoral syndrome frequently gets passed off as growing pains. Cause of this pain includes overuse, muscle imbalance, poor flexibility, poor alignment, or more commonly, a combination of these. Anterior knee pain is one of the most challenging adolescent knee injuries to sort out and treat. Accurate diagnosis and treatment with the assistance of a physiotherapist with a particular interest in this problem usually resolves the condition quickly.
More info: Patellofemoral Pain Syndrome
Knee Ligaments
The cartilage between the leg bones have a better blood supply and are more elastic in adolescents than in adults. As adolescents near the end of bone growth, their injuries become more adult-like. Hence more meniscal and ACL (anterior cruciate ligament) injuries are likely. MCL (medial collateral ligament) injuries result from a lateral blow to the knee. Pain felt on the inner side (medially) of the knee. MCL injuries respond well to protective bracing and conservative treatment.
More info: Knee Ligament Injuries
ACL (anterior cruciate ligament) injuries
This traumatic knee injury is significant. Non-contact injuries of the ACL are becoming more common than contact injuries of the ACL. Adolescent females are at high risk. Combination injuries with MCL or menisci are common. Surgical reconstruction is needed if the adolescent wishes to continue participating in "stop-and-start" sports.
More info: ACL Injury
Meniscal injuries
Your meniscus is crescent-shaped cartilage between the thigh bone (femur) and lower leg bone (tibia). Meniscal injuries usually result from twisting. Swelling, catching, and locking of the knee are common. If physiotherapy treatment does not resolve these damages within six weeks, they may require arthroscopic surgery.
More info: Meniscus Tear, Discoid Meniscus
Sever's Disease
Heel pain is commonplace in young adolescents due to the stresses of their Achilles tendon pulling upon its bony insertion point on the heel (calcaneum). It is a common overuse injury due to excessive volume of training and competition, particularly when loads are increased dramatically in a short period. Diminished flexibility and muscle-tendon strength mismatching may predispose you. Physiotherapy, reduced activity, taping and orthotics are the best ways to manage this debilitating condition for the active young athlete.
More info: Sever's Disease
Ankle Sprain
An ankle sprain is probably the most common injury seen in sports. Ankles sprains involve stretching of the ligaments and usually occur when the foot twists inward. Treatment includes active rest, ice, compression and physiotherapy rehabilitation. An ankle sprain usually improves in 2-6 weeks with the correct treatment. Your ankle physiotherapist should check even simple ankle sprains. A residually stiff ankle post-sprain can predispose you to several other lower limb issues.
More info: Sprained Ankle
Patellar Instability
Patellar (kneecap) instability can range from partial dislocation (subluxation) to dislocation with a fracture. Partial dislocation treatment is conservative. Dislocation with or without fracture is a much more severe injury and usually will require surgery.
More info: Patella Dislocation
Osteochondritis Dissecans
The separation of a piece of bone from its bed in the knee joint is Osteochondritis Dissecans (OCD). This injury is usually due to one major macro event with repetitive macro trauma that prevents complete healing. This injury is potentially severe. Treatment varies from rest to surgery. An Orthopaedic Surgeon's opinion is vital.
More info: Juvenile Osteochondritis Dissecans (JOCD)
Growth Plate Fractures
A fracture through the growth plate can be a severe injury that can stop the bone from growing correctly. These fractures should be treated by an Orthopaedic Surgeon, as some will require surgery.
Avulsion Fractures
Image source: https://radiologyassistant.nl/pediatrics/hip/hip-pathology-in-children
An avulsion fracture occurs when a small segment of bone attached to a tendon or ligament gets pulled away from the main bone. The hip, elbow and ankle are the most common locations for lower limb avulsion fractures in the young sportsperson.
Treatment of an avulsion fracture typically includes active rest, ice and protecting the affected area. This active rest period is followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. Your physiotherapist should supervise your post-avulsion exercises. Most avulsion fractures heal very well. You may need to spend a few weeks on crutches if you have an avulsion fracture around your hip. An avulsion fracture to your foot or ankle may require a cast or walking boot.
An excessive gap between the avulsed bone fragment and main bone may not rejoin naturally in rare cases. Surgery may be necessary to reunite them. In children, avulsion fractures that involve the growth plates also might require surgery. All avulsion fractures should be reviewed and managed by your trusted physiotherapist or an Orthopaedic Surgeon.
For more information regarding your youth sports injury, please consult your physiotherapist or doctor.
Youth Leg Injuries
Pelvis & Hip
Knee
- Osgood Schlatter's Disease
- Sinding Larsen Johannson Disease
- Patellofemoral Pain Syndrome
- Patella Dislocation
- Meniscus Tear
- Discoid Meniscus
- ACL
- Juvenile Osteochondritis Dissecans
