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Sports Injuries/Lower Limb Conditions
Sports Injuries/Lower Limb Conditions
Knee Pain/ Injuries
Various injuries of the knee are seen, including:
Cartilage (Meniscal) Injuries
The two menisci sit within the joint of the knee and act as shock absorbers. The cartilage is most often damaged when the foot is on the ground, the knee is bent and the knee is then twisted. The most common symptoms of a meniscal injury are knee pain and swelling, often accompanied with a restriction of movement and clicking or locking of the knee joint.
Cruciate Ligament Injuries
The anterior and posterior cruciate ligaments are two ligaments on the inside of the knee joint which are responsible for stability in the joint. Although both can be injured it is the anterior cruciate ligament (ACL) which is most commonly injured in sports. It is usually injured during pivoting movements. There will usually be quite a lot of pain and swelling with an ACL injury and the knee may “give way” or feel very unstable.
Patellofemoral Pain
This involves irritation of the cartilage on the undersurface of the kneecap. Normally the kneecap glides smoothly on the thigh bone or femur, however, often due to muscle imbalances around the hip and knee there may be more pressure under certain parts of the kneecap and the cartilage gets irritated in these areas thereby causing pain. The main symptoms of patellofemoral pain are pain around the kneecap, which may be aggravated by running.
Ankle Injuries
Ankle sprains are one of the most common sporting injuries. There are two main types of ankle sprains:
1. Inversion sprain: This involves the foot twisting inwards so that the ligaments on the outside or lateral aspect of the ankle are overstretched. Approximately 90% of ankle sprains are inversion injuries.
2. Eversion sprain: This involves the foot twisting outwards causing the deltoid ligament on the inside of the ankle to be overstretched.
Ankle sprains are graded 1-3 according to severity of the injury:
Grade 1 - ligament stretched, pain and some swelling over the area and on running/jumping
Grade 2 - some tearing of the ligament fibres. There will often be significant pain swelling and often bruising and it will be painful to walk on the foot.
Grade 3 - complete tear of the ligament. The ankle will be very painful and it will be extremely painful to walk on the foot. There may also be a feeling of weakness or instability in the ankle.
If a fracture is suspected, it is necessary to have an x-ray.
After initial RICE ( Rest Ice Compression Elevation) protocol is followed, Treatment will initially focus on limiting pain and swelling in the ankle.
Manual therapy is used to restore full range of motion to the ankle joint. A rehabilitation programme will include stretching exercises to improve the flexibility of the calf muscles, strengthening exercises and proprioceptive or balance exercises to improve the control of the ankle joint.
Achilles injuries
Achilles tendinitis is caused by repetitive or intense strain on the Achilles tendon, the band of tissue that connects your calf muscles to your heel bone. This tendon is used when you walk, run, jump or push up on your toes.
The structure of the Achilles tendon weakens with age, which can make it more susceptible to injury — particularly in people who may participate in sports only on the weekends or who have suddenly increased the intensity of their running programs.
More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.
Treatment can include stretches to the calf muscle along with strengthening of the muscles. Advice on adequate footwear with support and/or fitting of orthotics. Graded exercise and activity during rehabilitation.