Many of our clients run, and so we are well versed in the multitude of injuries that can happen to the lower limb in the active sportsperson.
There are a lot of ligaments, tendons and muscle that can be injured through biomechanical overuse or trauma.
Correct management of both acute and chronic sprains, tears and ruptures is crucial for short and long term successful return to exercise and sport.
Lateral Ankle Sprains
This injury is usually referred to as ‘someone rolling their ankle’. A very common injury seen in active people who partake in activities involving running or sport or directional movement.
There are a number of ligaments on the outside of the ankle which serve to limit the range of movement, however upon too much force or excessive rolling outward (inversion) movement the ligaments can tear.
Occasionally the patient may report a snap or pop upon injury.
Rehabilitation of this injury involves restoring range of movement, strengthening the surrounding muscles, increasing balance and proprioception and a safe return to functional sport/activity. When patients are reluctant to weight bear on the affected side, it is important that an X-ray is taken to clear the possibility of fracture.
Achilles Tendinitis and Rupture
Achilles injuries can present in several different forms. Injuries can be related to overuse and tissue changes (Achilles Tendinopathy) to more severe injuries such as Achilles rupture and tears.
Rupture can occur traumatically due to high force going through the tension beyond what it can withstand or, more commonly due to a spontaneous rupture from a progressive weakening of the tendon associated with chronic inflammation and overuse.
With tendinopathy patients may experience an ache or stiffness in the Achilles region that increases with rest following activities of stress. Alternatively, as the condition progresses pain may increase during activity.
Patients may also experience swelling, tenderness on firmly touching the Achilles tendon, weakness and sometimes palpable thickening of the affected tendon. Complete ruptures usually will go into a walker boot for up to 9 weeks, with sole large ruptures requiring surgery. We have an extensive 26 week rehab program for all Achilles ruptures for both surgical and non- surgical injuries.
Shin Splints and Tendinopathies
Shin splints, or more technically: “medial tibial stress syndrome” involves inflammation and tissue damage to connective tissue of the Tibalis posterior on the inside border of the shin bone.
There are a few causes that bring this condition on including: excessive pronation (rolling in of the feet), incorrect shoes, surface type, muscle dysfunction, muscle fatigue, reduced flexibility and poor biomechanics.
Soft tissue treatment is really helpful along with taping, program modification, change of running shoes and in many cases; custom orthotics to assist in poor biomechanics that cant be overcome with muscle strengthening.
Peroneal tendinopathy and tenosynovitis are often prevalent following ankle sprains or as part of the ankle injury.
Taping again here is very effective here coupled with soft tissue massage and strengthening work using balance boards, bands and load.
Calf Muscle Tears
The Gastronemius muscle is most common of the muscles to tear with sprinting or running, which almost every time has a muscle tightness, overload or overtraining problem as the cause of the tear.
The medial side is mostly affected, with tears largely at the Musculo-tendinous junction point rather than in the muscle belly. Tearing of the calf can range to a small partial tear where pain can be minimal to a complete grade 3 rupture.
Like all muscular strains and tears, there is a tissue healing timeframe to consider when planning return to exercise or running.
Alongside Physiotherapy treatment, dry needling and stretches, a carefully graded strengthening exercises is key in making sure adequate strength is restored before running or jumping load and endurance conditioning is added to the rehabilitation regime.
Plantar Fasciitis
Plantar fasciitis is the most common cause of heel pain seen by Physiotherapists. Patients typically experience pain underneath the heel and along the inner sole of the foot into the arch.
Symptoms are commonly reported at night or first thing in the morning upon weight bearing and then often improve during the day.
However, as the condition progresses pain may increase during activity, affecting performance. In severe cases pain is experienced both at rest and during activity, and subsequently may have trouble with running and walking.
It is important that you gain an assessment with a Physiotherapist if you experience these symptoms, as prognosis is improved if treatment is commenced sooner rather than later.
Like with Shin splints, the fitting of custom orthotics or met dome orthotic modifications maybe the end treatment result to help resolve the symptoms completely and allow full healing of the damaged tissue.
