Lower Leg Pain?
Lower leg injuries are most common in running athletes that train either too hard, too long and/or too ‘in’-frequently based on previous levels. Most, if not all of these injuries, can be prevented by proper running technique and appropriate sport-specific, tissue- specific adaptation. Here is a brief outline of conditions to watch for….
- Calf muscle Strain/Tear Calf-strain injuries are the most common muscle injury in endurance runners especially those trying to improve speed and performance. They involve tearing of the muscle fibers and fascia in the back of the lower leg, resulting in calf pain that can range from mild to severe, depending on the extent of tearing and the amount of fibers affected. This injury usually occurs from high speed movements like sprinting, hill training or jumping. Often runners changing running style from heel-striking to forefoot-landing rush the process and end up causing undue stress and damage. Calf muscles require adequate adaptation time. This injury is absolutely avoidable with proper training.
- Achilles Tendinopathy (Tendonitis) The Achilles tendon connects the calf to the heel and is the strongest tendon in the body, capable of withstanding impressive tensile loads. Unfortunately, it is also the most frequently injured tendon in short- and long-distance runners. This tendon can become inflamed (tendinitis) when over-stressed by speed, hills and jump- training. The pain tends to be worse in the morning or after long stretches of sitting. If pain persists for more than a few weeks, this inflammation can lead to the development of a scar tissue nodule (tendinosis) which may remain tender and vulnerable for months.
- Shin Splints (Medial tibial stress syndrome – MTSS) The condition known as ‘Shin splints’ is characterized by pain along the inner part of the shinbone (tibia). It is almost entirely an overuse, repetitive strain injury developing when the muscle, fascia and bone tissue are overloaded from repetitive activity, and usually occurs with increases in duration or intensity of training. Shin splints are especially present in runners who heel strike as beginners or start to increase their training distances for longer events. Often it is falsely assumed that this injury indicates a need for new shoes. More appropriate management starts with proper running form.
- Tibialis Anterior Tensonovitis The tibialis anterior is a small muscle found along the front of the shin connecting to the foot and controlling the ankle. The tibialis anterior helps prevent your foot from slapping the ground when it first makes contact during the gait cycle. It also helps lift the foot at the ankle, which is important for clearing the ground during the swing phase of walking/running. Tibialis anterior tenosynovitis is characterized by pain in the front of the ankle and leg. This condition is very common among trail runners, as extended runs including steeper downhill sections with heel striking cause severe overload.
- Anterior Compartment Syndrome ‘Compartment Syndrome’ occurs when pressure builds up within an enclosed muscle space as the result of bleeding or various other forms of swelling. It is often characterized by tightness, pressure and/or compression sensations in the shins. When the muscles at the front of the leg are working hard, the pressure increases within the sheath surrounding the muscles. In some runners, the pressure becomes high enough to cause pain. The pressure may also compress nerves that run along the compartment, and cause numbness in the foot. This condition is typically found in runners who have a genetic capacity to develop muscle size quickly and are usually landing on their heels. Initial onset may also be triggered by the combination of increased biking and running.
- Tibial Stress Fracture A tibial stress fracture is a hairline fracture in the tibia (larger lower leg bone) which usually results from overtraining or untreated shin splints. Often the symptoms are very similar to shin splints but the pain may be more localized and swelling can be observed. Stress fractures are actually tiny cracks in bone (i.e. microfractures), and as such are often not immediately visible on X-rays. Imaging done several weeks after injury-initiation may be more clearly confirming. Due to the boney nature of the damage, recovery requires greater protection of the area than other conditions.
For rapid recovery of these Leg Injuries appropriate progressions through the phases of healing are essential after which a return to performance is possible. However, only once the underlying causes of damage are established can the runner really run happily, pain-free. Please contact our clinic for foundational rehabilitation and further running success!
