Common Injuries and Conditions - A&LL PDF

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Common Injuries and Conditions ANKLE AND LOWER LIMB Exertional Compartment Syndrome An increase of pressure in a lower limb compartment, leading to pain

 Sudden onset of muscle hypertrophy can lead to the fascia surrounding the muscle becoming stretched as it is unable to expand at the same rate as the muscle fibres  It’s an overuse injury, and is also caused from muscle hypertrophy, during exertion  Exercise-induced muscle and nerve condition that causes pain and swelling in the affected muscles of your legs or arms. Anyone can develop the condition, but its more common in athletes who participate in activities that involve repetitive impact, such as running  Common muscles affected: tibialis anterior and posterior Common Causes  Sudden increase of training intensity, frequently involving jumping or running on a hard surface  Longer stride length and over-striding are significant causative factors (Roberts et al 2017)

 Age is a factor – Males and Females under the age of 30 are at higher risk of developing ECS  Overtraining – training too intensely or too frequently. • Type of exercise – repeated impact activity ie, running Signs and Symptoms  Increasing pain when active, until the athlete has to stop  Achy, burning, crampy pain  Weakness to muscle on active and resisted movements  A sensation of numbness to affected muscle may be experienced  Occasionally, local swelling is visible to the affected muscle • The affected muscle will feel ‘tight’  No pain at rest Treatment and Post Care Advice Treatment Apply appropriate soft tissue mobilisation techniques to the affected muscle; CTM and STR in order to increase fascial mobility Post care advice

 Stretch and mobilise the affected muscle, targeting the fascia. Use Self myofascial release over stretching as the key is to promote fascial mobility. For example, demonstrate how to foam roll the affected muscle.  Apply heat to the area before a long training session and ice post  Analyse running surfaces, training load and technique  Avoid wearing compression tights/socks/leggings as these will create further pressure to the muscle compartment. Medial Tibial Stress Syndrome – MTSS Referred to as shin splints. Inflammation of muscle attachments along the periosteum around the tibia.

 Occurs commonly on medial border of tibia

Common Causes  Over pronation/supination  A change of training surface, trainers, techniques  Intensive training on hard surfaces  Impact to the medial border  Poor biomechanics  Fatigue in posterior lower leg muscles, causing over load on the tibia Signs and Symptoms  Tenderness and lumps on palpation along the medial tibial border, more pronounced on the lower half of the bone  Diffuse pain along the border on activity, but no pain at rest  Pain decreases as the athlete warms up  Pain increases after exercise or is worse in the morning Treatment

 Address TrPs in the calf complex as these could be contributing to the early fatigue in the muscles  METs to the calf complex to increase dorsiflexion  Taping techniques may help offload the periosteum Post Care Advice  Advise athlete to ensure a proper warm up is completed  Address technique, footwear and training surface and alter if necessary  Rest and ice  Only commence training once pain has abated  Maintain CV endurance through cycling and swimming  Heat therapy once inflammation has dispersed If MTSS is poorly managed, it can lead to stress fractures.

Achilles Tendon A general term for tendon damage involving overuse, micro tears and collagen degeneration, resulting in pain and weakness. The largest tendon in the body which is able to sustain up to 17 times our body weight. Common Causes  Degeneration of the tendon is caused through overload of the tissue  Muscle weakness relative to the load being placed on it, overloads the tendon, causing it to become reactive (painful)

Cook and Purden Model of Tendinopathy

Intrinsic Factors  Changes in training load  Training errors  Recent lower limb injury  Reduced dorsiflexion

 Over pronation  Age Signs and Symptoms  Gradual swelling/thickening to the achilles tendon – mostly seen in lower 5cms  Sitffness first thing in the morning and often after activity  Tenderness on palpation of tendon  Increasing pain when loading the tendon – when running  Pin gradually becomes more frequent  Tightness to calf Treatment  Soft tissue work doesn’t have a role within tendinopathies. However it can help restore balances up the kinetic chain if movement patterns have been altered  If the calf complex is tight on assessment, the apply ischemic pressure for TrPs, STR and METs. These will all help to reduce the tension (avoid massage on the tendon) Ankle Sprain Over stretching to either the lateral or medial ligaments of the ankle. Common Causes  Inversion sprain is one of the most common – damaging ATFL and CFL  Lateral ligament sprain – landed on inversion position  Eversion sprain leads to deltoid ligaments damaged  Medial ligament sprain – everted foot (rare) Signs and Symptoms

 Pain when weight baring  Swelling and tenderness on palpation of malleolus  Bruising/skin discolouration  Instability at the joint – varies on grade of sprain  Joint laxity in accordance to grade Treatment  Immediate PRICE protocol  Effleurage proximal of the area  Gentle frictions in the proliferation stage  Taping and strapping Post Care Advice  Early mobility to increase strength and restore function  Weight baring asap  Proprioception work is paramount Plantar Fasciopathy Degeneration of the plantar fascia on the base of the foot, stretching from the plantar surface of calcaneus to metatarsal heads Common Causes  Achilles tendon injuries  Reduced dorsiflexion and hallux extension  Poor hallux and everter strength  Common in repeated jumping and running  Poor ligament sprain rehab

 Reduced hamstring strength  Changes in load such as surface, footwear, etc Signs and Symptoms  Painful to walk and stiff in the morning  Pain is local to calcaneus  ‘Stepping on a stone’  Disappears with activity  Tenderness on palpation on plantar surface of calcaneus Treatment  Ischemic pressure for TrPs and METs increase dorsiflexion  Taping Post Care Advice  Ice  Avoid pounding activities  Isometric toe flexor and plantar flexor exercises  Change shoes  Grip floor with toes...