Runners in the Comrades Marathon, South Africa June 10, 2018. REUTERS/Rogan Ward
Lower leg pain often plagues runners. The trick is distinguishing pain from an acute injury, overuse, or an emergent problem. In today’s feature article, Pat Gilliam offers an overview of lower leg injuries and identifies the particular characteristics of each syndrome.
In most acute injuries, the athlete experiences a sudden onset of pain and disability, often accompanied with a tearing or popping sensation. Muscle and tendon tears are graded as to severity of injury either through clinical exam or magnetic resonance imaging (MRI) (see table 1). Up to 65% of all calf strains occur in the medial head of the gastrocnemius and over half of these extend into the soleus as well (see figure 1)(1). Strains to the gastrocnemius occur primarily during sprinting, jumping, hill training or changes in direction due to the preponderance of fast twitch fibers within the muscle. Soleus strains tend to happen during endurance events or overextended training schedules because the muscle consists mostly of slow twitch fibers.
Table 1: Grading system for calf injury
Pain during or after activity
ROM normal at 24hr
Normal power and initiation
Pain on contraction
Myofascial - injury in the peripheral aspect of the muscle
Pain during activity and restricts participation
Limitation with ROM
Pain on contraction
Reduced power on testing
Musculotendinous - Injury within the muscle belly most commonly at musculotendonous junction (MTJ)
Sudden onset of pain
Significantly reduced ROM
Pain on walking
Obvious weakness on testing
Intratendinous - An injury which extends into the tendon
In part one of this two-part article, Chris Mallac explored the anatomy, diagnosis and imaging options for meniscal root tears. In this article, he discusses the management options for meniscal root tear injuries. The management of meniscal root tears can be either nonoperative, partial meniscectomy or meniscal root repair: Non-surgical treatment Non-surgical treatment is usually reserved for... MORE
Meniscal tears are fairly run of the mill in athletic populations. However, as Chris Mallac explains in our continuing series on uncommon injuries, a tear near the root, or attachment of the meniscus, results in severe pain and disability. Root tears often accompany other knee injuries such as anterior or posterior cruciate ligament tears. Because... MORE
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Knee pain is the most common of all sports injuries and virtually every sport has its share of knee injuries and related problems. If you or your client has played sport for any sustained period of time, the chances are you've already experienced at least one bout of knee pain. Be it a temporary, mild nuisance you've shrugged off, or a debilitating injury that forced you to seek specialist help.
The good news for athletes, coaches and sports injury professionals, is that thanks to some important recent work in this area, sports scientists now know more than ever about the diagnosis, treatment and prevention of knee injuries.
And now you too can share in these insights, courtesy of this special report.
Drawing from the knowledge and experience of our panel of sports scientists, physiotherapists and sports therapists we have compiled a holistic, technical and hands-on approach to understanding, treating and managing running injuries.
The report covers prevention, physiology, core stability and technique, and includes case studies and illustrations throughout. It will stay with you as an invaluable reference point through your running career, and not only help you stay injury free but also increase your biomechanical efficiency for long term gains. MORE