What hurts?
Some possible conditions • Leg Pain – Anterior
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Stress Fracture -
Shin Splints -
Swelling
Some possible conditions • Leg Pain – Anterior
Stress fractures are common injuries that begin with repetitive and excessive stress on the bone. The most common location in the body for a stress fracture is in the tibia, the largest bone in the lower leg, followed by the foot bones. People who participate in repetitive, high-intensity training, such as athletes and military recruits, are at an increased risk of developing stress fractures. Runners who average more than 25 miles per week are also at increased risk of stress fractures, as well as those who participate in track and field, basketball, soccer, or dance. Additionally, women are at higher risk of stress fracture than men.
Pain is a common symptom. Specifically, pain with walking, running or other activity. If the tibia is involved, there would be pain with focal tenderness (when tibia is touched) and swelling at the site of injury. Also, people say that they cannot “hop” on the affected leg without severe pain.
Stress fractures are due to repetitive and excessive stress on the bone. This leads to the acceleration of normal bone remodeling, the production of microfractures and, eventually, a stress fracture or fine bone break. Risk factors include excessive physical activity with limited rest (running >25 miles/week for example), being a female, having osteoporosis, smoking, low levels of vitamin D or calcium, drinking >10 alcoholic drinks /week. Additionally, having faulty biomechanics, such as limited range of motion in an ankle or foot joint, can create a problematic gait cycle that predisposes you to a stress fracture.
Healing time for stress fractures can vary from 4 to 12 weeks or longer. Initial treatment should include reducing activity to the level of pain-free functioning. Treatment should begin as soon as the injury is suspected, because delayed treatment has been correlated with a prolonged return to activity. Daily supplements of calcium and vitamin D are often recommended, as are medications such as Tylenol or Advil. Rest, ice and elevation are all great treatment options. But ultimately, a long-term solution will include physiotherapy, and orthotics or a footwear modification or proper footwear to address any biomechanical concerns.
Shin splints, also known as medial tibial stress syndrome, is a frequent injury of the lower leg and one of the most common causes of exertional leg pain in active individuals. It is an overuse injury involving the shin area. Although often not serious, it can be quite disabling and progress to more serious complications if not treated properly. Often, it is caused by a number of factors and involves training errors and various biomechanical abnormalities.
The most common complaint of patients with shin splints is “diffuse pain” of the lower leg, along the lower 2/3 of the tibia bone, associated with activity. In the early course of the condition, pain is worse at the beginning of exercise and gradually subsides during training and within minutes of stopping of exercise. As the injury progresses, however, pain presents with less activity and may even occur at rest.
Sport training errors appear to be the most common factor involved in causing shin splints, especially as active individuals attempt to do “too much, too fast”. Running on hard or uneven surfaces, such as concrete or trails, is also a common risk factor. Those with prior lower leg injuries and who run more than 20 miles per week are especially at risk for overuse injuries, such as shin splints. It is most often found in runners, and also found in those who play football, basketball, soccer, and/or participate in dance. A biomechanical abnormality or gait disturbance can be the underlying cause and needs to be assessed by a lower limb clinician.
Rest and ice to the inflamed or tender area really helps to allow for healing and minimize discomfort. It may be difficult to step away from your sport but it’s necessary for 4-6 weeks. Also, over-the-counter medications that work well, are Advil/Tylenol to reduce inflammation and pain. You will need to verify if you can take these with your family doctor/nurse practitioner. Finally, where a biomechanical abnormality exists, assessment for orthotics and proper footwear is key. Our clinicians can also teach you to stretch and strengthen as well, to prevent future episodes.
Chronic (long standing) leg swelling caused by the retention of fluid in leg tissues is also known as peripheral edema. It can be caused by a problem with the venous circulation system, the lymphatic system or the kidneys. Any sudden onset leg swelling with or without injury is reason to seek immediate medical attention. This could be an infection, fractured bone, or blood clot.
Most often people with chronic leg swelling complain of feeling a heaviness in their swollen leg(s) and an achiness or sometimes, pain. It can make walking distances or activity uncomfortable or unachievable. There may some skin changes to your leg that might include skin discoloration, wound formation +/- drainage.
Medicines and pregnancy can cause leg swelling. It also can be the result of a disease, such as congestive heart failure, kidney disease, venous insufficiency, blood clot or cirrhosis of the liver. A primary care professional or vascular specialist can offer more details on what is causing your swelling.
Mild swelling can go away on its own. Wearing compression garments and raising the affected leg higher than the heart when lying down helps.
Graduated compression socks and medicines that help the body get rid of too much fluid can treat worse forms of edema. A primary care provider can decide about the need for these water pills. Compression socks work by pushing stagnant fluid in the legs back up to the heart by leveraging your calf muscle pump. Over time, this improves any achiness, fatigue, discomfort, and reduces possible damage to leg skin.
Treating the cause of the swelling is often the focus over time. If edema is a result of medicines, for example, a care provider might change the dose or look for another medicine that doesn't cause edema.
