Leg Pain

Leg Pain

The leg is the area of the lower limb between the knee and ankle. The 2 bones within the leg are the tibia and fibula and these are surrounded by muscles, nerves, soft tissue and blood vessels. Ligaments join the 2 bones and attach the bones to the knee and ankle. Leg pain can range from a mild nuisance that comes and goes, to debilitating pain that makes it difficult to sleep, to walk or engage in simple everyday activities. There are a number of issues which can cause leg pain and more information can be found by clicking on the below. One of our experienced physiotherapists can come to you at home or work to provide a full assessment of the cause of your pain and treat appropriately.

  • Pain on front of leg
  • Pain on back of leg
  • Pain on inside of leg
  • Pain on outside of leg

Self diagnosis can lead to wasted time trying to sort without success. This can lead to Chronic Pain. One of our experienced physios can come to you and solve the cause of the pain and fix the problem.

Muscle strain or tear

There are a 2 main calf muscles that can be strained or torn which are called the gastrocnemius (main calf muscle on the surface) and the soleus (small calf muscle below the gastrocnemius). If you strain one of these muscles suddenly there will be a sudden pain on tearing sensation in the main part of the calf of near where the calf muscle inserts into the heel. When stretching the muscle or resisting movement of the muscles there is commonly pain. Also depending on the extend of the strain on tear you may have swelling or a haematomat which is bleeding within the muscle which comes out as bruising. number of muscles that can be strained on the front of the lower leg. There is normally pain over the muscle and pain on stretch of the muscle and when movement is resisted.

Physiotherapy can help with advice, ice, massage, soft tissue techniques, ultrasound and taping. Exercises can be set to regain flexibility and strength of the muscle.


Chronic muscle strain

This is a strain of the calf muscle which usually happens over time.

Physiotherapy can help with advice, soft tissue techniques, ultrasound and taping. Exercises can be set to regain flexibility and strength of the muscle


Accessory soleus muscle problems

This is a very small muscle in the calf which rarely gives problems. There can be a small swelling or bulding on the middle part part of the lower calf and near the Achilles tendon – normally medical referral is required.


Artheroschlerotic disease

Calf pain as a result of problems with the arteries usually happens later on in life and there is normally a history of cardiovascular disease. Symptoms include pain in the thigh and calf with exercise. Medical help is needed.


Popliteal artery entrapment Sural nerve entrapment

This results in pain and pins and needles or numbness in the outside of the heel and foot. It may result from compression from factors such as ski boots, trauma, intense physical training.

Physiotherapy can help with advice, working on the nerves, massage.


Compartment sydnromes

A compartment is referred to containing a group of muscles. In the back of the lower leg that includes the gastrocnemius, soleus and flexor halluces longus muscles. Normally pain is felt with activity and relieved by rest.

Physiotherapy can help with soft tissue therapy and if this is not successful then medical referral is required.


Deep Vein Thronbosis

This can occur occasionally following calf injury or surgery due to a lack of movement therefore not using the pump effect of muscles and the effect of swelling may lead to problems with blood flow. Symptoms include constant calf pain, tenderness, swelling. Immediate medical evaluation is required.


Referral

It always needs to be considered that pain can be referred from another part of the body. In this case the lower back and knee joint or other muscles.

Approximately 90% of stress fractures occur to the back middle tibia with the middle 1/3 and junction between the middle and end of the tibia being the most common. 10% of stress fractures happen to the front edge of the tibia and unfortunately these stress fractures are most resistant to treatment. Typical symptoms include pain that starts gradually and is aggravated by exercise which can be pinpointed when touching the bone. The pain may even occur with walking, at rest and even at night. Pain usually lasts up to 3 months.

Stress fractures of the fibula (small bone on outside of lower leg) are rare and tend to happen secondary to muscle pulls on the bone.

Physiotherapy can help by determining which factors are contributing to the problem and advice on exercise that can be done without causing pain and making the problem worse. Normally needs a period of rest but soft tissue techniques can help with the problem.


Medial tibial traction periostitis

This is an inflammatory reaction of the tibia due to a pulling of the muscles on the tibia. A number of factors can contribute to it including muscle problems, fatigue, shoe issues, training errors. Tbe pain is normally not along the inside of the tibia bone and usually becomes less as you warm up.

Physiotherapy can help with advice, taping, soft tissue techniques to the calf muscles, ultrasound, stretching and exercise prescription


Periosteal contusion

The perisoteum is a covering over the bone. Contusion also known as bruising happens as a result of a direct blow to the bone ie from football. Often it is extremely painful at the time of injury but settles quite quickly. If lasts longer normally due to formation of a haematoma (bleeding) under the bone. It is advised to rest and protect the area. Ultrasound can help with quicker resolving of the haematoma.


Acute compartment syndrome

This should be considered in anyone with a marked haematoma (bleeding within the leg) or swelling. Compartment refers to the group of muscles on the front of the leg. Symptoms include ongoing aching shin pain which is greater than one would expect and swelling. Pain is increased with providing a stretch to this group of muscles. Pins and needles, loss of feeling and some weakness may also be present due to the nerves being compromised. Referral for medical help is required in this situation.


Popliteal artery entrapment

The popliteal artery runs behind the knee and in the calf. When the artery is trapped it rarely causes calf pain but pain on the front of the lower leg. The pain usually disappears immediately when exercise is stopped. Often there is also pins and needles and numbness in the calf and foot.


Chronic exertional compartment syndrome

This is a long term pain that occurs in the compartment containing the muscles of the front of the leg. Symptoms including no pain being at rest and pain usually takes 1 and a half hours to ease following exercise. If exercise is done 2 days in a row there is often more pain on the 2nd day. The time for the pain to start with exercise is variable but usually 10-15 minutes. Normally surgery is recommended and then physiotherapy is required after surgery to regain your movement in your knee and provide advice on returning to sport as well as prescribing appropriate exercises to regain flexibility and strength.


Fracture of tibia and fibula bones

A fracture is usually a result of direct violence to the bones from landing from a jump or twisting the foot. Obviously medical assistance is required for the fracture and a cast of boot put in place. Physiotherapy can help by maintaining strength of the upper leg when in the cast and when out of the cast help to resotre movement and strength in the lower leg, ankle and foot.


Tumors

The cause of tumors in the shin is unknown and rare. The pain is often deep and nagging often at night and unchanged with activity. Medical help is required in this instance.


Referred pain

It always needs to be considered that pain in the shin can be referred from another part of the body ie. The lower back, knee, ankle joint, superior tibiofibular joint and nerves being entrapped.

Muscle strain

There are a number of muscles that can be strained on the front of the lower leg. There is normally pain over the muscle and pain on stretch of the muscle and when movement is resisted.

Physiotherapy can help with advice, ice, massage, soft tissue techniques, ultrasound and taping. Exercises can be set to regain flexibility and strength of the muscle.


Stress fracture

Approximately 90% of stress fractures occur to the back middle tibia with the middle 1/3 and junction between the middle and end of the tibia being the most common. 10% of stress fractures happen to the front edge of the tibia and unfortunately these stress fractures are most resistant to treatment. Typical symptoms include pain that starts gradually and is aggravated by exercise which can be pinpointed when touching the bone. The pain may even occur with walking, at rest and even at night. Pain usually lasts up to 3 months.

Stress fractures of the fibula (small bone on outside of lower leg) are rare and tend to happen secondary to muscle pulls on the bone.

Physiotherapy can help by determining which factors are contributing to the problem and advice on exercise that can be done without causing pain and making the problem worse. Normally needs a period of rest but soft tissue techniques can help with the problem.


Medial tibial traction periostitis

This is an inflammatory reaction of the tibia due to a pulling of the muscles on the tibia. A number of factors can contribute to it including muscle problems, fatigue, shoe issues, training errors. Tbe pain is normally not along the inside of the tibia bone and usually becomes less as you warm up.

Physiotherapy can help with advice, taping, soft tissue techniques to the calf muscles, ultrasound, stretching and exercise prescription


Periosteal contusion

The perisoteum is a covering over the bone. Contusion also known as bruising happens as a result of a direct blow to the bone ie from football. Often it is extremely painful at the time of injury but settles quite quickly. If lasts longer normally due to formation of a haematoma (bleeding) under the bone. It is advised to rest and protect the area. Ultrasound can help with quicker resolving of the haematoma.


Acute compartment syndrome

This should be considered in anyone with a marked haematoma (bleeding within the leg) or swelling. Compartment refers to the group of muscles on the front of the leg. Symptoms include ongoing aching shin pain which is greater than one would expect and swelling. Pain is increased with providing a stretch to this group of muscles. Pins and needles, loss of feeling and some weakness may also be present due to the nerves being compromised. Referral for medical help is required in this situation.


Popliteal artery entrapment

The popliteal artery runs behind the knee and in the calf. When the artery is trapped it rarely causes calf pain but pain on the front of the lower leg. The pain usually disappears immediately when exercise is stopped. Often there is also pins and needles and numbness in the calf and foot.


Chronic exertional compartment syndrome

This is a long term pain that occurs in the compartment containing the muscles of the front of the leg. Symptoms including no pain being at rest and pain usually takes 1 and a half hours to ease following exercise. If exercise is done 2 days in a row there is often more pain on the 2nd day. The time for the pain to start with exercise is variable but usually 10-15 minutes. Normally surgery is recommended and then physiotherapy is required after surgery to regain your movement in your knee and provide advice on returning to sport as well as prescribing appropriate exercises to regain flexibility and strength.


Fracture of tibia and fibula bones

A fracture is usually a result of direct violence to the bones from landing from a jump or twisting the foot. Obviously medical assistance is required for the fracture and a cast of boot put in place. Physiotherapy can help by maintaining strength of the upper leg when in the cast and when out of the cast help to resotre movement and strength in the lower leg, ankle and foot.


Tumors

The cause of tumors in the shin is unknown and rare. The pain is often deep and nagging often at night and unchanged with activity. Medical help is required in this instance.


Referred pain

It always needs to be considered that pain in the shin can be referred from another part of the body ie. The lower back, knee, ankle joint, superior tibiofibular joint and nerves being entrapped.

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