Tibialis Anterior Pain/Injuries

The tibialis anterior forms the fleshy part of the outside of the shin. Tibialis Anterior Syndrome, also called shin splints, are a common injury, but there is also risk for tendon sheath inflammation brought on by overuse. Running on hard surfaces or sports requiring frequent changes in direction heighten the risk for tendon sheath inflammation.

Tendon sheath inflammation can present with pain when the foot and toes are bent upward, or swelling/redness over the front of the ankle. General treatment options include resting until pain subsides, icing the injury down, or in more severe cases anti-inflammatory medications and a plaster cast may be employed.

Tibialis Posterior Pain/Injuries

Generally, the tibialis posterior muscle can suffer from Tibialis Posterior Syndrome or Tibialis Posterior Tendinopathy. This muscle comes from behind the shin bone and runs into a tendon passing behin the bony bit on the inside of the ankle.

Inflammation occurs near that tendon in TPS, presenting with pain over the tendon area, pain during exercise, or swelling around the bony bit on the inside of the ankle. Rest and anti-inflammatory medication are usually prescribed, though in severe cases a cast or even surgery may be recommended.

TPT is an overuse injury resulting from the degeneration of the tendon as opposed to inflammation as seen in TPS. TPT presents with pain similar to TPS, but it is worsened through passive eversion or resisted inversion (turning the foot outwards and inwards, respectively). Treatment includes icing the injury, stretching the muscles when possible, and a combination of anti-inflammatory and massage techniques to combat the pain.

Anterior Tibialis (Shin) / Shin Splints

Pain localized around the front of the lower leg, along the tibia, are collectively known as shin splints. These injuries occur from continuous stress or jarring of the bones, muscles, and joints without appropriate periods of rest.

Overtraining or running on hard surfaces are common causes of shin splints, especially among beginning runners.

RICE is the common method of treatment, used to control pain and inflammation. Returning to physical activity is gradual; non-weight bearing activity like cycling or swimming are recommended at first.

Rectus Femoris Injury

The rectus femoris is part of the quadriceps muscle group and crosses the hip joint acting as a powerful knee extensor when the hip is extended but is weak when the hip is flexed. Common injuries to this muscle include quadriceps strain, contusions, or a rupture of the rectus femoris tendon.

Gastrocnemius (Calf) / Calf Strains

Similar to Achilles tendonitis, calf strains occur when the muscle of the lower leg is torn away from the Achilles tendon. This injury happens mainly during acceleration or changes in direction; internal bleeding will cause visible bruising in the foot and ankle.

Treating calf strains starts with the RICE method to keep the blood from pooling in the foot. Anti-inflammatory medicine will reduce pain. Eventually, the tendon will reattach, but until then the calf is more prone to injury as it is shorter. Physical Therapy is usually recommended.

Hamstring Tear/Pull

Most common among runners, hamstring injuries involve the muscles running down the back of the leg from the pelvis to the lower leg bones. Commonly, doing too much too soon, poor flexibility, poor muscle strength, muscle imbalances and muscle fatigue are all common causes for hamstring injuries.

For treatment, the RICE method is used to control pain and swelling along with anti-inflammatory medication. Physical Therapy is usually recommended. A stretching and strengthening program can also help rebuild the injured muscle’s strength.

Quadricep Tear/Pull

A pulled or torn quadriceps causes pain in the front of the thigh; acute pain occurring during activity like sprinting. This injury comes about from strength imbalance between the quads and the hamstring. This imbalance is not uncommon with runners, who tend to strengthen their hamstrings far more than their quadriceps.

For treatment, use the RICE method and anti-inflammatory medication if necessary. Normal activity can be resumed in 3 weeks, at most.

Chronic Compartment Syndrome

This condition causes nerve compression and pain in the front of the lower leg for most patients. Excessive muscle swelling during activity may put pressure on blood vessels and nerves, resulting in pain and if the nerves get compressed, numbness in the feet or lower.

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