Leg Pain in a 22 Year Old Female Soccer Player

Acute compartment syndrome is a medical emergency. It is usually cause by a severe injury. And without treatment, it can lead to permanent muscle damage. Chronic compartment syndrome, also known as exertional compartment syndrome, is usually not an emergency. This is most often caused by an athletic exertion. Because the fascia does not stretch, this can cause increase pressure on the capillaries, nerves and muscles in the compartment. The blood flow to the muscle and nerve cells is disrupted. Without a steady supply of oxygen and nutrients, the nerve and muscle cells can be damaged. Compartment syndrome most often occurs in the anterior compartment of the lower leg. But can also be present in other compartments in the leg, as well as the arms, hands, feet and buttocks.

Hamstring Strains (HS) are identified by acute pain in the thigh with disruption of the muscle fibres, with 47% of all HS studies stating that the BF muscle is affected (3). This can be explained because the BF muscle tendon and muscle fibres are where the most common distribution of the ground force produced during running (3). Eccentric contraction is explained by a study from Guex (4) stating that between 75-85% of the running cycle the hamstrings are undergoing an active lengthening contraction. Having this amount of eccentric contraction upon the muscles has the potential to cause an overuse injury (4). At 85% of the running cycle, the SM, ST, and BF are stretched by 8.7-12.0% which is beyond their optimum lengths (4).

The most common symptom of this condition is pain that occurs during activity. Other symptoms include:

The causes of the injury could include stretching her leg too far, stretching her leg with too much force, poor stretching/warm up before hands or imbalance between hamstrings. Ways this could’ve been prevented include warming up and stretching properly beforehand and after the exercise and/or improving her kicking technique because that might be bad and causing the pain.

assess, diagnose and treat abnormalities and diseases related to the foot and lower limb in people of all ages

Each participant was diagnosed with chronic unilateral mid-line achilles tendiopathy using valid and reliable tests (palpation, Arc sign, and Royal London Test) by the lead investigator of the study. Excluded from the study were athletes, individuals diagnosed with paratendinopathy of the achilles, and individuals with metabolic disorders.

On examination of the right ankle, there is edema. Range of motion is limited in all planes. Dorsiflexion shows 15 degrees, flexion to 20 degrees and inversion/eversion of 10 degrees. There is tenderness upon palpation of the lateral and medial malleolus. Sensation is decreased. Atrophy/wasting is noted.

The objective for this case study is to give in detail the evaluation process of medial tibial stress syndrome, including treatment plan and progress. Medial tibial stress syndrome is a pathology common in sports that require a lot of running. It occurs when overuse and repetitive stresses are placed on the tibia. Some differential diagnosis are stress fracture, and entrapment of the superficial peroneal nerve. Treatment for this pathology are ulrasound, cold whirlpool and electric stimulation. The uniqueness of this case is how long the athlete had been experiencing pain before bringing it tot the attention

If the pain increases in intensity as to completely hinder the athlete from any activity, then one must consult a doctor in order to see the effects on the bone and muscle.

She says that she has been running quite a bit because she is training for a half marathon in November. She was finding about a couple of weeks ago that when she ran, particularly more than 3 or 4 miles, she would develop pain in near the heel of her right foot. She went to see Jennifer Sartori, D.P.M. last Monday on the 24th. She was diagnosed with Achilles tendinitis. By that point however, she was feeling better. Dr. Sartori told her that if she was asymptomatic, she could restart running. She said she did fine, if she ran two or three miles, but one day she ran five miles and the pain increased significantly. She went back to see Natasha Baczewski, D.P.M. and had her foot evaluated again. It was again, confirmed as Achilles tendinitis. She was given a splint to wear, but she tells me unfortunately it was a left foot splint and not a right foot splint. She did try to wear and when she did wear it, her pain felt better. She does plan on trying to get a proper splint for the foot. When she rests, her pain is better. She finds now that even if she walks a lot, her heel will start to bother her again. She is unfortunately feeling as though she may not be able to do the half marathon, after

Recent research has found that specific sports, such as soccer, have a higher incidence of abnormal bony features due to the high shear stress that is applied to the femoral head prior to the closure of the athlete’s growth plates. Indicating that Cam impingements occur during skeletal maturation and high-impact sports practice.1 Again it can be assumed that the athlete had been partaking in such practices for quite some time, making him a ‘typical’ case. However, this athlete also had a labrum tear present. This could be due to playing on an FAI for many years, causing additional stresses to the tissues surrounding the hip

Common lower extremity injuries for runners are iliotibial band syndrome, patellofemoral syndrome, patellar tendonitis, and plantar fasciitis. Iliotibial band syndrome occurs in runners who perform long distance training because of excessively bending and extending their knee (Grau, Maiwald, Krauss, Axmann, & Horstmann 2008). This will cause the distal iliotibial band to rub or brush against the lateral femoral condyle which will cause inflammation and swelling of the iliotibial band (Grau, et al., 2008). Patellofemoral pain syndrome or “runner’s knee” can cause excruciating anterior knee pain because of weak hip abductors, quadriceps, and external rotators (Petersen, Ellermann, Gösele-koppenburg, Best, Rembitzki, Brüggemann & Liebau, 2014). This will wear down, disrupt and ultimately damage the cartilage under the knee cap. Patellofemoral pain syndrome will cause imbalance and instability of the patella, hamstring

Additional questions to consider as source of pain include: Involvement in activities such as soccer, tumbling or gymnastics, which provide potential sources

Patient attends with complaints of leg pain for a period of about 1-1/2 weeks. Pain is so severe that he has to keep active, the more active he is the less the discomfort bothers him. He finds that sleeping at night really is uncomfortable because of the cramping in his legs, the cramps start in the base of his feet and run up into the calves, but again, if he gets up and is active it seems to reduce the discomfort considerably. His joints have not been red, or hot, or swollen. He has not had his limbs buckle or give way. He has not tried any medications for this. Interesting to note that he has started jogging some three weeks ago, and the discomfort in his shins is subsequent to that. He did not temporize that activity. The patient is concerned that he was on methadone and he knows that this can cause bony structure problems, dental problems. He was on it for about a year and he has been off of that now for at least two years. He is also concerned about his weight. He states he used to be 200 pounds he is now down to 160 pounds. Chart review shows that since he has been incarcerated in Faribault his weight has been pretty stable running between 155-165. I reassured him that this

Foot injuries are very common in athletics as well as in everyday life. It’s very debilitating to have a foot injury since we use our feet in all of our daily activities. Research published in "Medicine and Science in Sports and Exercise” indicates that the average adult takes between 5,000 to 7,000 steps a day. Some sports require the most dedicated athletes spend multiple hours a day pounding their feet on the turf or pavement. Most injuries that occur in the foot require a person to try and stay off of it or completely immobilize it. Since this is very difficult for a person to do, a large percentage of foot injuries often have a very high chance of reoccurring. The severity of some injuries that can be deceiving as well. Often times a nagging pain is ignored and eventually becomes a much bigger problem.