Lower Leg

Bones

  1. Tiba

  • weight bearing bone of the lower leg

  1. Fibula

  • non-weight bearing 

  • function is soft tissue attachment

Muscles

  1. Tibialis Anterior  (ankle dorsiflexion, ankle inversion)

  2. Tibialis Posterior  (ankle inversion)

  3. Peroneals

  4. Gastrocnemius  (ankle plantar flexion)

  • achilles 

  1. Flexor Digitorum

  2. Flexor Hallucis 

  3. Extensor Digitorum

  4. Extensor Hallucis

4 Compartments

  1. Anterior 

  • most commonly injured

  1. Lateral

  1. Superficial Posterior 

  • responsible for plantar flexion

  1. Deep Posterior

  • responsible for toe flexion

Injuries

Acute compartment syndrome

— any of the 4 compartments (usually anterior)

— occurs from direct blow

S/S

  • pain/swelling

  • numbness in between first and second toe

  • inability to actively move muscle

Treatment

  • Ice

  • Elevation

  • refer immediately 

  • surgical release

  • DO NOT USE COMPRESSION

Exercise induced compartment syndrome

— can be acute or chronic 

— build up of fluid during exercise increasing with activity but decreasing afterwards

— compartments simply cant accommodate for the increase in pressure

S/S

  • sharp pain

  • pressure

  • symptoms resolve with rest

  • weakness in toe extension

Treatment

  • ice

  • rest

  • stretch

  • rehab

  • possible fasciotomy

Medial tibial stress syndrome (shin splints)

—  pain specific 2/3 of the medial tibia 

S/S

  • diffuse pain around the medial tibia and soft tissues

— 4 different grades

Treatment

  • identify cause 

  • stretch 

  • refer