Knee and Lower Leg Injuries

Shin Splints, ACL Tear

ObjectivesTo identify the causes, symptoms, treatment,

and prevention of various knee and lower leg injuries.

Shin Splints

Shin Splints Also known as medial tibial stress syndrome.

Occur during physical activity and result from too much force being placed on your shinbone and connective tissues that attach your muscles to the bone.

The overload is often caused by specific athletic activities, such as: Running downhill Running on a slanted or tilted surface Running in worn-out footwear Engaging in sports with frequent starts and stops, such as basketball

and tennis

Shin splints can also be caused by training errors, such as engaging in a running program with the "terrible toos" — running too hard, too fast or for too long.

Symptoms of Shin SplintsTenderness, soreness or pain along the inner

part of your lower leg.

Mild swelling in your lower leg.

At first, the pain may stop when you stop running or exercising. Eventually, however, the pain may be continuous.

Risk Factors for Shin Splints

You're more at risk of shin splints if:You're a runner, especially just beginning a

running program.You have flat feet or rigid arches, causing your feet

to roll inward when running.You increase the intensity of your workouts by

doing more high-impact activities.You play sports on hard surfaces, with sudden

stops and starts.You're in military training.

Treatment for Shin Splints Rest. Avoid activities that cause pain, swelling or discomfort — but don't give up

all physical activity.

Ice. Apply ice packs to the affected shin for 15 to 20 minutes at a time, four to eight times a day for several days.

Compression. to compress the area with an elastic bandage or compression sleeve.

Elevation. Elevate the affected shin above the level of your heart, especially at night.

Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin, others), naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others) to reduce pain.

Wear proper shoes. Your doctor may recommend a shoe that's especially suited for your foot type, your stride and your particular sport.

Consider arch supports. Arch supports can help cushion and disperse stress on your shinbones. Off-the-shelf arch supports come in various sizes and can be fitted immediately. More durable arch supports can be custom-made from a plaster cast of your foot.

Prevention of Shin SplintsChoose the right shoes.

Consider arch supports.

Lessen the impact.

Strengthen your calves.

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ACL TearThe tearing of the anterior cruciate ligament.Most commonly occurs during sports that involve

sudden stops and changes in direction — such as basketball, soccer, football, tennis, and volleyball.

ACL Tear SymptomsAt the time of an ACL injury, signs and

symptoms may include:A loud "pop" soundSevere pain and inability to continue activityKnee swelling that usually worsens for hours after

the injury occursA feeling of instability or "giving way" with weight

bearing.

ACL Tear CausesThe ligament may tear when you slow down

suddenly to change direction or pivot with your foot firmly planted, twisting or hyperextending your knee.

Landing awkwardly from a jump can also injure your ACL, as can falls during downhill skiing.

ACL Tear Risk Factors in Female Athletes

Women are significantly more likely to have an ACL tear than are men participating in the same sports.

Women tend to have a strength imbalance, with the quadriceps being stronger than the hamstrings.

Increased Ligament laxity

Increased Q angle

Narrower femoral notch

ACL Tear Treatment Initial treatment for an ACL injury aims to reduce pain

and swelling in your knee, regain normal joint movement and strengthen the muscles around your knee.

Surgery plus rehabilitation, or rehabilitation alone.

The choice depends on several factors, including the extent of damage to your knee and your willingness to modify your activities.

Athletes who wish to return to sports involving cutting, pivoting or jumping usually pursue surgical reconstruction to prevent episodes of instability.

ACL Surgery and RehabA torn ACL cannot be successfully sewn back

together.

The ligament is usually replaced with a piece of tendon from another part of your knee or leg.

The use of crutches and, possibly, a knee brace

Range-of-motion exercises to regain your full knee motion

Muscle-strengthening and stability exercises

Prevention Training. Strengthening and stability exercises, plyometric

exercises, balance training, agility training, and risk-awareness training.

Strengthen your hamstrings. Women athletes in particular should make sure to strengthen their hamstring muscles as well as their quadriceps.

Use proper techniques. If your sport involves jumping, learn how to land safely. Studies have shown that if your knee collapses inward when you land from a jump, you are more likely to sustain an ACL injury.

Warm up and stretch. Being flexible enough to move freely can help you maintain ideal form.

Wearing a knee brace has not been found to be helpful in preventing ACL injuries.

ACL Tear & Preventionhttp://www.youtube.com/watch?v=xE8BkzxxTEU

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