Intro to physio- Leg pathologies

• What are characteristics of a bone fracture/stress fracture

  Localised acute/sharp pain that worsens with impact activity
• Why does an individual have to complete plantarflexion standing?


  because it is a class 2 lever therefore mechanical advantage >1 as the force is greater than the resistance
• What palpations need to occur for the lower limb?

  Tibailis anterior boarder, fibula, gastrocnemius, soleus, plantaris, dorsal pedis artery and the posterior tibial artery
• What are some intrinsic factors that contribute to shin splint?


  ROM of foot/ankle

  Tibial torsion

  Femoral anteversion

  Increased Q angle
• What extrinsic factors are linked with shin splints?


  Surface, footwear and training factors
• What are symptoms of shin splints?


  -Dull ache on the mid to distal posteromeidal tibial line

  -agrravated by exercise

  -Eases with rest
• What are signs of shin splints?


  -Tenderness of medial border of tibia

  -mild swelling

  -Pain on resisted plantar flexion, toe flexion and heel raises
• What is the treatment of shin splints?


  Rest, ice, taping and orthotics/alternative footwear
• What are rehabilitation options for shin splint?


  -Hip, knee, tricep surae, FHL muscle conditioning

  -running sprinting and landing techniques
• Where does the lateral head of the gastrocnemius originate?

  Lateral condyle
• where does the medial head originate?


  Popliteal surface superior to the medial condyle
• Where does the gastrocnemius insert?

  Achilles tendon
• What is the origin of the soleus?


  The posterior aspect of the head of the fibula and the medial border of the tibia
• What is the insertion of the soleus?

  Achilles tendon
• What is the gastrocnemius and soleus dependant on?


  Degree of stretch, load capacity of tissue and velocity of force
• What are the symptoms of gastrocnemius/soleus strain?


  -Sudden onset of pain and loss of function

  -pop or tear

  -soleus resembles DOMS
• What are the signs of gastronomic/soleus strain?


  Tenderness at the site of injury, potential swelling or bruising, decreased plantar flexion strength
• What is the first phase of treatment for a muscle injury?


  Acute phase: RICE, crutches or heal wedge
• What is the 2nd phase of treatment for a muscle injury?


  Improved ROM, double leg calf raise and stretching ankle dorsiflexion
• What is acute compartment syndrome?

  It is inadequate blood flow to a compartment within the body
• What are some signs and symptoms of acute compartment syndrome?


  Swelling, pain that is out of proportion and pins and needles
• What is Chronic Exertion Compartment Syndrome?


  It is inadequate blood flow to working muscles during exercise, involves surgery to remove fascia, occurs in endurance sports and repetitive movements
• What is CECS mostly likely to effect?


  Anterior compartment Deep tibial nerve and anterior vessels
• What is neuropathy?


  Condition that alterations to the function of the peripheral nerve
• What is key symptoms of fibular neuropathy?


  Foot drop,

  numbness and tingling over lateral, lateral lower leg and web space
• What are the key signs of fibular neuropathy?


  hot and cold testing, decreased strength in ankle dorsiflexion, eversion and knee flexion
• What are the treatment options for fibular neuropathy?


  Foot and ankle strength training, sensation retraining
• What is a key difference between compartment syndrome and popliteal entrapment?

  whether there is an increase in compartment pressure or a lack of blood flow to the lower leg due to entrapment of the popliteal artery.
• What is an anatomical popliteal entrapment?

  Defect that develops at birth and affects the relationship between the popliteal artery and the medial head of the gastrocnemius.
• What are the two types of popliteal entrapment?

  Anatomical and functional
• What is anatomical popliteal entrapment?


  Condition that occurs at birth which effects the relationship between the popliteal artery and the medial gastrocnemius
• What is functional popliteal entrapment?


  Gastronemeius rests in a more lateral position compressing the popliteal artery
• Symptoms of popliteal entrapment?


  Claudicent pain- gets worse with exercise but stops reletively quick after exercise

  -extremity numbness, tingling burning, discolouration, coolness
• What are some signs of popliteal entrapment?


  Hypertrophy of calf muscles and abnormal/absent distal pulse, both are present highly likely to be popliteal artery entrapment
• What is anterior cortex stress fracture?


  Similar presentation to shin splints, tenderness medial 2/3 of tibia, dull achy pain, needs a bone scan
• What is Deep vein thrombosis?


  Where the blood clots in the veins if it reaches the lungs it is known as pulmonary embolism - medical emergency
• Signs and symptoms of deep vein thrombosis?


  Pain, redness, swelling, tenderness on palpation
• What does deep vein thrombosis cause?

  Reduced blood flow, increased venous pressure
• What is arthoscleorosis?


  Build up of plaque on the artery walls, symptoms include cramping of the leg signs include decreased peripheral pulse following exercise
• What is hematoma?


  an accumulation of blood from outside the blood vessel