This post is about 3 Causes of Lower Leg or Ankle Pain a Chiropractor Can Help With. Exercise induced lower leg or ankle pain is common among athletes. Overuse injuries from hobbies or work can also cause varying degrees of muscle, tendon and bone irritation. Your leg pain may also be coming from your back or be a systematic (affecting entire body) problem.        

Achilles Tendinitis

Achilles Tendinitis occurs in athletes following jumping or running activities.  You will have pain in the achilles tendon because it is inflamed. So a tendon is a dense fibrous connective tissue that attaches a muscle to other body parts, usually bones.  It transmits the mechanical force of muscle contraction to the bones. The achilles tendon is a very large tendon which connects the gastronemius and soleus (calf muscles) to your calcaneus (heel bone). It is used when you walk, run, and jump.

Cause

Firstly, the Achilles tendon is covered by a peritenon (connective tissue sheath surrounding a tendon) composed of mainly areolar tissue (fatty tissue) which functions as a cushion.  The area most affected in tendinitis is approximately 2 cm proximal (close) to the calcaneal insertion (heel attachment). The demands on the tendon are high in running and jumping sports.

Secondly, at the heel insertion (attachment site) there can be a complicating problem. The retrocalcaneal bursa (small cushioning sac between the heel bone and the achilles tendon) can get irritated.  Eventually, this may lead to a Haglund’s deformity (bony enlargement found on the back of the heel).

Thirdly, if you have arthritis due to reiter’s syndrome or ankylosing spondylitis which are systemic diseases (affecting entire body), it can cause what’s called an enthesopathy. Enthesopathy is a disorder of the entheses.  The “enthesis” is the area where the tendon, ligament, or joint capsule inserts into bone.

Finally, in athletic children, pain and tenderness at the calcaneus (heel bone) may indicate sever’s disease/apophysitis. Sever’s disease is a painful condition of the heel that occurs in growing children. It happens when the tendon that attaches to the back of the heel (the Achilles tendon) pulls on the growth plate (the apophysis) of the bone of the heel (the calcaneus).

 

Shin Splints

Shin splints cause anterior (front of) or posterior (back of) lower leg pain that is often insidious (comes on gradually) in onset. Walking or running on a hard surface is a common inciting activity. Shin splints pain is a deep ache that is often worse with weight bearing.

Cause

Shin splints have many possible causes. Lower leg tendinitis, periostitis (inflammation of the periosteum, a layer of connective tissue that surrounds bone), muscle strain, or interosseous membrane (thick dense fibrous sheet of connective tissue) strain are all possible causes.

There are generally two types: anterior (front of leg) shin splints and posterior (back of leg) shin splints.

The anterior (front of leg) shin splints involves 3 muscles all located in the front of the tibia (shin bone): tibialis anterior (moves foot upwards), extensor hallucis longus (moves the big toe upward), and extensor digitorum longus (moves 2nd to fifth toes upward). So these muscles are used for “shock absorption”. Shock absorption is the process by which an object — in this case, your muscles — absorbs the brunt of the impact forces you sustain during movement. What occurs in shin splints is these muscles may be weak or placed under increased demand as in walking or running on hard surfaces.  Furthermore, when your shoe has no shock-absorbing quality, the force is transmitted to the tibia (shin bone) and its attachments.

The posterior (back of lower leg) type of shin splints involves 3 muscles all located in the back of the tibia (shin bone): the tibialis posterior (points the foot), flexor hallucis longus (points the big toe), and flexor digitorum longus (points the 2nd to fifth toe) muscles. The soleus (calf muscle) could also cause shin splints . These muscles act as ankle stabilizers. And they are overstrained if your foot is hyperpronated (inward rotation of the foot during gait).

Throwing away worn-out shoes and replacing them with a good shock-absorbing pair is important if you have shin splints.

 

Ankle Sprains

Ankle sprains can occur at any age.  You will have ankle pain and swelling following a twisting injury. You may simply step on an uneven surface or land on the outside heel and get an ankle sprain.  However, you may not recall how it happened.  

Cause

The vast majority of ankle sprains are plantarflexion (movement in which the ankle and foot bends forward or downward) and inversion (bending the ankle and foot inward toward the mid-line of the body) injuries. Furthermore, these sprains involve the lateral (side) ligaments (fibrous connective tissue that connects bones to other bones). In a sequence of injury: the anterior talofibular (ankle bone and long, thin and side bone of the lower leg) ligament, calcaneofibular (heel bone and long, thin and side bone of the lower leg) ligament, and the posterior talofibular (rear ankle bone and long, thin and side bone of the lower leg) ligament which are the lateral (outer side) ligaments. The more rare eversion turning (movement where ankle/foot bends inside-out) sprain damages the medial (toward middle) ligament complex referred to as the deltoid ligament.

Running on uneven surfaces or landing on the outside heel can cause ankle sprains. If you have a cross-over gait (involves running with your feet crossing the midline of your body) or over supinate (put most of the weight on the outer side of your feet) this may lead to ankle sprain injuries. Consequently, if you keep getting subsequent sprains, you may get ligament laxity (looseness of a limb or muscle).  This will play an important role in future ankle injuries.

 

Treatment for 3 Causes of Lower Leg or Ankle Pain a Chiropractor Can Help With at Meiri Chiropractic:

In the acute phase, ice and rest from the causative activity are essential. Myofascial release techniques are effective. Therapeutic exercises are prescribed for stretching, strengthening, and stabilization. Most importantly, Chiropractic adjustments, manipulation, and mobilization to the leg, ankle, foot and associated areas give relief.

Prevention is important with managing lower leg and ankle pain. Lower leg and ankle pain account for a lot of time lost in athletics. And football teams spend as much as $50,000 annually on tape for ankles!

A comparative study evaluated the outcome of treating Grade I and II ankle sprains with a chiropractic ankle adjustment or detuned ultrasound (placebo). There was significantly more improvement in the adjusted group for pain, range of motion, and function.

Getting regular chiropractic care from a West Palm Beach lower leg or ankle pain chiropractor can help relieve pain naturally from an already existing injury, or even offer injury prevention. Chiropractic is a holistic and natural way to not only treat existing injuries, but to keep your body in its best working condition.

Contact Meiri Chiropractic today on the 3 Causes of Lower Leg or Ankle Pain a Chiropractor Can Help With or/and other ailments.

 

References:

Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011

 

Meiri Chiropractic

561-253-8984

This post is about Hip Sprain/Strain or Osteitis Pubis: A Chiropractic Center Can Help. You may have had a fall onto the hip? Perhaps you have thigh pain from a sudden sports maneuver? Moreover, you may have developed this pain after a difficult delivery of a child or after a surgery?  Certainly, as a weight bearing joint, the hip is commonly affected by degenerative joint changes and soft tissue damage. So your problem may be in the hip or pelvis, but can spread to other areas of the body, such as the upper thighs, groin and lower back. Similarly, you may just have a muscle strain in the thigh?  Read on to learn more.

Hip Anatomy

The hip, like the shoulder, is considered a ball-and-socket joint. It is formed by the head of the femur (thigh bone) which sits in what’s called the acetabulum, a part of the pelvis. The head of the femur is large (ball) and the acetabulum (socket) is deep.  The soft tissues (refers to non-bony structures that connect, support, or surround other structures) in your hip are:

• the muscles, which allow you to move.
• the tendons, which connect your muscles to the bone.
• the ligaments are bands of tough elastic tissue around your joints. They connect bone to bone, give your joints support, and limit their movement.
• the fascia – stretchy, thin, white fibrous tissue. All your muscles are enveloped in fascia.
• the bursae – fluid-filled pads that act as cushions at the joints. Bursae reduce friction between the surfaces of a bone and soft tissue.

1. Osteitis Pubis

 

Osteitis pubis is a painful condition of the pubic symphysis articulation/joint. Your pubic symphysis is a unique joint consisting of a fibrocartilaginous disc sandwiched between the articular surfaces of the pubic bones. The pubic bone is the most forward-facing bone of the pelvic bones.

Firstly, osteitis pubis is characterized by bony resorption (bone breaks down) and spontaneous reossification (new bone develops). Secondly, your symptoms may be localized or referred and is usually described as “groin burning”.  Thirdly, the pain is often excruciating on direct palpation (touch) and relieved with rest. Fourthly, exercise or activities involving thigh adduction (bringing the thighs together), trunk flexion or even walking may cause pain. Fifthly, your gait may be antalgic (walk with a limp because of pain), with trunk flexion and waddling due to the pain. Lastly, an audible click in the area of the pubic symphysis may be heard during these activities.

Cause:

Although the mechanism or pathogenesis is uncertain, it can be due to the following:

– Pregnancy creates unique structural stresses to the female body. This coupled with ligament laxity resulting from maternal hormones may cause repetitive stress to the pubic symphysis.

– Surgery within close proximity to the pubic symphysis   (e.g. prostate, bladder, urethra, uterus or cervix surgery). Signs and symptoms occur usually within one to three months after surgery. The frequency of this post-surgical complication is between 1 percent and 3 percent.

–Trauma/Injury involving a sudden, forced adduction (motion of bringing your thighs/legs inward) injury or a repetitive minor trauma seen with kicking or running.

 

2.  Sprain or Strain

 

A sprain is a sudden or violent twisting injury of a joint with stretching or tearing of ligaments.  A strain occurs when a muscle is overstretched or torn. This usually occurs as a result of fatigue, overuse, or improper use. Furthermore, damage to your attached tendons can also occur with a strain.

 

Adductor Sprain

These adductor group of muscles of the hip are located on your inner thighs. They are mostly used for bringing the thighs together (called adduction). This adductor muscle ligament injury may occur to an athlete who is involved in kicking, sprinting, water skiing, or jumping (high jumps or hurdles). A sudden pulling or contraction from a stretched position of hip abduction (movement of the leg away from thigh) or flexion (movement when knee comes toward the chest) can cause this injury.

 

Hamstring Strain

This group of  hamstring muscles run along the back of your thigh from your hip to just below your knee. This injury may occur to an athlete or “weekend warrior” who feels a sudden pull or pop at the back of the thigh following a forceful knee extension (straightening your knee) maneuver. By over contracting the hamstrings while in a position of stretch, a tear may occur.

 

Quadriceps Strain

The quadriceps are a group of four muscles that make up the front of your thigh. This injury occurs with a  sudden pulling pain in the front of the thigh after attempting to sprint,”missing” a kick, or suddenly stopping. So  a sudden contraction of the quadriceps may result in a simple strain or a full rupture.

 

Treatment at Meiri Chiropractic for Hip Sprain/Strain or Osteitis Pubis: A Chiropractic Center Can Help

 

Treatment focuses on restoring normal mobility to the hip joint and pelvis. These treatments at Meiri Chiropractic include:

-Chiropractic manipulative therapy- to the hip joint, pelvis and associated regions. 

-Gentle myofascial release and/or post isometric relaxation techniques- to the soft tissues (e.g. muscles, tendons, ligaments, fascia) involved.

-Electric Muscle Stimulation, Ice and Heat Therapies for pain relief and inflammation reduction.

-Therapeutic exercise- with  gentle stretching and a long-term goal of restrengthening.

Finally, recommendations for prevention of further injury at the pelvis, hip and thigh.  This involves a routine of stretching and warming up prior to activity.

 

Getting regular chiropractic care from a West Palm Beach chiropractic center can give relief naturally from an already existing injury, or even offer injury prevention. Chiropractic is a holistic and natural way to treat existing injuries and to keep your body in its best working condition.

Contact Meiri Chiropractic today at 561-253-8984 on Hip Sprain/Strain or Osteitis Pubis: A Chiropractic Center Can Help or/and other ailments.

 

References:

Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011