- Types of Injuries:
- short leg syndrome: (see
growth deformities of the limbs)
- unequal leg lengths may predispose to injury in shorter leg;
- trochanteric bursitis:
- gluteus medius attaches by a broad insertion into its lateral aspect;
- below this insertion the bone is covered by the iliotibial tract;
- a bursa is occassionally the site of inflammaion, lies between the tract and the bone over the
relatively bare portion of the trochanter;
- diff dx:
avascular necrosis:
- AVN often refers pain laterally whereas DJD refers pain medially;
-
steroid injections can provide dramatic relief;
-
iliotibial band syndrome:
- semimembranosous tendonitis:
- predominates in males > 30 yrs of age;
- inflammmation at insertion site of direct head of
semimembranosous tendon into area of
posterior tubercle of tibia can be detected by increased activity on bone scan;
-
pes anserinus bursitis;
- pain 6 in below joint line in medial tibia, w/ swelling & tenderness;
- can be treated w/
NSAIDs and rest;
- this condition should be differentiated w/ stress frx of proximal tibia;
-
popliteus tendinitis
- popliteal tendinitis occurs mainly as result of either
hyperpronation or excessive downhill running;
- pain is localized over popliteus tendon just anterior to
LCL;
- refractory cases may benefit from a local injection of steroids;
-
patellar tendonitis (jumper's knee):
-
exertional compartment syndrome:
-
gastrocnemius rupture
- typically ruptures occur off of the medial origin and may mimic compartment syndrome;
-
tibial stress frx:
-
medial tibial shin splints:
- exercise related pain in the posterior mid to distal 1/3 of the tibia can be related to periostitis at origin of the posterior tibialis;
- exam is notable
for local tenderness with pain on resisted plantar flexion and inversion;
- x-ray may show periosteal change several wks after onset of symptoms;
-
achilles tendon contracture:
-
hyperpronation of the foot:
-
heel pain:
-
metatarsalgia:
-
hallux rigidus:
Muscular control of the ankle in running.
L. Reber et al.
Am J. Sports Med. Vol 21. 1993. p 805-810.
