Experiencing Discomfort in Your Legs?
What are some of the injuries of the leg that Physical Therapy can treat?
Sprains, strains, pulled muscles, broken bones, fractures and sciatica are just some of the reasons a person may visit a physical therapist for their leg. Sometimes it can be difficult to determine the cause of your pain or discomfort but a physical therapist is trained to evaluate the myriad contributing factors to identify the most likely causes and craft a plan of action to improve your symptoms.
WHAT LEG CONDITIONS CAN A PHYSICAL THERAPIST TREAT?
Sciatica: Sciatica refers to pain, burning, tingling, cramping, numbness and sometimes weakness that often begins in the buttock and travels down the back of the leg. It is caused by compression or irritation of the sciatic nerve that originates in the low back and travels down the posterior leg. With severe or prolonged compression or irritation muscle weakness can also occur. Your physical therapist will be assessing for a number of causes including disc herniations, misalignment of the pelvis, tightness in the hip or buttock muscles, narrowing of the spine or biomechanical problems before they begin treating you.
Muscle Strain: Muscles are made up of bundles of muscle fibers aligned in specific patterns. When these fibers contract they shorten the muscle and pull on the bones they attach to creating movement and strength. At either end of these fibers is a strong band of tissue called the tendon which connects the fibers to the bone. When overstretched, overused or contracted against a sudden load, a muscle strain can occur as muscle fibers or the musculotendinous junction are torn or injured.
Grade I strain (mild): very few muscle fibers are injured. Pain typically occurs the next day but no swelling or bruising is observed. Pain may be felt when the affected muscle is strongly contracted or stretched at its end range.
Grade II strain (moderate): many (but not all) fibers are injured resulting in stiffness, loss of flexibility and loss of strength. Pain is felt both during contraction of the muscle and during stretching. Swelling and bruising over the injured area is common.
Grade III strain (severe): all fibers of the muscle are completely torn or the muscle belly has detached from it’s tendon. Severe pain is often felt upon injury and heavy swelling and bruising will develop. Range of motion may be either significantly reduced due to pain or excessive because the muscle is no longer limiting it. This muscle will generally be unable to produce any force due to the severe disruption in the fibers.
Ligament Sprains: ligaments are bands of collagen tissue that support bones, joints and organs. In the leg the most common ligament sprains occur at the knee and ankle. A sprain typically occurs when these inelastic fibers are stretched beyond their capacity such as when you twist your knee or roll your ankle. Because the primary function of ligaments is to provide passive stabilization to the area, loss of stability can range from mild to severe with a ligament sprain.
Grade I (mild): microscopic damage has occurred to the ligament but only mild local tenderness and minimal bruising/swelling is noted without compromising joint stability. Typically takes 2-3 weeks to heal.
Grade II (moderate): partial tear/rupture of the ligament. Obvious swelling and tenderness noted over the injured ligament but joint instability is either minimal or absent. May require up to 6 weeks to heal.
Grade III (severe): complete rupture of the ligament with severe swelling and tenderness. This injury may be difficult to distinguish from a fracture initially. Instability of the joint is noticeable due to the severity of the rupture. Prolonged time to heal is frequent and may require surgery to repair.
Tendinopathy: Tendons are the thick, fibrous bands or cords that attach muscle fibers to bones. Pain felt outside of a joint at the end of a muscle which is exacerbated by movement may be tendonitis or tendinopathy. The most common cause of inflammation and irritation in the tendon is repetitive overuse. Often biomechanical or movement errors, muscle strength and length asymmetries or insufficiencies are an underlying cause. Pain is usually described as a dull ache that can interfere with your activities. Tenderness, mild swelling and general weakness may also be present. Patellar tendinopathy, achilles tendinopathy and hip flexor tendinopathy are examples of tendon irritation that may occur in the leg.
Muscle contusion: muscle contusions (bruises) are a common cause of injury in contact sports. Minor contusions typically heal quickly with little disruption to sports or daily life. A direct or repeated blow to the muscle can cause a severe contusion, however, which causes deep tissue damage to the muscle fibers and connective tissue and can take a long time to heal. Swelling, stiffness, weakness, localized bruising and pain are common. Sometimes a pool of blood called a hematoma can form over the area. Severe muscle contusions should always be evaluated by a health professional as there is a right and a wrong way to treat these injuries.
HOW WILL YOUR PHYSICAL THERAPIST TREAT YOUR LEG?
As you can see, leg injuries can vary widely and at times symptoms may even be referred from another area such as your back. Initially your PT will assess your leg to determine the cause and contributing factors to your symptoms and then will begin a customized treatment plan to get you back on your feet.
If you are being treated for an acute injury such as a sprain or strain, your physical therapist will educate you on how to protect these newly healing tissues. Treatment may include compression or bracing, offloading the injured area through crutches, modalities such as ice, ultrasound or electrical stimulation to reduce pain and swelling and activity modification.
In well-healed tissues, chronic injuries like tendinopathy or referred conditions like sciatica, your physical therapy program will focus not only on reducing or eliminating localized symptoms but on addressing factors that contributed to the onset of the symptoms. Often injuries or pain in the leg are caused by repeating faulty movement patterns or having an imbalance of muscle strength and length to carry out a task such as running, cutting, or jumping optimally and with good mechanics.
While some leg injuries may require intervention by a doctor or surgeon, a physical therapist should always be a primary member of your care team. A physical therapist at Evolve can help you get on the road to recovery. Our therapists do not just treat symptoms, but we get to the root of the cause. We strive to enable our patients to live pain free, and to prevent the recurrence of related issues.
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About EvolveNY-
Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.
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