Soft tissue injuries to the legs such as sprains or strains are most commonly treated with ice initially. Heat treatment may be used on tears to the leg muscles or tendons to help stimulate the blood flow necessary for healing. Immobilization in a splint or brace, along with limited weight bearing with crutches, may be required for initial treatment as well with more severe injuries.

Osteopathic manipulative therapy, or the use of manual pressure, can be employed to relieve pain for many musculoskeletal issues and repetitive stress injuries. Our osteopathic physician will complete a thorough physical examination and determine the most appropriate stretching, resistance or use of pressure technique that will help ease your pain or heal your injury. Osteopathic manipulation can be a complement to your physical therapy or injection therapy as well.

The conservative – albeit sometimes short-term – solution to many leg injuries is to adjust your exercise routine or use nonsteroidal anti-inflammatory drugs (NSAIDs). Most stress fractures heal with relative rest and activity modification.

For certain tibia injuries, immobilization with a splint, protective boot or crutches may be necessary.

Exercise prescriptions could come in a variety of formats. Specific movements may be suggested to stretch and strengthen key leg muscles. Biomechanical adjustments to your technique or form may help alleviate pain. You may have to take a complete break from your sport or switch to a low-impact activity such as swimming to allow the injury to heal and/or prevent recurrence.

Orthotic shoe inserts may be required to alleviate activity-related pain in the foot or throughout the lower extremity. These can be designed and constructed by our physical therapists upon recommendation and referral from our physicians.

Chronic exertional compartment syndrome, or CECS, occurs when lower leg musculature expands and creates pain and pressure, potentially causing numbness in the foot and cutting off vascular supply, thereby impeding movement. Surgeons use needle manometry – a needle fixed with a pressure gauge – to measure the pressures within the muscular compartments. Once the diagnosis is confirmed, the surgical procedure to release the pressure involves making a slit in muscle casing to give the muscle more room to expand when activity demands it. This relieves the pressure and helps restore blood flow, which diminishes foot numbness, allowing you to resume regular activity.

A common, high-risk injury for athletes is a tibia (shin) stress fracture. This results from repetitive overuse, which is common in many running and jumping sports. A tibial stress fracture may look normal on initial X-rays. A bone scan or MRI is usually required to confirm the diagnosis. Stress fractures that do not heal with nonsurgical treatment, involve multiple bone fragments or have a significant gap between sections of fractured bone usually require one of three types of specialized surgery:

Intramedullary nailing/rodding

This is one of the most preferred surgeries for tibial fractures. A metal rod is inserted through the knee and into the tibia to stabilize the bone from the inside out. An intramedullary “nail” is maintained in place while the fracture heals. This procedure usually results in a firm bonding of the fractured tibia and protects the remaining portions of the bone from later injury.

External fixation

This is another procedure that can be used for significant fractures. Metal screws or pins are externally affixed to the bone above and below the fracture. A bar is then attached to the screws or pins outside the skin to keep the fractured bone to maintain stability either temporarily or until the fracture heals. This surgery is somewhat less invasive than intramedullary nailing.

Open reduction and internal fixation (plates and screws)

When other surgical procedures are not an option because the fracture runs into the knee or ankle joint or if there are multiple fragments present, plates and screws can be used. First the bone fragments are realigned and then they are held in place using surgical screws and metal plates.