Bruised shin bone lump


  • Health A-Z
  • That Nagging Shin Pain…The Good, The Bad and The Ugly
  • Calf and Shin Problems
  • Bruising in leukaemia VS ordinary bruising
  • What causes you to get a dead leg?
  • What is Periosteal Contusion and How Can I Prevent It?
  • Health A-Z

    What causes you to get a dead leg? Or if you bang the side of your leg against a table and find yourself collapsing on to the floor?

    A very common sporting injury, the impact causes the thigh muscles quadriceps to be crushed against the underlying thigh bone femur. As a result, bleeding can occur both within and around the muscle and thigh. This can lead to wide-spread bruising, pain and restricted movement. Very often, these injuries can be treated conservatively with minimal complications.

    However in severe cases and when treated inappropriately, myositis ossificans may result. This term refers to the formation of bone tissue within the muscle. There are some steps you can take, however, to reduce your chance of injury.

    This is key in informing your rehabilitation and treatment programme. As more tissue healing is necessary, you can expect to return to play after a minimum of eight weeks. Myositis ossificans In more severe long-term cases, a condition known as myositis ossificans can develop.

    This involves the body laying down bone tissue into the muscle. This can become extremely debilitating and appropriate management early is important to avoid this. A return to competition can take upwards of twelve months. This will reduce inflammation to the area. The next step is to seek professional help from your physiotherapist for an assessment and treatment program.

    Your physiotherapist will be able to use various treatment methods to reduce pain, promote healing and get you back to normal life and sport. These treatments may include: Soft tissue massage.

    That Nagging Shin Pain…The Good, The Bad and The Ugly

    Referred Pain Muscle Strains Muscle strains are the most common causes of calf pain. An explosive acceleration such as stretching to play a ball at squash or tennis may cause injury. The calf region is also a common site of contusion local damage to the muscle which results in bleeding caused through a direct blow to the muscle. Some people experience episodes of cramping pain in the calf that may be due to recurrent minor calf muscle strains, which are as a result of poorly rehabilitated scar tissue.

    Calf pain can also be referred pain from neural structures or from the lumbar spine. Cramps The calf is the most common site of muscle cramps in the body. These can be treated with regular muscle stretching, correction of muscle balance and posture, and adequate conditioning for the activity.

    Other strategies implemented at Physio Team-Works include incorporating plyometrics and eccentric muscle strengthening into training programmes, educating regarding maintaining adequate carbohydrate reserves during competition and the treatment of myofascial trigger points. We can advise on adequate fluid, carbohydrate and electrolyte intake with the recommendation of appropriate supplement drinks. Physio Team-Works has strong background in strength and conditioning.

    Nutritional support is essential. Biomechanics Biomechanical factors may be the underlying cause of calf pain. Excessive flat footedness over pronation can overload the calf muscles causing muscle tightness and soreness. This can predispose to the development of compartment syndrome. Physio Team-Works can arrange for you too see one of our accredited podiatrists if we believe that your symptoms are caused by a biomechanical problem.

    We also have access to gait analysis which can aid appropriate management. Signs and symptoms include constant calf pain, tenderness, increased temperature and swelling within the calf. Hospital treatment is required for a confirmed DVT. Doppler investigation can be arranged. These pains are usually deep and aching all the time but can sometimes be exercise-induced.

    The knee joint may also occasionally refer pain to the calf. Patients often complain of pain to the calf or knee. Physio Team-Works are experts in diagnostic assessment to differentiate between a back referred pain and a local pain. Of course people can have both. Shin pain generally involves one or more of three pathological processes: 1. Bone Stress — a continuum of increased bone damage exists.

    Ranging from bone strain to stress reaction to stress fracture. Inflammation — inflammation develops at the insertion of muscles and fascia to the inside border of the shin bone. Raised Intra — compartment Pressure — the lower leg has a number of muscle compartments each enveloped by fascia. These muscle compartments may become swollen and painful as a result of overuse or inflammation. One of the major causes of all three injuries is abnormal biomechanics. Stress fracture of the tibia Stress fracture of the tibia presents as a gradual onset of shin pain aggravated by exercise.

    Pain may occur with walking, at rest and even at night. Pain is felt along the inside border of the shin and usually reduces with warming up. The patient can often complete a training session but pain gradually recurs after exercise and is worse the following morning.

    Initial treatment is to reduce inflammation. Podiatric assessment and physiotherapy advice regarding stretching and training are also important components of the management of this condition. The most effective definitive treatment involves a deep physiotherapeutic massage therapy and corrective foot dynamics. Stress fractures of the fibula Stress fractures of the fibula can cause shin pain.

    These can be caused by muscular stress and forces placed through the bone. This injury is often caused by biomechanical abnormality. It is treated with rest from activity until the tenderness settles and then with a graduated exercise programme.

    Soft tissue abnormalities should also be corrected. Chronic compartment syndrome Chronic compartment syndromes are a common cause of shin pain. The exact cause of this condition remains unclear.

    An inflammatory process occurs and leads to fibrosis and reduced elasticity of the fascia surrounding the muscle compartments. As a result, when the patient exercises, the muscles attempt to expand but are unable to do so. This results in increased pressure and, therefore, pain.

    Treatment consists initially of a conservative regimen of relative rest and deep massage therapy and assessment and correction of any biomechanical abnormalities. Surgery can be indicated if conservative treatment fails. Shin Splints What are shin splints? The term shin splints is a common misnomer in sports medicine. It does not imply a specific diagnosis, rather it is the symptom of pain over the front of the tibia bone.

    The pain from shin splints can be due to either problems of the muscles, the bone, or the attachment of the muscle to the bone. The most common cause is inflammation of the periostium of the tibia sheath surrounding the bone. Traction forces on the periosteum from the muscles of the lower leg cause shin pain and inflammation.

    This has lead to the use of terms such as Medial Tibial Traction Periostitis. What causes shin splints? The pain of shin splints is caused by trauma to either the muscles or bones of the lower leg. Muscle trauma exertional compartment syndrome is often related to overtraining or excessive running on hard surfaces. Repeated use makes the muscles swell and puts pressure on the fascia that covers the muscles in the lower leg leading to pressure and pain.

    Bone trauma to the lower leg can result in stress fractures. Constant pounding the leg bones may cause microscopic cracks and fractures in the tibia and fibula lower leg bones. Rest is needed to repair these cracks, but without adequate recovery, these cracks continue to grow and become a fracture. The result is acute pain and a long recovery. Beginning runners are at increased risk of shin splints and stress fractures because they are not used to the high impact running has on the muscles and joints of the lower leg and foot.

    Running on hard surfaces especially with worn, poorly cushioned footwear increases stress on the muscles, joints and bones and is another cause of shin splints.

    Excessive pronation or other biomechanical problems can increase the risk of developing shin splints. What are the symptoms of shin splints? Pain over the inside lower half of the shin. Pain at the start of exercise which often eases as the session continues Pain often returns after activity and may be at its worse the next morning.

    Sometimes some swelling. Lumps and bumps may be felt when feeling the inside of the shin bone. Pain when the toes or foot are bent downwards. A redness over the inside of the shin not always present. Physiotherapy treatment Shin splint from running, it will only get worse if you continue in that sport. You can, however, cross-train on a bicycle or elliptical machine, or hit the swimming pool to maintain your aerobic base until the injury heals.

    Our Physiotherapists will identify those areas which are seen to be contributing to the injury. We implement several strategies to help maximise recovery: Active rest with alternative training bicycle, swimming modify your training schedules.

    Arch supports prescribed orthotics from our podiatrists Ice therapy cryocuff on the tender area five to ten minutes a couple of times a day, we can supply these devices if required Stretching calf muscles before and after activity especially after Passive muscle energy techniques.

    Graded exercise program to strengthen the lower leg, abdominal, and pelvic muscles. Taping the ankle to take pressure off the lower leg muscles can also be helpful or dynamic bracing. Achilles Pain Achilles tendonitis is often now being referred to as Achilles tendinopathy.

    This is because it is no longer thought to be an inflammatory condition. On investigation, the main finding is usually degenerated tissue with a loss of normal fibre structure. Achilles tendonitis can be either acute, meaning occurring over a period of a few days, following an increase in training, or chronic which occurs over a longer period of time.

    In addition to being either chronic or acute, the condition can also be either at the attachment point to the heel or in the mid-portion of the tendon typically around 4cm above the heel. Healing of the Achilles tendon is often slow, due to its poor blood supply. Symptoms of achilles pain Gradual onset of pain at the back of the ankle, just above the heel bone. This develops over a period of days. Pain at the onset of exercise which fades as the exercise progresses.

    Pain eases with rest. Usually worse in the mornings this is thought to be due to lack of movement in the night and positioning of the ankle Tenderness on touch. Chronic Achilles tendonitis may follow on from acute tendonitis if it goes untreated or is not allow sufficient rest. Chronic Achilles tendonitis is a difficult condition to treat, particularly in older athletes who appear to suffer more often.

    A number of factors can lead to this condition, here are some of those: Years of running Increase in activity mileage, speed, gradient Decrease in recovery time between training sessions Change of surface.

    Calf and Shin Problems

    Of course people can have both. Shin pain generally involves one or more of three pathological processes: 1. Bone Stress — a continuum of increased bone damage exists.

    Ranging from bone strain to stress reaction to stress fracture. Inflammation — inflammation develops at the insertion of muscles and fascia to the inside border of the shin bone.

    Raised Intra — compartment Pressure — the lower leg has a number of muscle compartments each enveloped by fascia. These muscle compartments may become swollen and painful as a result of overuse or inflammation. One of the major causes of all three injuries is abnormal biomechanics. Stress fracture of the tibia Stress fracture of the tibia presents as a gradual onset of shin pain aggravated by exercise.

    Bruising in leukaemia VS ordinary bruising

    Pain may occur with walking, at rest and even at night. Pain is felt along the inside border of the shin and usually reduces with warming up. The patient can often complete a training session but pain gradually recurs after exercise and is worse the following morning. Initial treatment is to reduce inflammation. Podiatric assessment and physiotherapy advice regarding stretching and training are also important components of the management of this condition.

    What causes you to get a dead leg?

    The most effective definitive treatment involves a deep physiotherapeutic massage therapy and corrective foot dynamics. Stress fractures of the fibula Stress fractures of the fibula can cause shin pain. These can be caused by muscular stress and forces placed through the bone. This injury is often caused by biomechanical abnormality. It is treated with rest from activity until the tenderness settles and then with a graduated exercise programme. Soft tissue abnormalities should also be corrected.

    Chronic compartment syndrome Chronic compartment syndromes are a common cause of shin pain. The exact cause of this condition remains unclear. An inflammatory process occurs and leads to fibrosis and reduced elasticity of the fascia surrounding the muscle compartments. As a result, when the patient exercises, the muscles attempt to expand but are unable to do so. This results in increased pressure and, therefore, pain. Treatment consists initially of a conservative regimen of relative rest and deep massage therapy and assessment and correction of any biomechanical abnormalities.

    Surgery can be indicated if conservative treatment fails. Shin Splints What are shin splints? The term shin splints is a common misnomer in sports medicine. It does not imply a specific diagnosis, rather it is the symptom of pain over the front of the tibia bone.

    The pain from shin splints can be due to either problems of the muscles, the bone, or the attachment of the muscle to the bone. The most common cause is inflammation of the periostium of the tibia sheath surrounding the bone.

    Traction forces on the periosteum from the muscles of the lower leg cause shin pain and inflammation. This has lead to the use of terms such as Medial Tibial Traction Periostitis.

    What causes shin splints? The pain of shin splints is caused by trauma to either the muscles or bones of the lower leg. Muscle trauma exertional compartment syndrome is often related to overtraining or excessive running on hard surfaces. Repeated use makes the muscles swell and puts pressure on the fascia that covers the muscles in the lower leg leading to pressure and pain. Bone trauma to the lower leg can result in stress fractures. Constant pounding the leg bones may cause microscopic cracks and fractures in the tibia and fibula lower leg bones.

    Rest is needed to repair these cracks, but without adequate recovery, these cracks continue to grow and become a fracture. The result is acute pain and a long recovery. Beginning runners are at increased risk of shin splints and stress fractures because they are not used to the high impact running has on the muscles and joints of the lower leg and foot.

    Running on hard surfaces especially with worn, poorly cushioned footwear increases stress on the muscles, joints and bones and is another cause of shin splints. Excessive pronation or other biomechanical problems can increase the risk of developing shin splints.

    What are the symptoms of shin splints? Pain over the inside lower half mosaic artists the shin. Pain at the start of exercise which often eases as the session continues Pain often returns after activity and may be at its worse the next morning.

    What is Periosteal Contusion and How Can I Prevent It?

    This delay in diagnosis could potentially be fatal because of the risk of fracture. Although this risk is particularly high in elite athletes such as racehorses, I regard all horses as athletes to a greater or lesser extent and, therefore, any horse could potentially fracture a bone. It is interesting that in human orthopaedics, where MRI is part of a routine evaluation, bone oedema is also a common precursor to injuries in athletes too; a good example is in cruciate ligament injuries of the knee.

    Treatment The condition of sub-chondral bone disease is still not fully understood and many factors may affect speed of recovery.

    The aims of treatment are to restore the original bone function and metabolism as well as preventing further progression and ultimately fracture. Rest may be used initially to reduce the inflammation within the bone although prolonged rest may delay bone healing. Change in the frequency, duration and intensity of exercise as well as reducing concussion with swimming can be used to reduce the impact on the sub-chondral bone and therefore promote healing.

    This time to healing is generally a minimum period of several weeks but may be many months. Aspirin can be used to increase blood supply to these areas of bone damage although its effectiveness is not fully known. The use of internal fixation using screws to stabilise the area has a dual purpose of preventing fracture and allowing blood vessels to regrow to effect and speed up repair. It may be used following the failure of a prolonged restricted exercise regimen or as a first line treatment.


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