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Lower Limb

 

lower limb

Soft Tissue Injuries of the Hip and Groin

A soft tissue injury can be defined as damage of the muscles, ligaments and tendons throughout the body. A sprain, a strain, a one off blow resulting in contusion or overuse of a particular part of the body can all cause a soft tissue injury. Soft tissue injuries can result in pain, swelling, bruising and the loss of function.

The following list of injuries has many sources but they are generally present with pain at the front of the hip, radiating into the groin or lower abdomen. They are strongly associated with sports that require a strong rotatory component such as soccer, gaelic football and hurling.

Degenerative Changes

Degenerative changes in the spine is medically referred to as spondylosis, which is the medical term for degenerative changes in the spine. X-ray or MRI can identify this common condition. Growing old or the ageing process gradually leads to the degeneration of all joints.

One of the main joints associated with degenerative arthritis is the hip, however, not all arthritic hips require hip replacement. Early intervention is key when it comes to slowing down the degenerative process. Should you require interventions such as hip arthroscopy or joint replacement/re-surfacing; pre and post-op Physiotherapy will optimise your recovery. Early degenerative changes can be successfully managed for many years with a prescribed exercise programme and by modifying your general exercise i.e cycling and swimming. Keeping your gluteal muscles strong is a key factor in slowing down the degenerative process of the hip joint.

Adductor Muscle Strain

Adductor muscle strain can be defined as inflammation and pain along the inner thigh muscles and groin. Pain is usually felt on the inner thigh anywhere from the pubic bone to the inner knee. The strain may be a partial or a complete tear of any or all of the adductor muscles. Some bruising of the area may also occur and it might be painful to move your leg in and out.

Rectus Abdominis Strain

The rectus abdominis is a large muscle in the centre of your abdomen that extends from your ribs to the front of your pubic bone. Rectus abdominis strain will result in pain and tenderness over the upper part of the pubic bone and ‘six pack’ stomach muscles. Injuries to this muscle results in varying degrees of abdominal strain, but pain is particularly felt during abdominal contraction, i.e sitting forward, sit-ups or single leg lifts.

Iliopsoas Strain

Iliopsoas refers to a combination of anterior hip muscles and these muscles are sometimes referred to as the ‘hip flexor’ muscles. An iliopsoas strain is an injury characterised by tearing of one or more of the hip flexor muscles and typically causes pain in the front of the hip or groin. Pain in this muscle will be felt on lifting the leg (knee to chest).

Gilmore’s Groin

A tear in the oblique muscle tendon can cause an enlargement of the superficial inguinal ring and possibly a tear in the conjoint tendon (where the internal oblique and transverse abdominal muscles join the pubic bone). Pain is similar to an abdominal muscle injury or inguinal ligament injury, and treatment is usually surgical repair.

Ligament Injuries / Inguinal Ligament

The inguinal ligament is the tough fibrous band that supports the groin region and helps to prevent the intestines from protruding into the groin. It is an important connective tissue structure in the inguinal, or groin, region of the human body. An injury to the inguinal ligament is common amongst those who participate in certain types of sports.

Osteitis Pubis

Osteitis Pubis is an umbrella term that describes a non-infectious inflammation of the pubis symphsis, causing varying degrees of lower abdominal and pelvic pain. Pain is usually centred in the area where two pubic bones meet (pubic symphysis) and is first recognised by an unexplained reduction in performance. It results from a number of different pathologies usually caused by ‘overload’ of the pelvic region from lack of stability in the surrounding muscle.

Patello-Femoral

Patello-femoral pain syndrome is referred to as pain in the front of the knee that is caused by the wearing away, roughening, or softening of the cartilage under the kneecap. Palleto-femoral pain is prevalent in runners and cyclists and some of the symptoms include; knee pain when coming down stairs, buckling or popping of the knee and sometimes a grinding sensation when moving the knee. Local treatment to the inflamed tissues and addressing the faulty mechanics by screening the movement patterns of the lower limb is necessary to resolve the problem.

IT Band

Poor biomechanics can lead to the development of this problem. This can include fallen arches or high arches, weak gluteal or hip muscles and a poor running pattern. Biomechanical assessment of the lower limb is necessary to find the cause of this problem. Treatment will focus on correcting your biomechanics, strengthening weak muscles and advice regarding training frequency, intensity and duration to manage your symptoms effectively.  Functional rehabilitation may also be of value in improving movement control of the lower limb.

TIP: To help prevent IT Band syndrome, change your running shoes regularly. If you feel pain on the outside of the knee, rest from the aggravating activity for 3 days. If symptoms persist consult your Chartered Physiotherapist.

Osteoarthritis

Osteoarthritis is a common disease of the joints that will affect almost everyone as they get older, but it can also affect those who are younger. Knee osteoarthritis and hip osteoarthritis are two of the most common forms of this condition. Osteoarthritis cannot be cured but an early diagnosis and early treatment can help to slow down its progression. Ligament repair is enhanced by physiotherapy, however, cartilage tears, which continue to cause locking or clicking in the joint. This may require an arthroscopy to assess/treat the tear. The main risk factors of osteoarthritis include; age, gender, obesity, joint injury and other types of joint diseases.

Arthroscopy

This is a minimally invasive technique where a surgeon can see inside a joint and carry out repair. Usually mild pain afterwards for 1-2 days with some associated swelling. Some patients may require physiotherapy to restore full function. All will require an exercise programme.

Contact us here if you would like any more information regarding the above treatments.

Ankle Problems

The ankle joint is the meeting of the bones of the leg and the foot and it is responsible for the up and down motion of the foot. A short statement which understates the vital role of this joint in our mobility. For example, a poorly rehabilitated minor ankle sprain can result in localised stiffness; not much of a problem you might say but in later years the under-performing ankle joint can lead to overload of the knee and foot often resulting in pain.

Common problems in the ankle can result from inflammation or injury to any of the structures in this region, including the bones, joints, cartilage, ligaments, tendons, or muscles. Symptoms include; pain at the time of injury, followed by swelling and bruising. Difficulty with weight bearing may also be experienced. Common ankle injuries include ankle sprain, fracture, tendonitis, achilles tendon rupture and plantar fasciitis.

Ligament damage responds very well to physiotherapy and a rehabilitation programme is essential to prevent further injuries. Biomechanical assessment of the feet is of value, especially in recurrent injuries.

Achilles Tendon

If your Achilles Tendon pain from a sporting injury, please click here.

The Achilles tendon is the large tendon that stretches from your heel bone to your calf muscles and it allows you to point your toes to the floor. It is a commonly injured tendon and the majority of Achilles tendon injuries are due to tendinopathy, in which the tendon becomes swollen and painful.

Niggling pain/inflammation responds well to physiotherapy, sometimes eccentric loading programmes will be used. In a severe Achilles tendon injury, too much force on the tendon can cause it to tear partially or rupture completely. Often, when it is a complete tear, surgery is required as soon as possible.

To find out more about the services that Ballsbridge Physiotherapy can provide please contact us.