Lower Leg

Question 1

Anterior Compartment of the Lower Leg

Answer 1

Tibialis anterior
Peroneus tertius
Extensor digitorum longus
Extensor hallicus

Question 2

Lateral Compartment of the Lower Leg

Answer 2

Peroneus longus and brevis

Question 3

Superficial Posterior Compartment of the Lower Leg

Answer 3

Gastrocnemius
Soleus
Plantaris

Question 4

Deep Posterior Compartment of the Lower Leg

Answer 4

Flexor digitorum longus
Flexor hallicus
Tibialis posterior

Question 5

Acute Achilles Strain
Etiology

Answer 5

Common in sports and often occurs with sprains or excessive dorsiflexion

Question 6

acute achilles strain s/s

Answer 6

-Pain may be mild to severe
-Most severe injury is partial/complete avulsion or rupturing of the Achilles

Question 7

Acute Achilles Strain Management

Answer 7

• Pressure and RICE should be applied
• After hemorrhaging has subsided an elastic wrap should continue to be applied
• Conservative treatment should be used as Achilles problems generally become chronic
• A heel lift should be used and stretching and strengthening should begin soon

Question 8

achilles tendonitis etiology

Answer 8

• inflammation of tendon, sheath, paratendon
• tenosynovitis
• cause fibrosis +scar tissue, can lead to tendonosis
• restrict tendon motion in sheath
• due to extensive stress
• decrease flexibility

Question 9

achilles tendonitis s/s

Answer 9

• pain and stiffness, proximal to calc insertion
• warm and painful palpation, thickening
• limit strength
• crepitus w active plantar flex, passive dorsi
• Chronic inflammation lead to thickening

Question 10

achilles tendonitis management

Answer 10

-Must reduce stress on tendon
- anti-inflammatory modalities
- cross friction massage
- progressive strength

Question 11

achilles tendon rupture

Answer 11

E:
- sudden stop and go
- forceful plantar flexion w knee full ext
- more so >30 yrs
S/S:
- sudden snap w immediate pain
- pt tenderness, swelling, discoloration, decrease ROM
- positive thompson test
- 2-6cm proximal of calcaneal insertion
M:
- surgical repair 75-80%
- RICE, NSAIDs, walking cast
- rehab 6mo

Question 12

shin contusion

Answer 12

Direct blow to lower leg

• intense pain, rapid form hematoma
  w/ jelly consistency

-RICE; compression for hematoma; doughnut pad and could be osteomyelitis

Question 13

muscle contusion

Answer 13

contusion of leg, mostly in gastroc area

• bruise develop, weakness, partial limb loss function
• palpation reveal hard, rigid, inflexible due to internal hemorrhaging
• stretch to prevent spasm; cold compression
• superficial therapy and massage
• ultrasound
• wrap or tape

Question 14

gastrocnemius strain

Answer 14

• most common near the myotendinous junction
• quick start, stop, or jumping
• depends on severity
• swelling, pain, muscle disability (plantar flexion)
• “hit in leg with a stick”
• resisted plantar flexsion + knee extension painful

-RICE
-grade 1 apply gentle stretching
-weight bear as tolerated
-gradual rehab

Question 15

acute leg fracture

Answer 15

• fibula break in middle 3rd
• tibial fracture in lower 3rd
• blow or indirect trauma
• pain, swelling, soft tissue insult
• leg is hard and swollen
• x-ray, cast ~6 weeks

Question 16

Medial Tibial Stress Syndrome Etiology

Answer 16

shin splints (catch for all stress fractures, muscle strains, chronic ant compt syndrome)

• 10-15% running injuries, 60% in athletes
• repetitive microtrauma
• weak muscles, inaprop footwear, varus foot, pronated foot
• involve stress fracture or exertional comp. syndrome

Question 17

Medial Tibial Stress Syndrome S/S

Answer 17

Four grades of pain
1. Pain after activity
2. Pain before and after activity and not affecting
performance
3. Pain before, during and after activity, affecting
performance
4. Pain so severe, performance is impossible