Lower Extremity Injury

The lower extremity includes the hip, thigh, knee, lower leg, ankle, and foot. Common injuries include sprains and strains, joint dislocations, and fractures (broken bones), which can affect the entire leg or an isolated part of the lower extremity. For more information on knee conditions, specifically, visit our page on knee pain

Physical therapy for hip, leg, and foot pain

The lower extremity is a combination of bones, joints, and soft tissue (including muscle) responsible for bearing our bull body weight, helping with balance, and maintaining proper alignment. When anyone aspect of the lower extremity is weak or not functioning properly, the rest of the body compensates. If not addressed early on, this instability or misalignment can lead to additional sources of pain. Physical therapists use comprehensive, full-body evaluation to determine the causes of pain and dysfunction. As the first line of defense, physical therapy’s non-surgical approach is noninvasive, conservative, and cost-efficient.

Osteoarthritis of the hip

Osteoarthritis of the hip occurs when the cartilage coverings on the ball and the socket of the hip wear out. It is worse when bearing weight on the affected leg. The range of motion is often limited, especially internal rotation and hip flexion. However, with joint mobilization and stretching, significant pain relief can occur.

Muscle strains

A strain to the quadriceps, hamstring, gastrocnemius (calf), or adductor (groin) muscle is often the result of quick sprints or stops or sudden changes in direction. With a muscle strain, there is localized tenderness or a “bulge” in the tender area. The pain can be aggravated by walking, going up or downstairs, raising the heel, standing up, or lifting the leg. Sometimes a pulling or pop may be noted. Physical therapy can help rehabilitate a muscle strain, and also provide the knowledge around strengthening and proper body mechanics to avoid future injury.

Fractures and stress fractures in the leg

Fractures or broken bones may involve the outside or inside of the leg. The signs and symptoms of fractures are pain, swelling, and body deformities. Following x-rays, casting, or surgery, physical therapy can help the body heal and restore the patient’s ability to move properly. Types of fractures include compound, transverse, oblique, and comminuted. A bad fall or blow to the hip can break the thigh bone around the femoral neck region. Stress fractures, however, are the result of repetitive submaximal loads applied to the foot, ankle, or leg. They are often the result of overuse, especially in athletes who undergo heavy training, such as long-distance runners. Stress fractures are especially common in female athletes. Pain and point tenderness occurs in the stress fracture sites, and most heal with rest and a proper return to activity training plan from a physical therapist.

Tendonitis in the foot

Achilles Tendonitis or Tendinosis occurs when excessive stress is placed on a tight or fatigued calf muscle, causing the attached tendon to experience microtrauma, degeneration, or inflammation (in the case of tendonitis). Prolonged walking, overtraining, excessive running or jumping, or walking hills can cause this condition. Physical therapy can help stretch and strengthen the tendon, providing a progress return to daily activities or sports. Another common form of tendonitis is Tibialis Posterior Tendonitis. This often occurs in overweight, middle-aged patients as a result of degenerative changes in the tendon. A flattened arch is also typical. The rupture can cause pain below or behind the inside ankle bone. Physical therapy modalities can help lessen inflammation.

Ankle sprains

Ankle sprains are a very common injury and can range from Grade I to Grade III. They usually occur when the foot is forcefully inverted or turned inward. Signs and symptoms include ankle pain, swelling, and a sense of instability. Early rehabilitation can assist in a more rapid recovery.

Plantar fasciitis

The most common source of heel pain is plantar fasciitis or inflammation of the fascia on the bottom of the foot. There are many causes of this condition, but a physical therapist can help address each patient’s specific reason for pain. Causes may include poor flexibility in the calf muscles, a lack of arch support or poor footwear, a sudden increase in activity level, being overweight, excessive pronation, or repetitive stress on the foot (such as long-distance running). Regardless of the cause, plantar fasciitis can be incredibly painful and may lead to inflammation, swelling, warmth, loss of function, inability to stand or walk, and sometimes, redness. Pain is often worse in the morning when taking the first steps of the day.

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