{"id":1981,"date":"2024-06-12T18:15:06","date_gmt":"2024-06-12T18:15:06","guid":{"rendered":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/?p=1981"},"modified":"2024-06-13T00:47:42","modified_gmt":"2024-06-13T00:47:42","slug":"lower-leg-pain-finding-a-leg-to-stand-on","status":"publish","type":"post","link":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/lower-leg-pain-finding-a-leg-to-stand-on\/","title":{"rendered":"Lower Leg Pain: Finding a Leg to Stand On"},"content":{"rendered":"<p>\u201c<em>Not having a leg to stand on<\/em>\u201d is an adage for lacking physical support. Clients may experience physical pains or medical conditions of their lower legs. Certain conditions mandate modifications to exercise and activities of daily life. Others that are more severe may be only remediated by orthopedic intervention. Trainers\u00a0<em>can<\/em>\u00a0support clients\u2019 mobile actions as assurances they\u00a0<em>do<\/em>\u00a0have strong legs to stand on. They should also be aware of \u201c<a href=\"https:\/\/personaltrainertoday.com\/pre-hab\">pre-hab<\/a>\u201d and \u201cre-hab\u201d best practices to prevent lower leg pain.<\/p>\n<div id=\"attachment_65021\" class=\"wp-caption aligncenter\">\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-65021 size-medium\" src=\"https:\/\/nfpt.com\/wp-content\/uploads\/leg-pain_shin-splints-bioped-dot-com-300x300.jpg\" alt=\"Leg Pain Shin Splints Bioped Dot Com\" width=\"300\" height=\"300\" aria-describedby=\"caption-attachment-65021\" \/><\/p>\n<p id=\"caption-attachment-65021\" class=\"wp-caption-text\">Image source: Conditions\/Treatments \u2013 Relieve Foot Pain &amp; Leg Pain (bioped.com)<\/p>\n<p class=\"wp-caption-text\">I recently discussed how our <a href=\"https:\/\/personaltrainertoday.com\/terminal-thoughts-for-fit-feet\">ankles and feet<\/a>\u00a0<em>normally<\/em>\u00a0absorb high dynamic loads transferred to our bones. Moving up a biomechanical chain, our lower legs also absorb impressive static and dynamic loads from weight-bearing activities.<\/p>\n<\/div>\n<p><em>Notes:\u00a0<\/em>a.<em>\u00a0Adaptive<\/em>\u00a0protocols are assuredly needed if a client has a \u201cbelow the knee\u201d or a high leg prosthetic. The balance of this post will address clients that do\u00a0not\u00a0wear leg prosthetics. b. Moderate Leg Length Discrepancies (<a href=\"https:\/\/www.physio-pedia.com\/Leg_Length_Discrepancy\" target=\"_blank\" rel=\"noopener\">LLD<\/a>) of more than one inch (30 millimeters) might prescribe surgical intervention. Two added caveats for LLD are \u201c1. Individuals who are on their feet most of the day or who are involved in sports seem to be more sensitive to LLD\u201d and 2. \u201cyounger persons, on the whole, are able to adapt to larger LLD than older persons.\u201d (1).<\/p>\n<h3>Potential for Lower Leg Injury<\/h3>\n<p>Life can go wrong in a \u201cnormal\u201d locomotion or in a dynamic workout. Consider how a client steps off a curb, or makes an exercise plyometric move, or jogs on a sloped beach, or increases running distances too quickly over time. Excess or chronic stresses on our muscles, connective tissues and bones can, at times, go wrong. And LLD can exacerbate such instances for our\u00a0<a href=\"https:\/\/personaltrainertoday.com\/lower-leg-joint-anatomy\">lower legs<\/a>.<\/p>\n<p>According to one National Institute of Health report, Hospital Emergency Rooms or Urgent Care facilities address\u00a015 million\u00a0cases of lower limb strains, pains, and sprains annually (2).<\/p>\n<ul>\n<li>This article cites the four compartments of a lower leg as context for potential overuse or trauma conditions.<\/li>\n<li>It then addresses three prevalent conditions or injuries which clients may experience in their fitness journeys.\n<ul>\n<li>Prudent \u201c<em>pre<\/em>-habilitation\u201d or preventative actions are cited for those top 3 problems, as \u201c<em>re-<\/em>hab\u201d may unfortunately take several to many months for recovery.<\/li>\n<\/ul>\n<\/li>\n<li>Key takeaways will help Trainers enable best possible mobility for their clients, factoring gender, age and exertion levels into their recommendations for safe and effective training.<\/li>\n<\/ul>\n<h3>Four Compartments<\/h3>\n<p>Our lower legs (regionally from our knees to our ankles) can be physically described in four (4) longitudinal compartments that are separated by fascia and adjoin the tibia and fibula bones.<\/p>\n<p>Each of these lower leg compartments can cause either\u00a0<em>acute or chronic pain<\/em>\u00a0when something goes wrong.<\/p>\n<ul>\n<li>Anterior (along the smaller tibia bone and connecting to toes)\n<ul>\n<li>Anterior Tibia Syndrome can develop in this region after sudden strenuous exercise or long hikes.<\/li>\n<\/ul>\n<\/li>\n<li>Lateral (distal and connecting to the heel and underside of foot)\n<ul>\n<li>Acute or chronic pain in this\u00a0<a href=\"https:\/\/www.sportsinjuryclinic.net\/sport-injuries\/lower-leg\/calf-pain\/lateral-compartment-syndrome\" target=\"_blank\" rel=\"noopener\">compartment<\/a>\u00a0can be generated by swelling of the lateral muscles that rub against fascia.<\/li>\n<\/ul>\n<\/li>\n<li>Deep Posterior (backing the fibula and connecting to the side and lower parts of a foot)\n<ul>\n<li>A client may sense needles and pins or numbness in a foot or have\u00a0<a href=\"https:\/\/www.sportsinjuryclinic.net\/sport-injuries\/lower-leg\/calf-pain\/posterior-compartment-syndrome\" target=\"_blank\" rel=\"noopener\">deep aching pains in the leg<\/a>. These compartment pains may suggest medical attention when the deep calf muscle has swollen significantly.<\/li>\n<\/ul>\n<\/li>\n<li>Superficial Posterior (the largest compartment that connects to the heel\/calcaneus foot bone).\n<ul>\n<li>Pain here may be caused by anterior\/posterior muscle imbalances, or other causes.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>About a third of athletic injuries to our lower limbs are strains or sprains (2). These injuries can often be self-administered with classic \u201c<strong>R I C E<\/strong>\u201d treatments (and non-prescription painkillers) or done under a medical professional\u2019s observation.<\/p>\n<ul>\n<li><strong>R<\/strong>est<\/li>\n<li><strong>I<\/strong>ce (for the first day or two after trauma)<\/li>\n<li><strong>C<\/strong>ompression<\/li>\n<li><strong>E<\/strong>levation.<\/li>\n<\/ul>\n<p>[sc name=\u201drunning\u201d ][\/sc]<\/p>\n<p>&nbsp;<\/p>\n<h3>Three Priority Medical Conditions or Injuries of Lower Legs<\/h3>\n<p>Three lower leg conditions or injuries that can be more severe and longer-lasting are:<\/p>\n<p>1.\u00a0\u00a0<a href=\"https:\/\/personaltrainertoday.com\/shin-splits-why-your-lower-legs-hurt\"><strong>Shin Splints<\/strong><\/a>, with 3 million reported cases in the USA annually (3) and\u00a0<strong><a href=\"https:\/\/personaltrainertoday.com\/bone-up-on-stress-fractures-and-prevent-the-pain\">Stress Fractures<\/a><\/strong>:<\/p>\n<p>The National Athletic Trainers\u2019 Association and American Academy of Orthopedic Surgeons provide an information-rich online\u00a0<a href=\"https:\/\/www.nata.org\/sites\/default\/files\/shin-splint-stress-fracture-infographic.pdf\" target=\"_blank\" rel=\"noopener\">infographic<\/a>\u00a0for key Facts, Diagnoses and Prevention of Shin Splints or resultant Stress Fractures.<\/p>\n<p>Shin splints are acute or chronic pains in a ~5-centimeter region along one\u2019s tibia. \u201cMedically known as\u00a0<strong>medial tibial stress syndrome (MTSS)<\/strong>, shin splints often occur \u2026after intensified or changed training routines (3)\u201d thereby taxing lower leg muscles, tendons and bone tissue. If training is\u00a0<em>not<\/em>\u00a0relaxed, the painful area may become<em>\u00a0stress fractured<\/em>.<\/p>\n<p><em>Half<\/em>\u00a0of all diagnosed stress fractures occur in our lower legs.<\/p>\n<p>Female athletes may experience these fractures more than males.<\/p>\n<p>2.\u00a0<strong><a href=\"https:\/\/www.physio-pedia.com\/Achilles_Tendinopathy\" target=\"_blank\" rel=\"noopener\">Achilles Tendinopathy<\/a><\/strong>\u00a0is a fairly common \u201coveruse\u201d injury for about 200,000 persons each year.\u00a0 An acute extreme for this lower leg tendinopathy is a rupture that can sideline a client for many months of pre-hab, intervention and rehabilitation. Some studies suggest that Achilles Tendinopathy is more prevalent above the age of fifty.<\/p>\n<p>3.\u00a0<strong><a href=\"https:\/\/www.webmd.com\/dvt\/default.htm\" target=\"_blank\" rel=\"noopener\">Deep Vein Thrombosis<\/a>\u00a0<\/strong>(DVT). This type of leg pain can be life threatening yet is not always easy to diagnose. Who is most susceptible to potentially dangerous clotting in lower legs?<\/p>\n<ul>\n<li>\n<ul>\n<li>Those over the age of 40, and males at higher incidences than females<\/li>\n<li>Those with a family history, or having had a prior blood clot<\/li>\n<li>Those who are inactive, or who sit for long periods \u2013 like knowledge workers or air-travelers.<\/li>\n<li>Overweight or obese clients<\/li>\n<li>Clients who suffer a major injury.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>A Big Deal? Yes, as\u00a0<em>one-tenth<\/em>\u00a0of all DVT sufferers experience pulmonary embolisms.<\/p>\n<h3>Preventative Steps and Modifications<\/h3>\n<p>When clients experience \u201cminor\u201d leg pains that are not muscular soreness or delayed onset of muscle soreness (<a class=\"broken_link\" href=\"https:\/\/personaltrainertoday.com\/understanding-and-preventing-delayed-onset-muscle-soreness-doms\">DOMS<\/a>), trainers may recommend modified motions and add special stretches to keep clients moving with manageable discomfort. If lower leg pains are diagnosed by medical professionals as more than muscle fatigue, trainers should evaluate the client\u2019s exercise trends and potential for\u00a0<a href=\"https:\/\/personaltrainertoday.com\/how-to-recover-from-overtraining-syndrome\">overtraining<\/a>\u00a0that may lead to compartment syndromes, or the more serious conditions described above.<\/p>\n<p>Certain competitive clients may try to press on through lower leg discomforts or pains that are\u00a0<em>not<\/em>\u00a0muscle fatigue. Remediations like these may be suggested,<\/p>\n<ul>\n<li>Analyze athletic shoes for pronation or supination wear<\/li>\n<li>Recommend level and soft walking or running surfaces<\/li>\n<li>Establish limitations to the volume and intensity increases of weight-bearing motions\n<ul>\n<li>Ten percent (10%) increases are prudent benchmarks for distance escalations per week.<\/li>\n<\/ul>\n<\/li>\n<li>Reduce repetitive stresses by cross-training\n<ul>\n<li>America\u2019s Olympic Medalist and Boston Marathon Winner, Meb Keflezighi, cross-trained on an elliptical trainer and wore \u201chigh\u201d compression socks* in his impressive volume training<\/li>\n<\/ul>\n<\/li>\n<li>Establish longer periods of post-exercise recovery<\/li>\n<li>Suggest focused flexibility and strength moves to improve muscle imbalances and stability.<\/li>\n<\/ul>\n<p>*For clients that sit or travel significantly,\u00a0<a href=\"https:\/\/personaltrainertoday.com\/proper-footwear-for-clients\">compression hosiery<\/a>\u00a0is often a practical solution for swollen lower limbs and DVT avoidance.<\/p>\n<h3>Physical Support Summary<\/h3>\n<p>Statistics cited in this article show that lower leg pains and conditions are quite common.<\/p>\n<p><strong>Professional trainers should be mindful that shin splints can lead to stress fractures, and that \u201ctraining through\u201d leg pain is an\u00a0<em>unsuccessful<\/em>\u00a0approach for remediation<\/strong>. Clients should always be mindful of non-DOMS pains that may need professional medical attention.<\/p>\n<p>Encourage clients to listen to their body\u2019s feedback for both acute and chronic pains so that they can still \u201chave legs to stand on.\u201d<\/p>\n<hr \/>\n<h4>References<\/h4>\n<ol>\n<li>Khamis S, Carmeli E. A new concept for measuring leg length discrepancy. Journal of orthopaedics. 2017 Jun;14(2):276. Available from:\u00a0https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5376249\/<\/li>\n<li>Lambers, Kaj et al. \u201cIncidence of patients with lower extremity injuries presenting to US emergency departments by anatomic region, disease category, and age.\u201d\u00a0<i>Clinical orthopaedics and related research<\/i>\u00a0vol. 470,1 (2012): 284-90. doi:10.1007\/s11999-011-1982-z.<\/li>\n<li>\u00a0Shin splints \u2013 Symptoms and causes \u2013 Mayo Clinic<\/li>\n<\/ol>\n<div class=\"et_pb_row abfd_et_pb_row\">\n<div class=\"et_pb_column\">\n<div class=\"abfd-container\">\n<p>&nbsp;<\/p>\n<div class=\"abfd-photograph\"><img decoding=\"async\" src=\"https:\/\/secure.gravatar.com\/avatar\/4c89f533081a30ae830857851e9e5d74?s=96&amp;d=mm&amp;r=g\" alt=\"Dave Frost\" \/><\/div>\n<p>&nbsp;<\/p>\n<div class=\"abfd-details\">\n<div class=\"abfd-name\"><a href=\"https:\/\/personaltrainertoday.com\/author\/davefrost\"><br \/>\nDave Frost<\/a><\/div>\n<div class=\"abfd-biography\">\n<p>Dave Frost has served the fitness community as a NFPT-certified CPT since 2013, and a Master Fitness Trainer since 2019.<br \/>\nAs a Medicare-aged baby boomer, he specializes in training those clients who intend to stay \u201cwell past forty\u201d.<br \/>\nHe is a former world champion in Masters Rowing and National Indoor Rowing champion for his age group. He is also a group fitness instructor for The Row House. His website is https:\/\/wellpastforty.com. Dave recently published his work: KABOOMER: Thriving and Striving into your Nineties to promote stamininety for those intending to add years to their lives and life to their years.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u201cNot having a leg to stand on\u201d is an adage for lacking physical support. Clients may experience physical pains or medical conditions of their lower legs. Certain conditions mandate modifications to exercise and activities of daily life. Others that are more severe may be only remediated by orthopedic intervention. Trainers\u00a0can\u00a0support clients\u2019 mobile actions as assurances [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1982,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[24],"tags":[],"class_list":["post-1981","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-latest-blogs"],"_links":{"self":[{"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/posts\/1981","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/comments?post=1981"}],"version-history":[{"count":4,"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/posts\/1981\/revisions"}],"predecessor-version":[{"id":2106,"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/posts\/1981\/revisions\/2106"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/media\/1982"}],"wp:attachment":[{"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/media?parent=1981"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/categories?post=1981"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/demo-websitedesigns.com\/david-frost\/v1\/wp-json\/wp\/v2\/tags?post=1981"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}