SOFT-TISSUE DIFFERENTIAL DIAGNOSIS

LEG AND RELATED ANKLE INJURIES

By Dylan Morrissey & Nat Padhiar

In the past two decades there has been a substantial increase in the number of people taking part in recreational sport and in particular, recreational running.

It is

estimated that 60% of these participants will experience an injury that will limit, reduce or lead to cessation of their activity.

This paper focuses on some of the com- mon chronic injuries of the leg and ten- dons around the ankle.

Consideration is

given to aetiological and pre-disposing factors to injury together with guides to diagnosis and management.

This includes information on the impor- tance of intensive rehabilitation and a prevention education programme to reme- dy and prevent injuries.

The knee is the most common site of injury, followed by the achilles tendon, an assortment of leg pain, foot, groin and hip injury. The injuries are as a result of poor training technique, abnormal biomechanical factors, congenital or acquired conditions, or a combination of these factors.

This year 90,000 prospective runners applied to run the London Marathon, out of which 41,500 are accepted and it is predicted that 31,500 will take the field on 16th April 2000. It is therefore hardly surprising that there is equally an increase in sports injuries.

The first ever London Marathon in 1981 attracted 20,000 applications of which 7,747 were accepted and 6,255 success- fully finished the marathon.

Since than

there has been a boom in long distance running in United Kingdom.

Chronic exercise induced leg pain Pain in the lower leg brought on by exer- cise but relieved by variable periods of rest, is a common complaint among ath- letes, particularly after an unaccustomed increase or change in activity or at the start of the season.

The term ‘shin splints’ or ‘freshers leg’ are often used by athletes, trainers and doc- tors alike to describe the condition. These are non-specific terms and although the history and symptoms have long been recognised the actual term itself has never been restrictively defined. In 1966 the American Medical Association pub- lished ‘The Standard Nomenclature of Athletic Injuries’. This was prepared by a sub-committee of the Committee on Medical Aspects of Sports, after extensive canvassing of opinions from physicians, trainers, physical educators and other

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