Category: Lower Limb

  • 12
  • Nov
Turf Toe
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Brief Outline of Turf Toe

Tur Toe

Pain at the base of the big toe may be a result of turf toe. Athletes who jam their toe or repetitively push off when running or jumping are susceptible. Also caused by hyperextending the metatarsophalangeal joint of the great toe. The name turf toe comes from the fact that this injury is common among athletes who play on artificial turf.

Anatomy and physiology

Turf toe develops at the metatarsophalangeal joint of the great toe. The capsule that covers this joint is torn, leading to instability and pain. This can lead to dislocations, cartilage wear and eventually arthritis. The tendons that cross the joint can become involved as well. Jamming the toe, or pushing off when running or jumping puts stress on the capsule and can lead to tearing.

Cause of Turf Toe Injury

Jamming the toe. Repetitive pushing off the toe, especially on a harder surface such as artificial turf.

Signs and symptoms of Turf Toe

Pain at the base of the toe. Some swelling may be noted in the joint. Pain increases when pushing off with the toe.

Complications if left Turf Toe unattended

Turf toe can lead to chronic pain and the inability to run or jump. When left unattended, turf toe can lead to other conditions such as toe dislocations and arthritis.

Treatment for Turf Toe

  • Rest
  • Ice
  • Anti-inflammatory medication
  • Lubricant injection to the joint

Rehabilitation and prevention of Turf Toe

As the pain subsides, it is important to work on the strength and flexibility of the toes. Adjusting the way the pressure is applied to the foot when pushing off will also help to correct the conditions(s) that caused the turf toe. Alternating workouts from hard to softer surfaces will help prevent the development of this condition. Special inserts, which support the toe may be used when returning to activity. A gradual return to full activity is important.

Long-term prognosis of Turf Toe

Turf toe does have a tendency to return when working out on the same surface. In most cases, pain will subside and normal function will return. In very rare cases, surgery is required to alleviate the symptoms.

Foot Specialist Treating Turf Toe

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

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  • 09
  • Nov
Foot Stress Fracture
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Brief Outline of Stress Fracture to the Foot

Stress fractures in the foot are usually a result of repetitive impact to the bones of the feet. Running or jumping on hard surfaces, changing the duration or distance of workouts too quickly, or fatigued muscles that can no longer absorb shock can lead to small cracks in the bone. The small cracks accumulate and become a stress fracture.

Anatomy and physiology

A stress fracture can occur in any of the bones of the foot but are generally seen in the metatarsals. The heel bone, or calcaneus, can also become fractured with improper footwear or as the result of an old injury that has gone untreated. The bones subjected to repetitive trauma develop minor cracks and then these cracks build on each other leading to a stress fracture. A weak point in the bone from a previous injury or due to bone rebuilding can lead to stress fractures under normal stress conditions.

Cause of Stress Fracture to the Foot

Repetitive trauma to the bones of the foot. Weakened area of bone due to previous injury or other condition. Muscle fatigue, making the muscles ineffective shock absorbers.

Signs and symptoms of Foot Stress Fracture

Pain at the site of the fracture. Pain with weight bearing, with inability to walk in severe cases. Swelling may be noted over the fracture site. Some loss of foot function may be noted.

Complications if left Foot Stress Fracture unattended

More serious stress fracture including a complete break in the bone may occur if left unattended. Swelling and inflammation may cause blood flow and nerve problems in the foot. Pain may increase to the point of disability and inability to walk.

Treatments for Foot Stress Fracture

  • R.I.C.E
  • Anti-inflammatory medications
  • Observe and monitor
  • See a doctor if not better

Rehabilitation and prevention

Strengthening of the muscles that support the foot will help to lessen the impact on the foot, with stronger muscles absorbing more shock. A gradual start to activity after the injury has healed is important to prevent recurrence. Proper footwear, correct warm-up techniques, avoiding hard running surfaces and a diet with calcium-rich foods will help prevent stress fractures in the foot.

Long-term prognosis for Foot Stress Fracture

Stress fractures will usually heal completely and have no lingering effects if rest and rehabilitation are used. The fracture site should heal to become stronger than it was originally. Only in severe cases where the bone fractures completely and does not respond to rest and immobilisation, will surgery be required.

Orthopaedic Specialist Treating Foot Stress Fracture

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

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  • 29
  • Oct
Tibia Stress Fracture
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Brief Outline of Tibia Stress Fracture

Tibial Stress Fracture

Repetitive impact activities, such as running and jumping, can cause small cracks in the bone called stress fractures. These most often occur in the weight bearing bone, the tibia, of the lower leg. Athletes with lower bone density, due to dietary issues or genetic predisposition, are more susceptible, as are athletes who train on hard surfaces at increased distance and duration. Women are more susceptible to this injury than men due to bone density deficiency conditions such as irregular or absent menstrual cycles, eating disorders or osteoporosis.

Anatomy and physiology

The tibia (shin bone) is the larger and more medial of the bones in the lower leg. At the proximal end, the medial and lateral condyles articulate with the distal end of the femur to form the knee joint. The tibia tuberosity is a roughened area on the anterior surface of the tibia. The tibia is the weight bearing bone of the lower leg and therefore takes a large amount of the force of impact during running and jumping activities. This force is transferred up the length of the bone. Bones are constantly repairing and rebuilding, leading to the robbing of calcium from one area of the bone to build another, causing a weak area. When the impact is transferred up the shaft and encounters a weak area, due to either calcium deficiency or a prior stress fracture, the bone will crack slightly. Overtime, this leads to a more serious crack or fracture. Fatigued muscles also contribute to the possibility of stress fractures. The muscles are meant to take some of the shock away from the bones but a fatigued muscle is a poor shock absorber.

Cause of Stress Fracture

Repetitive stress on the bone through impact activities such as running or jumping. Low bone density. Muscle fatigue leading to lower shock absorption by the muscles.

Signs and symptoms for Tibia Stress Fracture

Pain with weight bearing, worsens with activity and diminishes with rest. Pain is most severe at the early stage of activity, subsiding in the middle and returning at the end. Point tenderness and some swelling possible.

Complications if left Tibia Stress Fracture unattended

If left stress fracture unattended, a stress fracture can become a complete fracture and lead to complications such as bleeding and nerve compromise. The pain from an untreated stress fracture may lead to a complete cessation of activity and further injury to surrounding tissues.

Treatment for Tibia Stress Fracture

  • Anti-inflammatory medication.
  • Shockwave therapy
  • Seek medical help if any instability is noted in the lower leg, or inability to bear weight.

Rehabilitation and treatment for Tibia Stress Fracture

During the recovery phase, it is important to maintain fitness levels by using low or non-impact activities such as swimming or biking. Strengthening the muscles of the lower leg will help add extra shock absorption. Warming-up properly and using cross training techniques to limit the impact of the bone will help prevent stress fractures.

Long-term prognosis for Tibia Stress Fracture

Stress fractures generally heal completely with rest. Returning to activity too soon may cause a recurrence. Very rarely surgical intervention may be needed to strengthen the bone at the fracture site.

Orthopaedic Specialist Treating Tibia Stress Fracture

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

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  • 29
  • Oct
Medial Tibial Pain Syndrome (Shin Splints)
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Brief Outline of Medial Tibial Pain Syndrome – Shin Splints

Shin Splints

Shin splints are a common complaint of runners and other athletes who have just taken up running. Shin splints are actually a term used to cover all pain in the anterior shin area. There are several possible causes. Medial tibial pain syndrome, the most common cause of shin pain, refers to pain felt over the shin bone from irritation of the tendons that cover the shin and their attachment to the bones. Changes in duration, frequency or intensity of running can lead to this condition.

Anatomy and physiology

The tibialis anterior muscle originates from the lateral condyle of the tibia, and inserts into the medial and plantar surfaces of the medial cuneiform bone. Tibialis anterior is responsible for dorsiflexing and inverting the foot and is used frequently during running to toe up with each step. When the muscle and tendon becomes inflamed and irritated through overuse or improper form, it will cause pain in the front of the shin. Repetitive pounding on the lower leg, such as with running, can also lead to pain in the shin.

Cause of Shin Splints

Repetitive stress on the tibialis anterior muscle leading to inflammation. Repetitive pounding force on the tibia, as with running and jumping.

Signs and symptoms of Shin Splints

Dull, aching pain over the inside of the tibia. Pain is worse with activity. Tenderness over the inner side of the tibia with possible slight swelling.

Complications if left Shin Splints unattended

If left unattended, shin splints can cause extreme pain and cause cessation of running activities. The inflammation can lead to other injuries, including compartment syndrome.

Treatment for Shin Splints

Rehabilitation and prevention for Shin Splints

It is important to use low impact activities, such as swimming or cycling, to maintain conditioning levels while recovering. Stretching of the tibialis anterior muscle will help with recovery. To prevent this condition from developing, try alternating high impact activity days with lower impact days. It is also important to strengthen the muscles of the lower leg to help absorb the shock of impact activities.

Long-term prognosis for Shin Splints

Medial tibial pain syndrome can be effectively treated with no long-term effects. Only in rare cases does the condition fail to respond to rest and rehabilitation, leading to chronic inflammation and pain. Surgery may be required in those rare cases.

Orthopaedic Specialist Treating Medial Tibial Pain Syndrome (Shin Splints)

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

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  • 28
  • Oct
Calf Strain
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Brief Outline of Calf Strain

Calf Strain

Failing to warm-up properly can lead to muscle strains. The calf muscles are used when taking off during a sprint, when jumping, changing directions, or when coming out of the bottom of a deep squat. These are usually explosive movements requiring forceful contractions of the calf muslces, which can lead to a muscle strain. Strains can result from incorrect foot positioning during an activity or an eccentric contraction beyond the strength level of the muscle.

Anatomy and physiology

The muscles of the calf include the gastrocnemius, plantaris, and soleus, known as the triceps surae. These muscles attach to the foot through the Achilles tendon. The popliteal fossa at the back of the knee is formed inferiorly by the bellies of gastrocnemius and plataris, laterally by the tendon of biceps femoris, and medially by the tendons of semimembranosus and semitendinosus. The calf muscles are responsible for extending the foot, and rising up on the toes. When taking off or changing direction, the calf muscle must contract forcefully. This contraction can cause tearing of the muscle at the attachment of the tendon. An eccentric contraction, a contraction while the muscle stretches, such as landing from a jump, can also cause a tear if the muscle is fatigued or not strong enough to handle it.

Cause of Calf Strain

Forceful contraction of the gastrocnemius or soleus muscle. Forceful eccentric contraction. Improper foot position when pushing off or landing.

Signs and symptoms of Calf Strain

Pain in the calf muscle, usually mid-calf. Pain when standing on tiptoes, and sometimes pain when bending the knee. Swelling or bruising in the calf.

Complications if left Calf Strain unattended

Any strain left unattended can lead to a complete rupture. The calf muscle is used when standing and walking, so the pain could become disabling. A limp or change in gait due to this injury could lead to injury in other areas.

Treatment for Calf Strain

  • Anti-inflammatory medication
  • Anti-inflammatory injection
  • Physiotherapy
  • Shockwave therapy

Rehabilitation and prevention for Calf Strain

As the pain subsides, a program of light stretching may help facilitate healing. When the pain has subsided, strengthening and stretching will help to prevent future injury. Proper warm-up before activities will help protect the muscle from tears. Strong flexible muscles resist strains better and recover more quickly.

Long-term prognosis of Calf Strain

Muscle strains, when treated properly with rest and therapy, seldom have any lingering effects. In very rare cases where the muscle detaches completely, surgery may be required to re-attach the muscle.

Orthopaedic Specialist Treating Calf Strain

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

Book Appointment Online for Calf Strain Treatment

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