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Patient information about orthopedic disorders.

Hip
> Snapping Hip Syndrome

What is Snapping Hip Syndrome?

Snapping hip syndrome
results in an audible popping or snapping sensation
as bands of ligaments or tendons slip over the bony
protuberances on your upper thighbone, called the greater
and lesser trochanters. This friction causes a localized
inflammation or swelling in the soft tissue that is
rubbing against your bones. Ligaments, tendons, or muscles
are held taut against bony bumps in your hip. As you
move your thighs, these bumps shift position and the
popping sensation occurs as the soft tissue bands snap
from one side of a bony bump to the other. If the bands
are too tight or the bone surface is not well lubricated,
the popping sensation becomes uncomfortable. Snapping
hip syndrome also may be associated with a tear in the
acetabular labrum, which is a horseshoe-shaped lip of
fibrocartilage that attaches to the rim of your shoulder
socket.

Overuse is the most common cause of
snapping hip syndrome. Any activities that require repetitive
leg and hip motions, particularly distance running,
may cause this syndrome. Snapping hip syndrome is most
often seen in women who have increased looseness, or
laxity, in the hip joint and who participate in sports
that require a great deal of hip rotation. The snapping
or popping sensation is usually noticed on either the
outside (external) or inside (internal) of your hip
and upper thigh when you move your leg. The two common
causes are as follows:

External
snapping – generally caused by friction as the
ITB (iliotibial band), which runs along the outside
of your thigh from your knee to your hip, pops over
your greater trochanter on the outside of your hip.

Internal
snapping – less common, this popping sensation
is usually caused by friction as the iliopsoas tendon,
which runs along your inner thigh, slips over bony protuberances
in your inner thigh at the top of your thighbone.

Muscles in your thigh that pop over hipbone surfaces,
like the ischial tuberosity, may less frequently cause
snapping hip syndrome. In rare cases, mild hip dislocations
or loose bone chips cause the popping sensation during
leg movement.

Orthopedic Evaluation

[top]

There are usually three parts to an
orthopedic evaluation: medical history, physical examination,
and tests your physician may order.

Your physician may ask you about the
following information to help make the diagnosis:

Your
age and history of other medical conditions.

The
nature of your pain – when it began; how long
it lasts; its location and severity; whether it radiates;
and any factors, like running or climbing stairs, that
relieve or increase the pain.

Your
physical and athletic goals – information that
will help determine what treatment might be best for
you in achieving those goals.

Whether
you have recently increased the duration or intensity
of your workouts or training.

Your physician
usually performs a number of physical tests while your
hip is in various positions: Standing – your posture,
stride, hip alignment, muscle tone, and ability to move
from a standing to sitting position will be observed
for abnormalities. Lying in your back – your abdomen,
lower back, pelvis, and hip joint may be put through
range of motion tests where your physician moves your
hips and legs in different directions. Lying on your
side – your physician may press on your ITB (iliotibial
band) to check for any damage. Ober manuever – while
laying on your unaffected side, your physician will
have you rotate and hyperextend the affected hip and
leg to determine what causes pain. Sitting – your
physician may test your muscle strength, reflexes, and
sensitivity to touch. Your physician may also check
your pulse in your hip.

Imaging tests are rarely used to diagnose
snapping hip syndrome. If your physician suspects the
snapping in your hip is caused by a tear of the acetabular
labrum, he may order MRI
(magnetic resonance imaging) or arthrogram.

RELATED TOPICS

Imaging
techniques

Quadriceps Contusion (for Teens) – Nemours KidsHealth

What Is a Quadriceps Contusion?

A quadriceps contusion is an injury to the quadriceps. This group of four muscles is at the front of the thigh. They help you straighten your knee and flex (bend) your hip. They’re important for many movements, including walking and running.

With rest and proper treatment, most people get better from a quadriceps contusion within a few weeks.

What Are the Signs & Symptoms of a Quadriceps Contusion?

All quadriceps contusions cause thigh pain. Other signs and symptoms depend on how severe the contusion is, but can include:

tenderness
bruising
swelling
a bump in the thigh
trouble bending the knee
trouble flexing the hip
trouble walking

What Causes Quadriceps Contusions?

A quadriceps contusion happens when someone gets hit very hard in the thigh. The force makes the muscle tear and bleed. It also can tear the sheath that covers the quadriceps muscles.

Most quadriceps contusions happen from playing sports. For example, it can happen:

How Are Quadriceps Contusions Diagnosed?

Doctors diagnose a quadriceps contusion by asking about the injury and the person’s symptoms, and doing an exam.

Usually no testing is needed. If the injury is serious or doesn’t get better after treatment for a few weeks, the doctor may order an MRI scan. This lets them get a closer look at the contusion and check for other injuries.

How Are Quadriceps Contusions Treated?

With rest and proper treatment, most quadriceps contusions heal on their own within a few weeks.

To help with symptoms while it heals:

Rest the area and avoid activities that cause pain. Use crutches if your doctor recommends them.
For the first day or two, put an ice pack on the area 3–4 times a day for 15 minutes at a time. Put a towel between the ice and the skin to protect it from the cold.
Use an elastic wrap to help support the quadriceps and keep swelling down.
Take medicine for pain, such as ibuprofen (Advil, Motrin, or store brand) or acetaminophen (Tylenol or store brand). Follow the directions that come with the medicine for how much to take and how often.

It also helps to raise the thigh:

When sitting, bend the knee slightly and prop it up on pillows.
When lying down, put pillows under your hips to lift them and your thigh.

Do not put heat on the contusion. This can make swelling worse. Also, do not massage the area without talking to your doctor first.

When the doctor says it’s OK, you can do muscle strengthening and stretching through physical therapy (PT) or an at-home exercise program.

Most people heal from a quadriceps contusion within a few weeks. Rarely, some need surgery if the contusion is very severe or doesn’t get better with treatment.

When Can I Return to Sports?

You can go back to sports when you are completely pain-free or the doctor cleared you to start playing again.

What Else Should I Know?

In a few cases, a quadriceps contusion can lead to other problems, including:

Compartment syndrome: This is when blood builds up inside the muscle sheath in the days after the injury. It needs treatment right away to prevent permanent muscle damage.
Myositis ossificans: This is a hardening, or calcification, of the muscle. It can happen several weeks after the injury and is more likely if the contusion wasn’t treated.

When Should I Call the Doctor?

These problems do not happen often, but call your doctor right away if you have:

pain that’s even worse than the pain you had when you were injured
tingling or burning in the injury area

Can I Prevent Another Quadriceps Contusion?

It can be hard to prevent a quadriceps contusion because they happen suddenly and often without warning. But you can make one less likely by following safety guidelines while playing sports:

Wear protective gear that fits well. For example, wear thigh pads for hockey and football.
Know the rules of your sport and follow them. In a football game, you wouldn’t want someone to ram his helmet into your thigh, so make sure you don’t do it to another player.
With skiing, snowboarding, and skateboarding, know your limits. Always stay under control and follow all posted signs to lower the risk of falling or running into a railing, park feature, or tree.

Muscles of the Posterior Thigh – Hamstrings – Damage

The muscles in the posterior compartment of the thigh are collectively known as the hamstrings. They consist of the biceps femoris, semitendinosus and semimembranosus, which form prominent tendons medially and laterally at the back of the knee.

As group, these muscles act to extend at the hip, and flex at the knee. They are innervated by the sciatic nerve (L4-S3).

In this article, we shall examine the anatomy of the muscles in the posterior thigh – their attachments, innervation and actions.

Muscles in the Posterior Compartment

The muscles located within the posterior compartment of the thigh are the biceps femoris, semitendinosus and semimembranosus.

Note: The hamstring portion of the adductor magnus has a similar action to these muscles, but is located in the medial thigh.

Biceps Femoris

Like the biceps brachii in the arm, the biceps femoris muscle has two heads – a long head and a short head.

It is the most lateral of the muscles in the posterior thigh – the common tendon of the two heads can be felt laterally at the posterior knee.

Attachments: The long head originates from the ischial tuberosity of the pelvis. The short head originates from the linea aspera on posterior surface of the femur. Together, the heads form a tendon, which inserts into the head of the fibula.

Actions: Main action is flexion at the knee. It also extends the thigh at the hip, and laterally rotates at the hip and knee.

Innervation: Long head innervated by the tibial part of the sciatic nerve, whereas the short head is innervated by the common fibular part of the sciatic nerve.

Semitendinosus

The semitendinosus is a largely tendinous muscle. It lies medially to the biceps femoris, and covers the majority of the semimembranosus.

Attachments: It originates from the ischial tuberosity of the pelvis, and attaches to the medial surface of the tibia.
Actions: Flexion of the leg at the knee joint. Extension of thigh at the hip. Medially rotates the thigh at the hip joint and the leg at the knee joint.
Innervation: Tibial part of the sciatic nerve.

Semimembranosus

The semimembranosus muscle is flattened and broad. It is located underneath the semitendinosus.

Attachments: It originates from the ischial tuberosity, but does so more superiorly than the semitendinosus and biceps femoris. It attaches to the medial tibial condyle.
Actions: Flexion of the leg at the knee joint. Extension of thigh at the hip. Medially rotates the thigh at the hip joint and the leg at the knee joint.
Innervation: Tibial part of the sciatic nerve.

Fig 1 – The muscles of the posterior thigh.
Fig 2 – Cross section of the thigh, showing the position of the major muscle groups.

[start-clinical]

Clinical Relevance: Damage to the Hamstrings

Muscle Strain

A hamstring strain refers to excessive stretch or tearing of the muscle fibres. They are often seen athletes involved in running or kicking sports. Damage to the muscle fibres is likely to rupture the surrounding blood vessels – producing a haematoma (a collection of blood). The haematoma is contained by the overlying fascia lata.

Treatment of any muscle strain should utilise the RICE protocol – rest, ice, compression and elevation.

Avulsion Fracture of the Ischial Tuberosity

An avulsion fracture occurs when a fragment of bone breaks away from the main body of bone.

In an avulsion fracture of the ischial tuberosity, the hamstring tendons ‘tear off’ a piece of the ischial tuberosity. Such an injury usually occurs in sports that require rapid contraction and relaxation of the muscles – such as sprinting, football and hurdling.

[end-clinical]

Tendon Disorders : OSH Answers

The most common sites for occupational tendon disorders are (Figure 3):

Figure 3

Shoulder

Bicipital tendinopathy – disorder of the tendon to the biceps.
Rotator cuff tendinopathy – disorder of the tendons that rotate the humerus [upper arm bone] and help raise the arm.

Elbow

Lateral epicondylitis or tennis elbow – inflammation of the tendon that attaches some forearm muscles to a “bump” or projection [lateral epicondyle] on the side of the humerus, just above the elbow.

Hand and Wrist

Flexor tendinopathy – disorder of the tendons in the palm side of the wrist and hand.
Extensor tendinopathy – disorder of the tendons in the back of the hand and wrist.
Flexor tenosynovitis – inflammation of the tendon sheaths in the palm side of the wrist and hand.
Extensor tenosynovitis – inflammation of the tendons in the back of the hand and wrist.
De Quervain’s disease – inflammation of the tendon sheaths at the base of the thumb.
Dupuytren’s contracture – in this condition, the tissues (fascia) under the skin on the palm of the hand thicken and shorten enough that the tendons connected to the fingers cannot move freely; this leads to a non-inflammatory degeneration of the tendons of the palmaris muscle in the hand.

Shoulder tendinopathy

The most common tendon disorders of the shoulder are bicipital tendinopathy and rotator cuff tendinopathy. Bicipital tendinopathy may be caused by inflammation of the tendon around the biceps muscle, or by degeneration of the tendon from repetitive overhead motion or from the normal aging process. Rotator cuff tendinopathy is also known as supraspinatus tendinitis, subdeltoid bursitis, subacromial bursitis or partial tear of the rotator cuff.

Tendon disorders of the shoulder are seen among workers exposed to high repetitive movements requiring a significant use of force. Workers doing jobs requiring awkward postures such as overhead work, arm elevation, and specific postures relative to the degree of arm bending and arm elevation.

Elbow tendinopathy

Tendinopathy of the elbow also known as tennis elbow or lateral epicondylitis is associated with jobs that require repeated or forceful movements of the fingers, wrist, and forearm. Specific movements associated with the development of tendinopathy of the elbow include simultaneous rotation of the forearm and bending of the wrist; stressful gripping of objects with inward or outward movement of the forearm; jerky, throwing motions. For more information please refer to our OSH Answers document on Tennis Elbow.

Hand and wrist tendinopathy

Tendinopathy of the hand and wrist include a variety of diagnoses such as tenosynovitis, tendinitis, De Quervain’s disease, and Dupuytren’s contracture.

High risk occupation and activities associated with hand and wrist tendinitis include assembly line work, meat processing, manufacturing, knitting, typing, and piano playing.

There is some evidence that workers exposed to risk factors such as high force and high repetition are at increased risk for hand and wrist tendinopathy. Excessive texting on cellular phones has been found to be a potential risk factor for De Quervain’s disease from overuse of the thumbs.

Patellar (knee) tendinitis

Patellar tendinitis is an injury to the tendon connecting your kneecap (patella) to your shinbone. This tendon helps to extend your knee so you can kick, run and jump. Running and jumping are the most common causes, but sudden increases in how hard or how often you run or jump can add stress. While common in athletes, people in occupations with similar movements may be at risk.

Front, Inner, Upper and Outer Thigh Pain Causes & Treatments

Deep vein thrombosis

Deep vein thrombosis (DVT) is a blood clot that forms in a vein deep in the body. Most deep vein clots occur in the lower leg or thigh.

Rarity: Uncommon

Top Symptoms: fever, thigh pain, upper leg swelling, calf pain, butt pain

Urgency: Hospital emergency room

Greater trochanteric pain syndrome

Greater trochanteric pain syndrome, also called trochanteric bursitis or GTPS, is an inflammation of the bursa of the greater trochanter. Bursae are the small “cushions” between tendons, bones, and muscles. The greater trochanter is th..

Patellofemoral pain syndrome

Patellofemoral pain syndrome (PFPS) is also called runner’s knee, jumper’s knee, anterior knee pain, chondromalacia patella, and patellofemoral joint syndrome.

Overuse through training for sports is a common cause, especially if there is a misalignment in the knee joint or a previous knee injury. This wears away the cartilage beneath the kneecap and causes pain on exercising.

It is most common in females and in young adults who are active in sports, but can affect anyone.

Symptoms include dull pain at the front of the knee and around the kneecap (patella) while running, squatting, or climbing stairs, or after prolonged sitting with knees bent.

Diagnosis is made through physical examination and through x-rays, CT scan, and/or MRI.

Treatment most often involves rest; over-the-counter pain relievers; low-impact exercise such as swimming or bicycling; physical therapy to strengthen and stabilize the knee; and orthotics (shoe inserts) to help correct a misaligned stride.

Surgery is needed only for severe cases, and is done through arthroscopy to remove any fragments of damaged cartilage.

Rarity: Common

Top Symptoms: knee pain, pain in one knee, knee pain that gets worse when going up stairs, dull, achy knee pain, knee pain that gets worse when squatting

Symptoms that always occur with patellofemoral pain syndrome: knee pain

Urgency: Primary care doctor

Thigh nerve issue (meralgia paresthetica)

Meralgia paresthetica is a nerve condition that causes an area of skin over the upper outer thigh to feel numb, tingly, or painful. This is caused by compression of a nerve known as the lateral cutaneous nerve of the thigh as it passes underneath a tough fibrous ligament known as the inguinal ligament.

Rarity: Rare

Top Symptoms: pain in the outside of the hip, pain in one thigh, thigh numbness, tingling upper leg, hip numbness

Symptoms that never occur with thigh nerve issue (meralgia paresthetica): new headache, swollen hip, swollen hips, swelling of one hip, leg swelling, weakness of both legs, leg weakness

Urgency: Primary care doctor

Compartment syndrome

Acute compartment syndrome describes the damage done to certain muscle groups of the arms or legs after a traumatic injury.

All of the long muscles are bundled into sections – “compartments” – by the white sheets of strong, tough connective tissue called fascia. If something interferes with circulation so that blood flow is trapped within the compartment, pressure rises because the fascia cannot stretch. This causes serious damage to the muscles and other tissues within the compartment.

Acute compartment syndrome is caused by a broken bone; a crush injury; burns, due to scarred and tightened skin; and bandages or casts applied before an injury has stopped swelling.

Symptoms can rapidly intensify. They include severe pain and tightness in the muscle; tingling or burning sensation; and sometimes numbness and weakness.

Acute compartment syndrome is a medical emergency which can result in loss of the limb. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history and physical examination.

Treatment involves hospitalization for emergency surgery and, in some cases, skin graft.

Rarity: Rare

Top Symptoms: arm numbness, hand numbness, foot numbness, pain in one leg, thigh numbness

Urgency: Hospital emergency room

Repetitive strain injury of the quadriceps

Repetitive strain injury of the upper leg is caused by consistent repetitive use.

Rarity: Uncommon

Top Symptoms: upper leg numbness, thigh weakness, thigh pain from overuse

Symptoms that always occur with repetitive strain injury of the quadriceps: thigh pain from overuse

Symptoms that never occur with repetitive strain injury of the quadriceps: upper leg injury, severe upper leg pain

Urgency: Self-treatment

Pulmonary embolism

An embolus is a blood clot that forms in the bloodstream, breaks loose, and is carried by the blood to become lodged elsewhere in the circulatory system. If this clot (embolus) blocks part of the bloodstream in the lungs (pulmonary system,) this condition is called pulmonary embolis. .

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Thigh bone infection (osteomyelitis)

Osteomyelitis of the thigh is a bacterial or fungal infection of the thigh bone, typically caused by Staph Aureus (40-50% of the time). It is difficult to diagnose as the infection can come from a break in the skin at the area or anywhere else in the body that spreads by blood.

Rarity: Rare

Top Symptoms: moderate fever, constant upper leg pain, spontaneous thigh pain, painful surgical site, warm red upper leg swelling

Symptoms that always occur with thigh bone infection (osteomyelitis): spontaneous thigh pain, constant upper leg pain

Urgency: Hospital emergency room

Groin Pain.

Structures and conditions that can contribute to groin pain.

The nervous system (Figure 5.1) is a complex network of nerves and cells that carry messages between the brain and spinal cord and your body. It is through this system that we feel, move and control our bodily functions.

Nerve roots leave the spinal cord via the intervertebral foramina (holes or spaces between the vertebrae) and join together from various levels of the spine to travel as cord-like structures, called nerves, to their destinations.

It is these nerves that travel outside the spinal cord that are referred to as “peripheral nerves”.

Some peripheral nerves travel only a short distance and others all the way from the lower back to the foot. Along their journey they run between and through muscles and fibrous tunnels.

While radicular pain arises from a problem as the nerve root exits the spine, nerve-related pain may develop due to a problem along the pathway of a peripheral nerve, outside the spine. Pain related to a nerve is called “Neuralgia”.

Neuralgia felt around the hip and pelvis may develop in many ways including excessive compression or stretch of the nerve. This may be caused by a sudden, acute mechanism, for example a fall or blow to the area resulting in compression, or the leg being caught and wrenched, resulting in stretch.

Alternatively, the onset may be subtle, with a gradual onset associated with sustained postures or repetitive movements that cause cumulative nerve irritation.

Nerves will also be influenced by the health of the tissues they run through or alongside. For example, high muscle tension or tendinopathy may over time result in irritation of neighbouring nerves. Nerve related symptoms are usually experienced differently from pain associated with muscle and joint problems.

Peripheral nerve irritability may result in:

symptoms in the area served by that peripheral nerve (which is different from dermatomal patterns associated with nerve root irritation -radicular pain)
burning pain
odd zings or zaps of pain
tingly sensations or numbness
weakness – only for those nerves that supply muscles, like the femoral nerve

Be aware that some nerves may cross through and supply more than one region around the hip and pelvis. Additionally, some areas of skin may have several nerves that serve the area. This sometimes makes accurate diagnosis tricky. Your hip pain professional will help to identify the cause of your pain.

Nerves of the Groin Region:

Nerves that supply the front to inside of the hip, groin and thigh (Figure 5.2) include:

the iliohypogastric nerve
the ilioinguinal nerve
the obturator nerve
the anterior femoral cutaneous nerve (a branch of the femoral nerve)

Nerve Related Pain/Neuralgia in the Groin Region

Irritation or damage to the ilioinguinal, iliohypogastric and genitofemoral nerves may occur as they travel through the muscles of the back and abdomen. Most commonly, symptoms may arise following some sort of abdominal or groin surgery, such as hernia repair.

The nerves may be damaged at the time of surgery or become entrapped in the scar tissue or mesh used for hernia repair. Endometriosis may also sometimes affect these nerves.

The symptoms are usually pain, with or without tingling or numbness in the area of nerve supply (Figure 5.3). The iliohypogastric and ilioinguinal nerves also provide some motor supply (the ability to make the muscles contract and work) to the abdominal muscles, so there may be some weakness of the abdominals experienced in conjunction with the nerve irritation.

The obturator nerve runs through the pelvic cavity and may be affected by pregnancy or pelvic surgery, as it exits the pelvis through a tunnel called the obturator canal, or as it runs between some of the deep muscles (the obturator externus & pectineus).

People with obturator neuralgia may experience pain, tingling or numbness in its area of skin supply (Figure 5.3) and may experience some weakness of the adductor (inner thigh) muscles it supplies.

The symptoms are often only felt during/after activity when the nerve has been compressed between contracting muscles.

Neuralgia of the femoral nerve is not very common, but may develop following pelvic surgery (gynaecological, prostate, bladder surgery), hip surgery or sometimes associated with problems of the adjacent soft tissue structures (psoas bursa or iliopsoasmuscle and tendon).

Femoral nerve related symptoms may be felt in the front of the thigh (in the region of the anterior femoral nerve branches that serve the skin) (Figure 5.3).

Sometimes symptoms may also be felt over the inner surface of the calf and shin (served by another branch of the femoral nerve called the saphenous nerve).

If the femoral nerve is more severely affected, muscle weakness may occur in the hip flexors (muscles at the front of the hip that lift the thigh) and the quadriceps (muscles at the front of the thigh that straighten the knee).

For Pain Related to the Nerves/Neuralgia of the Groin Region

Your Hip Pain Professional can:

Perform specific tests in the clinic to see if nerve involvement is likely
Provide treatments and give you exercises that may improve the health or movement of the nerve
Help improve health of the muscles and tendons beside the nerve (this may be the source of nerve irritation)
Review the position you spend time in and activities you perform daily and provide strategies when performing these tasks that might help protect the nerve, thus reducing your symptoms. This may include changing your sitting or lying posture, or changing stretches or strength exercises that you may have been performing that may be contributing to the irritation of the nerve.
Provide nerve gliding or mobility exercises that can be useful in some situations.
Refer you for further tests or to a neurologist, orthopaedic specialist or other pain specialist required.
In some case, your hip pain professional may refer you to a pelvic floor physio for further assessment should they consider the pelvic floor muscles are involved.

*Please note: Nerve supply can overlap and be quite variable between individuals. The diagram provided in this section provides an approximate guide only of the nerve supply in this region.

Leg Injuries | Michigan Medicine

Do you have a leg injury?

How old are you?

Less than 5 years

5 years or older

Are you male or female?

Why do we ask this question?

If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Have you had surgery on the leg in the past month?

If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.

Yes

Leg surgery in the past month

Has it been more than a month since the leg injury?

Yes

Leg injury over a month ago

Have you had a major trauma in the past 2 to 3 hours?

Yes

Major trauma in past 2 to 3 hours

Are you having trouble moving the leg?

Pain and swelling can limit movement.

Can you move the leg at all?

Have you had trouble moving the leg for more than 2 days?

Yes

Difficulty moving leg for more than 2 days

Has the pain:

Gotten worse?

Pain is increasing

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is improving

Do you have any pain in your leg?

How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

Has the pain:

Gotten worse?

Pain is getting worse

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is getting better

Has the pain lasted for more than 2 days?

Yes

Pain for more than 2 days

Is the leg blue, very pale, or cold and different from the other leg?

If the leg is in a cast, splint, or brace, follow the instructions you got about how to loosen it.

Yes

Leg is blue, very pale, or cold and different from other leg

Is there any swelling or bruising?

Did you have swelling or bruising within 30 minutes of the injury?

Yes

Swelling or bruising within 30 minutes of injury

Has swelling lasted for more than 2 days?

Yes

Swelling for more than 2 days

Do you have numbness, tingling, or weakness in your leg that has lasted more than an hour?

Weakness is being unable to use the leg normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness.

Yes

Numbness, tingling, or weakness for more than 1 hour

Do you suspect that the injury may have been caused by abuse?

This is a standard question that we ask in certain topics. It may not apply to you. But asking it of everyone helps us to get people the help they need.

Yes

Injury may have been caused by abuse

Do you think the problem may be causing a fever?

Some bone and joint problems can cause a fever.

Are there red streaks leading away from the area or pus draining from it?

Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?

“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

Have you had symptoms for more than a week?

Yes

Symptoms for more than a week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Major trauma is any event that can cause very serious injury, such as:

A fall from more than 10 ft (3.1 m)[more than 5 ft (1.5 m) for children under 2 years and adults over 65].
A car crash in which any vehicle involved was going more than 20 miles (32 km) per hour.
Any event that causes severe bleeding that you cannot control.
Any event forceful enough to badly break a large bone (like an arm bone or leg bone).

With severe bleeding, any of these may be true:

Blood is pumping from the wound.
The bleeding does not stop or slow down with pressure.
Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

The bleeding slows or stops with pressure but starts again if you remove the pressure.
The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

The bleeding stops on its own or with pressure.
The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Pain in adults and older children

Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Symptoms of infection may include:

Increased pain, swelling, warmth, or redness in or around the area.
Red streaks leading from the area.
Pus draining from the area.
A fever.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
Long-term alcohol and drug problems.
Steroid medicines, which may be used to treat a variety of conditions.
Chemotherapy and radiation therapy for cancer.
Other medicines used to treat autoimmune disease.
Medicines taken after organ transplant.
Not having a spleen.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Pain in children 3 years and older

Severe pain (8 to 10): The pain is so bad that the child can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and sleep, but the child can tolerate it for hours or days.
Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

Passing out (losing consciousness).
Feeling very dizzy or lightheaded, like you may pass out.
Feeling very weak or having trouble standing.
Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

Passing out (losing consciousness).
Being very sleepy or hard to wake up.
Not responding when being touched or talked to.
Breathing much faster than usual.
Acting confused. The child may not know where he or she is.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don’t have one, seek care in the next hour.
You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don’t have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

Make an appointment to see your doctor in the next 1 to 2 weeks.
If appropriate, try home treatment while you are waiting for the appointment.
If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Leg Problems, Noninjury

Postoperative Problems

90,000 ultrasound of the musculoskeletal system: injuries of the lower limb. Part 1.

Authors: Nathaniel B. Meyer, Jon A. Jacobson, Vivek Kalia, Sung Moon Kim

Introduction

Ultrasound is becoming the imaging modality of choice for assessing the range of lower extremity injuries. In addition to its high spatial resolution, ultrasound assessment offers several advantages in allowing dynamic assessment based on the patient’s underlying complaint.

In this case, the patient can provide feedback in real time. Additional information is obtained with color Doppler and graduated transducer pressure to assess pain, lesion compressibility and fluid content.

The anatomical integrity of the structure can be verified during stressful maneuvers, and pathologies present only in position or motion can be documented.

Thigh

Snapping hip syndrome

Clicking hip syndrome can relate to multiple individual subjects in which the patient experiences an unusual clicking sensation and, in some cases, pain during hip movement.

In general, they can be divided into intra-articular and extra-articular types, where intra-articular types are the result of intra-articular bodies or previous joint injury and are poorly evaluated on ultrasound examination. Extra-articular causes are well evaluated with dynamic ultrasound and are further subtyped as external or internal in localization.

An internal thigh click, visualized at the level of the anterior inferior iliac spine with a transducer in an oblique axial plane, is the result of abnormal movement of the ilio-lumbar complex. At this level, there is the main tendon of the psoas muscle, the muscle fibers of which are located in the middle, and the iliac muscle fibers are located anterolateral (Fig. 1).

When the patient flexes, abducts, and externally rotates the hip, the psoas main tendon rotates anterolaterally around the medial iliac muscle fibers. Typically, the psoas major muscle gently pivots back to the position where the patient straightens the leg; however, in the snapping hip, the medial iliac fibers are temporarily trapped between the psoasis major tendon and the superior pubic ramus (Fig.1).

In the later phase of extension of the legs, the inserted iliac muscle fibers suddenly move laterally and the tendon of the psoas major muscle clicks the superior pubic ramus.

Figure 1 : 17-year-old girl with injury to the right iliopsoas muscle.
A. Oblique transverse ultrasound (the right side of the image is medial) with the patient’s hip in the frog position shows the median fibers of the iliac muscle (arrow) temporarily sandwiched between the psoas major tendon (arrowhead) and the superior pubic ramus (SPR) ). B. When the leg is extended, the medial fibers of the iliac muscle move laterally (arrow), and the main psoas tendon (arrowhead) is pressed against the superior pubic ramus, returning to its normal anatomical position at rest. LFI – lateral fibers of the iliac muscle; FA, femoral artery.

External hip fracture occurs at the greater trochanter and is the result of abnormal movement of the iliotibial tract or gluteus maximus muscle over the greater trochanter.Typically, these two structures glide smoothly along the lateral edge when the patient flexes the hip, but either structure may be abnormally restrained during the early flexion phase until it suddenly releases, jumps from the front and produces a clicking sensation (Fig. 2). Ultrasound may show a thickened tract or band with surrounding swelling.

Figure 2 : 20-year-old woman with a fracture of the iliotibial tract.
A. Transverse ultrasound of the lateral thigh (left posterior side) over the greater trochanter (GT) shows a thickened iliotibial tract (arrow). B. With hip flexion, the iliotibial tract (arrow) moves forward and snaps over the greater trochanter. GM, gluteus maximus muscle.

Athletic Pubalgia

Athletes with pubic symphysial pain and groin pain, called athletic pubalgia, often play sports involving sprinting or rapid changes of direction, including football and ice hockey.

There are several etiologies; however, the term “sports hernia” is misleading because symptoms are often not associated with an actual hernia.Instead, the pathology most often affects the general aponeurosis, which spreads continuously from each lower rectus muscle, above the pubis and to the long adductor muscle.

Features of visualization of pubalgia include a thickened and hypoechoic general aponeurosis with or without anechoic clefts, as well as irregularities in the pubic bone (Fig. 3).

Partial or complete ruptures on the adductor muscle or rectus muscle are considered as anechoic ruptures or retraction of muscle fibers with heterogeneous hematoma, respectively (Fig. 4). Expansion of fluid in the pubic symphysis capsule may represent sympathetic trauma or osteoarthritis.

Figure 3 : Athletic pubalgia.
Ultrasonography of the long axis of the anterior lower abdominal wall to the rectus abdominis (RA) in a 24-year-old male demonstrates a thickened, hypoechoic general aponeurosis (arrowheads) and irregularities of the underlying pubic (P) bone. B. Similar results are seen in a 34-year-old woman, but with additional small hypoechoic clefts (curved arrow) representing partial tears at the beginning of the adductor longus (AL) muscle.

Figure 4 : Ultrasound of a 36-year-old man with full-thickness rupture of the adductor longus.
Ultrasound of the long axis to the adductor shows a full thickness tear of the tendon with a heterogeneous hypoechoic fluid representing a hematoma (H) between the retracted tendon (arrow) and the pubic bone (P).

Injury to the rectus muscle

Anomalies of the proximal rectus femoris are common in runners and soccer players.

The rectus muscle begins as two tendons. The straight head, also known as the anterior head, originates from the anterior lower iliac spine, while the indirect head, also known as the reflected or posterior head, is located slightly laterally and posteriorly and arises along the lateral edge of the acetabulum.

Both heads must be displayed for a complete examination. To locate the indirect head, start with the short axis of your transducer over the straight head in the anterior inferior iliac spine, then move the transducer laterally over the acetabulum and rotate the lateral aspect of the transducer 30 degrees lower to visualize the long axis indirect head.

The results of visualization of damage to the proximal rectus tendon are similar to other tendon pathologies. Hypoechoic and possibly enlarged tendon fibers representing tendinosis, anechoic clefts indicating partial rupture, and complete rupture with mismatched fibers and heterogeneous hypoechoic interstitial hematoma can be identified.

Calcium hydroxyapatite deposition (calcifying tendinosis) can also be identified as irregular areas of hyperechoicity with posterior acoustic shading.

Although the aforementioned tendon pathologies are more familiar, the distinctive anatomy of the musculoskeletal junction of the rectus muscle results in a unique pattern of injury. The musculoskeletal junction of the oblique head extends from the thigh to about two-thirds of the distance to the knee, with the tendon located centrally. Damage to this central aponeurosis can lead to edema or hematoma surrounding the tendon, resulting in a bull’s-eye (Fig. 5).

Figure 5 : 13-year-old boy with a ruptured rectus femoris tendon.
Proximal transverse ultrasonography shows a slightly thickened but intact tendon of the rectus femoris (arrow). B. Distally the tendon is thickened, irregular and hypoechoic (arrowheads) with a characteristic bull’s-eye. C. Long-axis ultrasound shows intermittent fibers and hematomas (arrowheads)

Elbow

Quadriceps tendon injury

Injury to the quadriceps tendon usually occurs in basketball or volleyball players, secondary to repetitive jumps, but can also result from severe flexion occurring with rapid deceleration during running.

Since the rectus femoris muscle spans two joints, it is the most commonly injured component of the quadriceps femoris. In the distal thigh, the quadriceps tendon consists of three layers. The superficial layer arises from the rectus femoris, the middle layer consists of the combined vastus medialis and vastus lateralis, and the deep layer consists of the vastus intermedius.

While most of the tendons of the quadriceps femoris in the antero-superior part of the patella continue, the superficial fibers of the rectus femoris attach to the anterior surface of the patella and connect to the tendon of the patella, the so-called extension of the prepatellar quadriceps.

As in previous descriptions, tendinosis appears as a hypoechoic and possibly thickened tendon (Fig. 6). While color Doppler can reveal flushing, the term tendinosis is used instead of tendinitis because the flushing is due to neovascularization rather than inflammation.

An anechoic cleft in the patella insert, which is a tear, may include one, two, or all three layers (Fig. 7). Full thickness tears often occur 1–2 cm proximal to the avascular insertion.

While a torn tendon is usually retracted by fibers, in doubtful cases dynamic maneuvers where the leg is passively flexed and extended, or when the patella is manually moved downward, can determine if the proximal intact fibers are moving with the patella.

An isolated rupture of the distal rectus femoris muscle may move away and appear much later after injury in the form of a palpable “pseudo-formation” representing a retracted tendon stump (Fig.eight).

Figure 6 : 60-year-old woman with quadriceps tendinosis.
Ultrasound of the long axis from the knee to the quadriceps tendon shows a thickened and hypoechoic tendon (arrowheads). The normal fibrillar structure is proximally visible (arrow). P, patella; F, femur.

Figure 7 : A 27-year-old male with partial rupture of the quadriceps.
Ultrasound of the long axis from the knee to the quadriceps tendon shows rupture and retraction of the median deep tendon fibers (arrowheads). A linear fragment of a hyperechoic fracture (curved arrow) and a hematoma (H) are visible. The superficial fibers of the rectus tendon remain intact (arrows). F, femur.

Figure 8 : 54-year-old male with full-thickness rectus rupture.
Ultrasound examination of the anterior part of the thigh in the longitudinal axis demonstrates complete destruction of the rectus femoris tendon with muscle retraction and hypoechoic hematoma (H).The right side of the image is distal.

Jumper’s Knee

Tendinopathy of the patella, leading to pain in the front of the knee, is colloquially called the “jumper’s knee”.

Similar to quadriceps tendon injury, and as the name suggests, it occurs in people involved in sports that require repetitive jumping.

There is no true tendon inflammation and therefore the term tendinitis is not appropriate.

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Abnormal imaging findings include hypoechoic tendinosis, anechoic interstitial ruptures, and hyperemia resulting from neovascularization, which correlates with the severity of the patient’s symptoms (Fig.nine). The deep aspect of the proximal patellar tendon is the most common site of involvement.

Figure 9 : 13-year-old boy with patellar tendinosis.
A, B. Ultrasound examination of the long axis (A) and short axis (B) shows a thickened, hypoechoic and hyperemic central patellar tendon (arrowheads) at its origin with an irregularity in the lower pole of the patella (curved arrow).The normal fibrillar tendon is seen distally and laterally (arrow). P, patella; F, femoral condyle.

Source

90,000 10 strength training exercises for runners

Strength training is extremely beneficial for runners. First, strong leg muscles help you run more efficiently, and strengthening your connective tissues (tendons and ligaments) helps reduce your susceptibility to injury.

Strengthening the muscles of the upper body can also improve running performance.Strong core muscles help stabilize your upper body, minimizing core sway, and maintain proper trunk position by the end of your workout when you start to fatigue. Even the muscles of the arms affect the result, because no one has canceled the importance of correctly set arm work during the race.

The following selection of exercises from running coach Laura Fontaine focuses on working your legs, arms and core and will be helpful if you are considering taking part in the Wings For Life World Run on May 9, 2021 – a unique running event in which participants run for those who cannot.100% of entry fees will go to Spinal Cord Injury Research at the Wings for Life Foundation.

Start doing bodyweight exercises, and as your endurance grows, move on to using free weights.

How to Start:

Follow the sequence of exercises below, taking a 90 second break between each set and two minutes of rest before each subsequent exercise. Take your time, while exercising, focus on improving your physical fitness, not on the speed of the exercise.Use a mirror or ask a friend to check if you are doing the exercises correctly.

Exercise 1: Push-ups

Reps and Sets: 10 reps, 2 sets

Benefits: Strengthens the muscles of the chest, shoulders and arms, improving posture and arm movement while running …

● Lie face down, place your hands on either side of your chest and rest your palms on the floor. With the toes of your feet, rest on the floor.

● Pushing with palms, raise your body above the floor.Keep your body straight, do not wring your head or bend your lower back: the whole body should be a single line.

● After the arms are almost straight (do not block the elbows), lower yourself down again, without touching the floor, and repeat the exercise.

Exercise 2: Dumbbell Press

Reps and Sets: 12 reps per side, 2 sets

Benefit: Strengthening the upper back in a pair to the strong chest muscles …

● Place your left knee and left hand on the bench. The upper body should remain horizontal.

● Take a dumbbell in your right hand, lower your hand to the floor.

● Lift the weight towards you, pressing your elbow to your waist, then lower your arm to the starting position.

Exercise 3: Bench Dips

Reps and Sets: 12 reps, 2 sets

Benefit: Strengthens the muscles of the arms and shoulders to maintain correct upright position during running.

● Sit on the edge of the bench with palms on either side of the bench, elbows facing back.

● Push and straighten your arms at the elbows, transferring your body weight to your arms and, bending your elbows, lower yourself down. From the bottom point, push off with your hands up again, without connecting the muscles of the legs.

Exercise 4: Step on the platform

Reps and sets: 10 reps on each side, 2 sets

Benefit: work out all major leg muscle groups, improve strength indicators for running.

● Stand in front of a bench or box (make sure the object is strong enough to support your weight).

● Place one foot on the bench, and push the other to step, maintaining an upright body position and keeping the knee on the toe on the supporting leg. It is important to move the pelvis forward and upward, and not to lift up due to the load on the knees.

● Fully straighten with your back knee parallel to the floor. Then put your foot back on the floor.

● To complicate the exercise, pick up dumbbells.

Exercise 5: Squats

Reps and Sets: 15 reps, 2 sets

Benefit: Strengthens the major muscle groups involved in running, reducing the risk of injury. Exercise also increases flexibility by squatting depth, which improves speed and overall running performance.

● Place your feet slightly wider than your shoulders, with your toes slightly outward.

● Sit down, pulling your hips back and bending your knees, as if you were sitting on a chair.

● Keep your knees within your socks, keep your chest open. Focus on the movement of your pelvis.

● Lower your hips to a position where they are parallel to the floor, then push upward, focusing on the heel, and return to a standing position.

● To make the exercise more difficult, you can squat with a barbell or do the exercise with a kettlebell or pancake in front of your chest.

Exercise 6: Forward lunges

Reps and sets: 8 reps per side, 2 sets

Benefits: Improves coordination, stability and helps maintain balance while running …Helps to increase stride length, helping to run faster.

● Stand up straight with feet shoulder-width apart.

● Take a large step forward with one foot and lower your torso and back knee to the floor without touching it.

● Keep the body upright with the knee just above the ankle.

● Push off with your back foot and take your front foot back to the starting position.

● Repeat alternating with your lead leg.

● To complicate the exercise, pick up dumbbells (you can start with 2 kg).Alternatively, hold a medicine ball in front of you for better body development. Taking a step forward for a lunge, straighten your arms and raise the ball over your head. Lower it when you return to a standing position.

Exercise 7: One-legged deadlift

Exercise 7: One-leg deadlift

Reps & Sets: 10 reps per side, 2 sets

Benefits: Strengthens the glutes and hamstrings to improve running performance, improve stability and reduce the risk of injury.

● Stand up straight with a dumbbell or kettlebell in your right hand.

● Lift your left foot off the floor and stretch your leg back. Lower your body down, keeping your back straight, extending your right arm along the floor.

● Slightly bend your right knee while keeping your hips level.

● Shift your body weight to your legs, keeping your back parallel to the floor if possible, then return to the starting position and repeat the exercise on the other leg.

Exercise 8: Boat / Back Extension

Reps and Sets: 10 reps, 2 sets

Benefit: Helps to strengthen the mid and upper back for greater stability body position while running, increases running efficiency.

● Lie face down, arms bent and at ear level, palms facing down.

● Lift your chest and shoulders off the floor and bring your shoulder blades together. Keep looking at the floor to avoid wringing your neck.

● Get down to the starting position and repeat the exercise.

Exercise 9: Glute Bridge

Reps and Sets: 15 reps, 2 sets

Benefit: This exercise is aimed at strengthening the gluteus muscles involved in running.It will help you keep your pelvis in a stable position and align your legs, pelvis and core as you run to stabilize your torso and therefore improve your running performance.

● Lie on your back, stretch your arms along your body, feet on the floor.

● Lift your pelvis up so that your knees, hips and shoulders form a straight line.

● Keep your shoulders on the floor to avoid injuring your neck.

● Hold this position for two seconds, then slowly lower yourself and repeat the exercise.

● To complicate the task, stretch your arms out in front of you or place them on your hips, holding the ball or pancake with your hands.

Exercise 10: Leg Raises

Reps and Sets: 10 reps, 2 sets

Benefit: Strengthens the hip flexor muscles, which are responsible for raising the knees while running … Helps to work and strengthen the lower abs.

● Lie on your back, stretch your arms along your body.

● Bring your feet together and raise them as high as possible, trying to bring them to an angle of 90 °.

● Slowly lower your legs back, holding them a couple of centimeters above the floor, then lift them up again.

● If it is too difficult at first, do the exercise on each leg alternately.

Wondering how much exercise will pump your run?

Join us in the Wings for Life World Run on May 9, 2021.At the same time, runners from all over the world will use the app to run for those who cannot. 100% of the entry fees go to Spinal Cord Injury Research.

You choose the distance yourself, and the finish line catches up with you in the form of a virtual finish car. He leaves 30 minutes after the start, gradually picking up speed. Curious at what kilometer he would have caught up with you!

Hip pain – causes, diagnosis and treatment

Causes of hip pain

Traumatic injury

Contusion of the thigh occurs upon impact or fall, manifested by moderate local pain.At first, the pain is sharp, then dull, aching, aggravated by palpation and movements. Due to the large array of soft tissues, pronounced edema often develops. Bruising is possible. The function of the limb is usually slightly limited, the support is preserved.

Hematoma also forms after impacts and falls, and resembles a bruise in its manifestations. It differs from a bruise in the bursting or pressing nature of the pain, the formation of a dense local edema, in the zone of which, after a while, a fluctuation site appears.With deeply located hematomas, nonspecific edema, fluctuation may be absent. A hematoma can be suspected by a significant increase in swelling in the first days or its persistence for a long time.

Damage to the tendon of the quadriceps muscle is observed in athletes, rarely develops in everyday life. It is characterized by acute pain along the front of the thigh, just above the knee joint, sometimes by a crackling sound at the time of injury. Subsequently, the pain subsides, but remains quite intense.In the area of damage, soreness, swelling of soft tissues, a defect in the place of rupture are revealed. With a complete rupture, support and independent straightening of the lower leg are impossible, with incomplete – difficult.

High-energy impacts such as falls from a height, road traffic and industrial injuries become the cause of the diaphyseal hip fracture. The injury is accompanied by unbearable explosive pain. In the future, the pain is very intense, aggravated by attempts to move, feeling, passively shifting the limb.The thigh is swollen, deformed. The leg is shortened. Revealed crepitus, pathological mobility. The general condition is disturbed, traumatic shock is possible.

A pathological fracture of the hip shaft can be diagnosed with bone cysts, tumors, and some hereditary and infectious diseases. Differs in mild symptomatology. Slight to moderate pain. Displacement, pathological mobility and bone crunch are absent, which is why the injury is often mistaken for a bruise.Distinctive features of a pathological fracture are long-term persistence of symptoms, the presence of previous pain during exertion or at rest.

Inflammatory diseases

Myositis of the thigh muscles occurs after unusual physical activity: prolonged walking or running, the first workouts after a long break. It is characterized by aching pains in the projection of the affected muscle or muscle group. There is an increase in pain on palpation, muscle tension.When palpating, diffuse compaction of the muscle is determined, slight edema, slight local hyperthermia are possible.

Tendonitis of the quadriceps tendon is usually found in active people over 40 years of age, manifested by vague, non-intense pulling pains in the lower parts of the front side of the thigh. The pain increases with the extension of the lower leg. With tendonitis of the biceps tendon, characteristic of runners, the pain is localized in the depths of the buttock, spreads to the back of the thigh, and intensifies during running, especially when accelerating.Subsequently, the pains become long-term, constant, occur after a slight load, at rest, at night.

Pain along the outer surface of the thigh is sometimes accompanied by aseptic arthritis of the hip joint of various etiologies (reactive, allergic, post-traumatic). Painful aching, dull, non-localized, supplemented by soreness in the groin and buttock, limitation of movement, difficulty walking.

Hip pain

Bone infections

Femoral periostitis develops infrequently, as a rule, becomes the result of injuries (bruises, fractures) or purulent lesions (deep infected wounds, abscesses, phlegmon, arthritis).In the first case, the process is aseptic in nature, accompanied by moderate pain, aggravated by palpation. A slight edema is revealed. The general condition is not disturbed.

Serous post-traumatic periostitis is sometimes observed, characterized by a significant accumulation of fluid under the periosteum. Pathology is manifested by moderate bursting pains, edema, deformity. With purulent inflammation of the periosteum, there is an acute onset with intense twitching, throbbing pains.Local hyperemia, significant segment edema, increased body temperature, chills, and fever are revealed.

The femur is one of the most common sites of hematogenous osteomyelitis. Bone inflammation develops in childhood, often against a background of minor injury or after an acute infection. It proceeds with a sharp rise in temperature, fever, chills, delirium. One day after the onset of hyperthermia, intense localized deep pain in the hip occurs. The pain increases, becomes unbearable, forcing the patient to freeze in bed.

There is a local form of hematogenous osteomyelitis, in which the pain syndrome is less pronounced, the general condition is slightly disturbed. In some cases, there is a severe hurricane course of the disease with a predominance of general symptoms. Post-traumatic and postoperative osteomyelitis is also manifested by pain, edema, hyperemia, general disturbances, but pain appears against the background of suppuration of an open fracture or postoperative wound, progressing more slowly, and does not reach the degree of unbearable.

Infections of blood vessels and soft tissues

Pain in the hip is noted with purulent lesions of soft tissue structures. Initially, it has a bursting or pressing character. The intensity of the pain syndrome rapidly increases, the pain becomes pulsating, tearing, twitching, sharply restricting movement, disrupting the night’s sleep. Puffiness, an increase in local temperature are revealed. The severity of general manifestations (hyperthermia, fever, symptoms of intoxication) depends on the prevalence of the purulent process.Pain is caused by:

Furuncle. A limited focus of inflammation, which is a convex, sharply painful formation, covered with bluish-purple skin. In the center of the formation is a black core surrounded by pus. The general condition usually does not suffer.
Carbuncle. Represents several closely spaced small foci, merging into one infiltrate with a diameter of up to several centimeters. Severe hyperthermia and fever are observed.
Abscess. Limited purulent focus, the diameter of which can range from 2-3 to 10 centimeters or more. It is accompanied by weakness, weakness, fever up to febrile numbers.
Phlegmon. Widespread purulent inflammation without clear boundaries. It is characterized by intense pain throughout the thigh, severe intoxication.

From foci in soft tissues, the infection can spread to the lymphatic vessels.The manifestation of reticular lymphangitis is evidenced by increased pain, deterioration of the general condition, the appearance of a marble pattern around the primary inflammatory focus. With trunk lymphangitis, a longitudinal strip appears on the thigh, along which painfulness is determined on palpation, edema, hyperemia, cord-like compaction of tissues. With the defeat of deep vessels, stripes on the limbs are not detected, there is a rapidly growing bursting pain, lymphedema of the underlying sections.

With phlebitis and thrombophlebitis of the superficial veins of the thigh, developing against the background of infectious lesions or varicose veins, rapidly progressive soreness along the vein is found.The pain increases with walking, usually localized in the lower third of the segment. Phlebitis and thrombophlebitis of deep veins are manifested by constant increasing pain, edema, general hyperthermia, milky white color of the skin of the limb.

A special form of venous disease is postpartum thrombophlebitis, which occurs in the first weeks after childbirth. Intense pain on the inner side of the thigh is observed with inflammation of the great saphenous vein, combined with edema, deterioration of the general condition. With the involvement of deep femoral veins, unbearable sharp pains along the anterior-inner thigh, significant edema, pallor of the skin of the limb, fever are noted.

Cancer

For benign tumors of the femur, slow growth and prolonged, often many years, are typical. Osteomas and chondromas are manifested by minor transient vague pains, with chondromas in children, deformities and shortening of the limb are possible. With osteoid osteomas, pain is intense, sharp. The growth of neoplasms is accompanied by increased pain, the appearance of palpable formations of bone density.

Osteosarcoma, chondrosarcoma and Ewing’s sarcoma are among the most common malignant tumors of the hip.Chondrosarcomas are usually localized in the upper part of the bone, osteosarcomas – in the upper or lower, Ewing’s sarcomas – in the lower. Pain with such neoplasms is initially dull, unclear, rapidly intensifies, becomes unbearable, combined with the appearance of a venous pattern, deformation, weight loss, and general weakness.

Neurological causes

Hip pain is a common cause of neurological disease. Distinctive features of such pain are a shooting, burning, shooting or piercing character (some patients compare the sensations with a “dagger strike”), a combination with paresthesias, weakening of muscle strength, impaired sensitivity.Pain in the hip region is provoked by the following pathologies:

Femoral nerve neuropathy. Pains are noted along the anterior-inner surface of the thigh and in the groin, aggravated by extension of the knee joint.
Sciatic nerve neuropathy. The patient complains of pain along the back of the thigh, which spreads from the buttocks to the lower leg and foot, aggravated when trying to raise a straight leg while lying on the back.
Piriformis syndrome. Occurs when the nerve trunk is compressed in the piriform opening. Pain – as with neuropathy of the sciatic nerve, combined with constant pulling, aching, cerebral pain in the buttock.
Neuropathy of the external cutaneous nerve. Characterized by pain that spreads along the outer side of the thigh, makes it difficult to walk, and is relieved by lying down with bent legs. Due to the pain syndrome, gait changes are formed that resemble intermittent claudication.
Radicular syndrome. Develops in osteochondrosis, spondylosis, intervertebral hernias, and other diseases of the lumbar spine. It is manifested by pain, spreading from the center to the periphery, aggravated by exertion, sudden movements, coughing, sneezing. Localization of pain is determined by the level of output of the affected root.
Lumbosacral plexitis. Manifests sharp pain in the thigh, buttock, sacrum, lower leg, groin area.With the defeat of the lumbar plexus, the pain is disturbed mainly along the front, with the defeat of the sacral plexus – along the back of the leg.

Other reasons

Sometimes hip pains are provoked by diseases of neighboring structures or distant organs, mental disorders. Possible causes of soreness include:

Coxarthrosis. Aching, pulling pains occur at the beginning of movements and after exertion, combined with pain in the hip joint.
Renal cell carcinoma. Pain syndrome mimics the sciatic nerve neuropathy, caused by compression of the nerve trunk by an enlarging neoplasm.
Mental disorders. Pain can appear in depression, hysterical neurosis, and some other conditions. Typical signs are indistinctness, unusualness and variability of complaints that do not fit into the picture of a specific somatic disease.

Diagnostics

The examination is usually performed by orthopedic traumatologists.In case of purulent processes, patients are examined by a surgeon, in case of neurological pathology – by a neurologist. At the initial stage, the doctor finds out the history of life and disease, conducts an external examination. The following additional examinations are assigned:

X-ray of the thigh. The basic diagnostic method that allows you to identify all the main bone pathologies: fractures, cancer, osteomyelitis, periostitis. In case of lesions of soft tissue structures, it is performed to exclude damage to the bones, to carry out differential diagnostics.
CT bone. It is used at the final stage of the examination to clarify the results of radiography, planning conservative therapy or surgical intervention. It makes it possible to accurately determine the size, configuration and structural features of the pathological focus in the bone tissue.
Ultrasound. Soft tissue sonography in myositis and tendinitis reveals areas of inflammation or degeneration. Doppler ultrasonography of the veins of the lower extremities is effective in assessing the condition of the veins and lymphatic vessels in patients with phlebitis and lymphangitis, and in detecting blood clots in thrombophlebitis.
MRI of soft tissues. Recommended in case of ambiguous results of other diagnostic procedures. It is carried out to determine the localization of deep hematomas, to confirm degenerative or inflammatory changes in tendinitis and myositis.
Electrophysiological research. Patients with pain of neurological origin are shown ENMG, ENG or EMG to clarify the level of nerve damage, to study the state of the nervous and muscle tissue.
Laboratory analyzes . They are performed to determine the severity of the inflammatory process in purulent diseases, to assess the state of organs and systems in malignant neoplasms.

Treatment

Help before diagnosis

In case of traumatic injuries, rest the limbs. In case of fractures, the leg is fixed using two splints: the inner one from the foot to the groin, the outer one up to the armpit. Cold is applied to the leg, in case of severe injuries, pain relievers are administered, according to indications, anti-shock measures are taken.The severity of the symptoms of myositis and tendinitis is reduced with the help of anti-inflammatory, analgesic gels and ointments. Sharp pains, significant swelling, general disturbances are the reason for immediate medical attention.

Conservative therapy

Patients with fractures are given blockages, the hip is fixed using skeletal traction, which, after the appearance of clinical and radiological signs of adhesion, is replaced with a plaster cast. Treatment tactics for other lesions are determined based on the nature of the disease.Conservative treatment for most hip pathologies includes:

Safety mode. The mode of physical activity is selected taking into account the type and severity of the disease. It is possible to fix it with a plaster cast, use splints, crutches or canes.
Physiotherapy exercises. To maintain muscle strength and joint mobility, prevent complications and improve the general condition, individually selected exercise therapy complexes are prescribed.
Physiotherapy procedures. UHF, electrophoresis, laser therapy and other techniques are used to reduce pain, accelerate resorption, improve blood circulation and tissue nutrition, and stimulate healing.

The listed activities are complemented by massage, sometimes manual therapy, taping. For purulent diseases, antibiotics are prescribed, for inflammatory pathologies – NSAIDs, for neurological lesions, blockades are performed.

Taping thigh

Surgical treatment

Operations are indicated when conservative therapy is ineffective, to reduce the duration of recovery, early activation of the patient, and reduce the risk of complications.Taking into account the peculiarities of the defeat, the following are carried out:

In the postoperative period, antibacterial and anesthetic agents are used, complex rehabilitation measures are carried out. For cancer, radiation therapy and chemotherapy are prescribed.

90,000 Severe pain in the back of the thighs

Semitendinosus and semimembranosus

Semitendinosus and semimembranosus are the other half of the popliteal muscles.They supplement and balance the strength of the biceps femoris. Their names reflect the fact that half the length of both muscles is a very strong tendon-like tissue. They act as one and will be described as a single muscle; for brevity, let’s call them “half-muscles”.

Symptoms

The pain from the trigger points in the semi-muscles is felt mainly high in the back of the thighs, near the gluteal groove (Fig. 9.4 7). It sometimes extends downward and is felt in the calves (not shown).In these cases, the entire back of the thigh is sensitive to touch. When the pain from the crescents reaches the knee, it is more acute than pain from the biceps muscle and is felt closer to the inside of the knee.

Pain and stiffness caused by trigger points in the half muscles is often mistaken for tendonitis, and widespread pain also suggests sciatica. It happens that they resort to surgery on the spine to identify the cause of the alleged pinching of the sciatic nerve.Meanwhile, first of all, it is necessary to look for starting points.

Even if there is indeed physical injury to the hamstrings, the pain is partly due to the influence of trigger points. They can be the underlying cause of injury, as they cause the muscle to lose elasticity and become more vulnerable.

Reasons

The half-muscles are attached to the ischium and to the apex of the tibia from its inner side. They straighten the hip and flex the knee. These muscles are damaged by maximizing hip flexion and knee extension, i.e.That is, in a position where these two muscles are stretched as much as possible. This is, for example, the position of the foot immediately after the ball is thrown in football. If you are jogging or doing splits, your hamstrings in your front leg are at risk.

Overstretching contributes to the formation of launch points in the half-muscles, as does inaction. Their length decreases if a person sits at work, in the car and at home all day and evening. Constant pressure on the lower thighs from the edge of the seat interferes with circulation and again promotes the formation of launch points.

Often, hamstring stiffness is the underlying cause of chronic low back pain. They destabilize the pelvis, smooth out the natural curve in the lower back, and disrupt muscle mechanics in the back and buttocks. Posture changes, corresponding to

The head is pulled forward and the upper back and neck are stressed. Thus, the stiffness of the hamstrings creates a domino effect that causes pain in distant parts of the body, including the jaw, face and head.In other words, your hamstrings may even be the cause of your only complaint, a headache.

Treatment

Determine the position of the half-muscles in the back of the thigh from the inside. Explore this entire area with a tennis ball, placing it under your thigh on the seat of a wooden chair, as you did with the biceps femoris (see Figure 9.46). Move your foot on the ball from side to side across the entire width of your thigh. Most trigger points are found in the middle and lower thighs, although they often occur under the ischium.In Figure 9.4-7, each black dot in the lower half of both muscles denotes the location of possible multiple trigger points in the semimembranosus muscle, which is hidden under the semitendinosus. You may not be aware of the presence of trigger points in your hamstrings unless you are careful to look for them. The most important thing to remember is the fact about all the popliteal muscles that they will not be able to fully stretch unless the starting points in them are eliminated, which intensively prevent the lengthening of muscle fibers.Routine stretching before exercise can make you feel like you’re doing the right thing for your muscles, but they are at risk of injury if they have trigger points.

Based on Claire Davis “Trigger Points” and Kelly Starrett “Becoming a Supple Leopard”

90,000 Partial injury, cruciate ligament rupture. Cruciate ligament plastic of the knee joint

The cruciate ligaments are located in the cavity of the knee joint.Their ruptures are caused by exorbitant movements in the knee joint.

The anterior cruciate ligament (Latin lig.cruciatum anterius) starts from the posterior-superior part of the inner surface of the outer condyle (bony protrusion) of the femur, crosses the cavity of the knee joint and attaches to the anterior part of the anterior intercondylar fossa of the tibia, also in the joint cavity. The cruciate ligament stabilizes the knee joint and prevents the lower leg from moving excessively forward, and also supports the lateral condyle of the tibia.The posterior cruciate ligament of the knee joint (Latin lig.cruciatum posterius) starts from the anteroposterior part of the lateral surface of the inner condyle of the thigh, crosses the knee joint and attaches to the posterior intercondylar fossa of the tibia. It stabilizes the knee joint and keeps the lower leg from shifting backward.

The articular surfaces of the bones are covered with cartilage. Between the articulating surfaces of the femur and tibia, there are inner and outer menisci, which are sickle-shaped cartilages.The knee joint is enclosed in a joint capsule. In humans, the knee joint allows flexion and extension movements, and in the bent position, rotation around the axis.

The knee is the most common site for sports injuries (such as meniscus or ligament tears).

Cruciate ligament injuries

A rupture of the anterior cruciate ligament can occur when a force is applied forward on the posterior surface of the knee joint when the lower leg is bent and turned inward.Cruciate ligament ruptures can be accompanied by avulsion fractures of the bone plates at the ligament attachment sites or a fracture of the intercondylar eminence. Which greatly complicates the subsequent treatment. Very often, cruciate ligament ruptures occur in athletes while playing football, while doing alpine skiing, and among wrestlers. The posterior cruciate ligament is torn by a sharp extension of the lower leg at the knee joint or by a direct impact on the anterior surface of the lower leg when it is bent at the knee joint.

Ligament tears are often associated. The most severe damage is considered to be a rupture of both cruciate, both lateral and joint capsule. This leads to a loosening of the knee joint and to the loss of the ability to walk with that leg. When the cruciate ligaments rupture, severe pain occurs. Bleeding occurs in the joint (hemarthrosis). The joint increases in size. The symptom of “ballot” of the patella is revealed. However, for some patients, the very moment of injury may go unnoticed.Later, there is a feeling of instability, looseness in the knee joint.

The main symptom of a cruciate ligament rupture is the “drawer” symptom.

With the help of special techniques, the doctor shifts the patient’s lower leg forward or backward. When the anterior cruciate ligament ruptures, the lower leg is excessively displaced forward – symptom of the “anterior drawer” , and with a rupture of the posterior cruciate ligament, the lower leg is easily displaced back – symptom of the “posterior drawer”.

With old ligament ruptures, the “drawer” symptom may become indistinct due to the development of fatty tissue around the rupture site, which partly stabilizes the knee joint. The diagnosis is clarified by MRI examination.

Treatment of injuries of the anterior cruciate ligament

1. Conservative treatment of the cruciate ligament of the knee joint

In the acute period, that is, immediately after the injury, treatment should be aimed at relieving pain and swelling of the knee joint, later – at restoring normal mobility in the joint.Do not attempt to walk unaided immediately after injury. You must protect your knee from further damage that can occur without proper treatment. Conservative treatments include ice packs, anti-inflammatory drugs, and rest. In the presence of hemarthrosis, it is necessary to aspirate the accumulating fluid. Physiotherapy and physiotherapy exercises can also be prescribed.

Exercise can help restore normal joint mobility more quickly and prevent muscle wasting.Specific exercises target the hamstrings and quadriceps, which help stabilize the knee. An important argument in favor of treatment is the fact that long-term joint instability leads to early arthritis of the knee joint.

Knee pads – bandages, orthoses and calipers. Bandages are jerseys that tightly fit the joint and improve its stability. They can have special silicone inserts for better fixation of the patella – in the form of a ring or half ring.An orthosis is an orthopedic device, the main task of which is to compensate for impaired joint functions. Orthoses are usually defined as complex structures made of metal, plastic and fabric that are used for more serious disorders and better stabilize the joint (Fig. 1). Sometimes it is difficult to draw a clear line between a bandage and an orthosis, as there are bandages with lateral iron inserts in the form of elastic springs or simple hinges, which are additionally fixed with tightening Velcro.The word “support” comes from the English word support, which translates to “support” and is used as a general term. Calipers are often used for knee instability. If you do not lead an active lifestyle, then you can completely do without surgical treatment. The support will provide the necessary stability.

However, there is no evidence that the use of calipers prevents the development of arthrosis of the knee joint. The use of a caliper can give a false sense of security when playing sports.Supports will not always be able to fully protect your joint, especially during sudden movements, stops and jumps. Therefore, with pronounced instability of the joint, people leading an active lifestyle, going in for sports, are recommended surgical treatment. Many doctors recommend the use of calipers for at least a year after surgery. So if you have a cruciate ligament injury, you will need the calipers anyway.

2. Surgical treatment of rupture of the anterior cruciate ligament of the knee

If, after a course of conservative treatment, the stability of the joint does not meet the requirements of physical activity and the supports do not provide the necessary stability of the joint, then it is suggested to resort to surgical treatment.Even when it is obvious immediately after an injury that surgery is necessary, most doctors prescribe a course of physical therapy and physiotherapy exercises in order to quickly relieve swelling and restore full joint mobility. Only after this is a surgical operation possible.

Surgical treatment of anterior cruciate ligament rupture consists of arthroscopic reconstruction of the anterior cruciate ligament. Arthroscopy is a method of endoscopic joint surgery. The operations are performed using very thin instruments and special optics connected to a digital video camera (Fig.2). During the operation, the surgeon looks at the monitor and sees everything that is happening at the moment in the joint, with a high magnification – from 40 to 60 times. The use of modern instruments and highly sensitive optics allows performing the finest manipulations on the knee joint with minimal damage to the surrounding structures and the joint itself (for example, suturing or removing part of the menisci, cartilage transplantation, ligament reconstruction) – all through 2-3 small incisions. After such an operation, the patient is usually discharged on the same day.

For the reconstruction of the anterior cruciate ligament, grafts, which are pieces of human tissue, are currently used in leading sports medicine clinics. In world practice, several sources of graft are used: autograft from the patellar ligament, autograft from the hamstrings, allografts.

Patellar ligament reconstruction. This ligament connects the patella to the tibia.The autograft is cut off from the tibia and patella with bone fragments. The bone fragment is then used to fix the autograft in the bone canal. This technique not only increases the strength of the graft attachment to the new bed, but also ensures its faster fusion with the latter, since the fusion of the cancellous bone in the canal, the walls of which are represented by a spongy structure, takes 2-3 weeks, which is much shorter than the period of fusion of such a ligament or tendons with bone.The edges of the cut ligament are sutured. In the tibia and femur, canals are drilled out into the cavity of the knee joint. The internal openings of these canals in the joint are located in the same place where the anterior cruciate ligaments were attached to the articular surfaces of the femur and tibia. The ligament graft is inserted into the joint cavity through the tibial bone canal. The ends of the prosthesis are fixed in the bone canals using special metal or biopolymer absorbable screws.This method is most often used in most clinics in the world.

Hamstring autograft. Tissue from the tendon of the semitendinosus femoris muscle can be used as a material for grafting. Until now, there is no consensus on the question of which autograft is better. Reconstruction with an autograft from the patellar ligament is more traumatic and recovery after such an operation is more difficult due to injury to this ligament.But on the other hand, it is believed that such an operation is more reliable. The knee is then more stable and better withstands the load. Although, if the surgeon has mastered the technique of performing surgery for reconstruction from the tendons of the semitendinosus and tender muscles, comparable results are obtained. With the second method of surgery (from the tendon of the semitendinosus muscle), fewer incisions are made and in the future it is almost imperceptible that surgery was performed on the knee. With the first technique (from the patellar ligament), an additional 5-centimeter scar will remind of the operation, which in reality is not very striking, especially in men…. Recently, preference has been given to semitendinosus autografts or the tendon of the quadriceps femoris muscle, but this operation technique is not applicable in all cases, and the patellar ligament is also rarely used. The solution to this issue is approached individually. Allografts are tissues obtained from a donor. After a person dies, tissue is removed from the body and sent to a tissue bank. There she is checked for all infections, sterilized and frozen. When an operation is needed, the doctor sends a request to the tissue bank and receives the necessary allograft.The source of the allograft can be the patellar ligament, hamstrings, or the Achilles tendon. The advantage of this method is that the surgeon does not have to cut the graft from the patient’s body, disrupting his normal ligaments or tendons. This operation takes less time, because time is not wasted on the allocation of the graft. Taking into account the complex structure and biomechanics of the anterior cruciate ligament, the term “restoration of the cruciate ligaments or their plastics” was rejected during the development of the surgical technique.Performing only one stage of the operation, namely, the location of the graft in the articular cavity similar to the course of the normal cruciate ligament, does not give grounds to call this surgery the restoration of the cruciate ligaments, since the structure of the ligament is not fully recreated, each portion of which plays a significant role in its effective functioning. Therefore, the correct and theoretically justified term would be “restoration of stability” or “stabilization of the knee joint in one way or another.”

Sports injuries

Sports injury

What is trauma? How often have you been injured while playing soccer, exercising with weights, or just running? An injury can feel like a tear, sprain, or any injury to the knee, shoulder, ankle, or other part of the body. And before you feel pain, you get scared. Applying ice to the injured area, you are perplexed – how could this happen? What will the traumatologist say? How to avoid similar injuries in the future?

This article will answer these questions, as well as professional training programs to help you regain fitness after injury.Also in it you will find expert recommendations that will help you restore your previous physical shape without harm to health and unnecessary stress on injured bones, joints and muscles. If you are not injured right now, use the training programs and expert advice presented here to avoid possible injury in the future.

Workout Optimization

The moment after which you were injured – a bad landing after a jump or a hard collision on the football field – cannot be considered the cause of your injury.The cause of the injury is an imbalance in training, as a result of which you train some muscles too intensely, while others are completely ignored.

Overtraining is the shortest path to injury, as you overwork your muscles. Tired muscles weakens the tendons that hold muscles to bones. The tendons become swollen and become damaged if you continue to exercise and overcome the pain. Incessant pain during exercise can be a sign that you are overloading your muscles and tendons.As a result, you get hurt.

One method to avoid overloading is the ten percent rule. The load (running distance, running speed, weight of weights, etc.) should be increased by no more than 10% per week. This will allow the tendons, muscles and bones to adapt to new stress.

Pre-workout warm-up

Never start training without first warming up. If you sweat a little during the warm-up, this is a good sign that your core temperature has risen, which means that your tendons and ligaments have become more elastic.It also suggests that the cartilage and the bones they protect are abundantly supplied with synovial fluid for lubrication. In general, stretching should be done before exercise to improve flexibility. Stretching before exercising, however, does not always prevent injury. It is preferable to observe the following order: before a sports game or workout in the gym, first warm up (5 to 10 minutes – low-intensity aerobic exercises, such as running or an exercise bike), and stretch after the warm-up.Stretching should also be repeated after playing or exercising when the muscles and tendons are more elastic.

Balanced program

All training programs must be balanced. This condition is especially true after you have suffered an injury. The balance of the training program determines the speed of recovery of the injured area.

Go through each section and determine which programs are right for you. Then read the training instructions and exercise descriptions to determine if the suggested requirements are appropriate for your fitness level.Indeed, in some cases, the training program may contain exercises that will not suit you, since they are contraindicated with your injury and its severity.

Pay particular attention to the exercises suggested for each type of injury that develop flexibility and strength. In many cases, you will be offered exercises or whole exercise programs to prevent injury. If your injury has other functional impairments, consult a physician before embarking on any program.

Prevention of injury

Engage in the chosen program three times a week (every other day) for 4-6 weeks. Warm up with 5-10 minutes of low-intensity aerobic exercise before each workout. Then you need to do exercises for the development of flexibility and strength in the order presented. Rest 30 to 60 seconds between sets and exercises. When working with higher weights and doing fewer reps, you should increase the pause time between sets and exercises.On non-programmed days, allow up to 45 minutes of non-strenuous aerobic exercise.

Do not forget that the number of approaches, repetitions and weights are given for recommendations. You may need to start small. And while all the exercises presented are safe, you should listen carefully to your body’s reactions. At the first painful sensations, the exercise should be stopped.

Pain relievers

Over-the-counter pain relievers can help relieve pain for many minor injuries.You should also take first aid measures for trauma and ensure that four conditions are met: immobility, cooling, compression and lifting.

Return to training

The first rule of injury rehabilitation is not to rush. Do not strive to quickly return to your previous sports form. This is especially true if you have had surgery for a ruptured tendon or ligament after an injury. Set yourself the following goals:

1.Resume movement of the injured joint. Without this, you will not be able to restore the overall functionality of the limb.

Trauma recovery requires balance: find the right combination of exercises to develop flexibility and strength. Take your time to return to active activity, but also do not give yourself indulgences. Excessive stress will lead to another injury.

2. Restore flexibility with daily stretching, which will help speed up recovery and reduce pain.

3. To restore strength and endurance, gradually increasing the load. Use the cross-training method (including additional exercises in addition to the main exercises) to maintain the level of general fitness; do developmental exercises specific to your sport to prepare your body for a full workout.

4. To restore balance and coordination of movements. To do this, perform an exercise such as maintaining balance on one leg with your eyes closed.

Your main goal is to return the previous level of physical fitness. This task can take anywhere from a few days to several months, depending on the severity of the injury.

FIRST AID FOR INJURY

The body responds to injuries with pain and swelling. Knowing how to provide first aid for injuries can help speed up the healing process. And first aid for injuries is to provide four conditions: immobility, cooling, compression and lifting.

Immobility means the intentional limitation of the movement of an injured part of the body. If your ankle is swollen and black as a result of an injury, do not step on the injured leg. Use crutches or a cane when walking. If the sprain is not severe, you can try to move the injured body part to determine the severity of the injury. Usually the body gives “signals”. If you cannot move a limb and feel unbearable pain, then your body is letting you know that the injured part of the body should be left alone and seek medical attention.

Cooling of the injured area is carried out by applying ice to the place of edema for 20 minutes every 4-6 hours for 1-2 days after the injury. Ice should be applied until the pain disappears and the swelling subsides. To protect your skin from frostbite, wrap ice in a towel.

To stop the spread of edema, it is necessary to bandage the injured limb, that is, to do compression. In some cases, you can do without a bandage or tight bandage. For example, if you sprained your ankle, just keep your boot on.The pressure that he creates on the ankle will prevent the swelling from spreading, and then, after removing your boot, you can apply ice to the injured area.

The injured limb should be kept raised – at a height higher than the level of the heart. This measure will help reduce pain and swelling by limiting the access of fluids to the injured limb.

Your foot and ankle carry the weight of your body all day – and in most cases they do a wonderful job.Unfortunately, running on hard surfaces or bouncing on a tennis court can cause you to stretch and tear your tissues. As a result, you will be incapacitated for weeks or even months. In some cases, athletes do not have time to properly stretch and stretch the corresponding muscles and tendons before training or playing. In other cases, athletes choose the wrong shoes. The result is injury to the foot, lower leg, or ankle. Below you will find a description of such injuries.

STRETCH OR RUPTURE OF ACHILLIAN TENDON

Trauma Sensation

First, you hear the characteristic sound of the Achilles tendon tearing at the back of the ankle.Pain and swelling follow. In some cases, these symptoms may appear the day after exercise. It is difficult to step with an injured leg, it is painful to stand up on toes.

Causes of injury

Sharp acceleration while driving, running uphill. The muscles of the lower leg may be stiff.

Trauma treatment

Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.This will reduce pain and swelling. You may need to use crutches or instep supports to relieve stress on the tendons during the recovery period. Calcaneal instep supports should be placed in the shoes of both feet, otherwise curvature of the spine can occur. If your Achilles tendon is completely ruptured, you will have surgery.

Personal injury prevention

Even without exercising daily, work to improve the elasticity of the calf muscles and the Achilles tendon.Do stretching exercises.

LINEAR HEEL PAIN

Trauma Sensation

You feel pain on the sole of the foot in the heel area. In this case, the pain is given throughout the arch of the foot and can intensify in the morning or during long runs.

Causes of injury

The plantar fascia tendon, located on the bottom of the foot, can be stiffened if it is not stretched enough before training.Another reason may be that the arch of the foot is too high.

Trauma treatment

Stretching allows you to increase the length of the Achilles tendon and the plantar fascia tendon. Appropriate exercises will help make the tendons more elastic. This will take time, of course. If the pain is severe, a cortisone injection may be needed.

Personal injury prevention

Stretch harder. Choose the right footwear. Change it regularly (after about 650–800 km).

ANKLE EXTENSION

Trauma Sensation

In the event of tissue rupture, trauma may be accompanied by a characteristic sound. This is followed by pain, swelling, or bruising around the ankle.

Causes of injury

You may have torn one or more of the ligaments that hold the ankle joint together.

Trauma treatment

Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.This will help control the swelling. Try small movements using your ankle. Strengthening blood circulation in the tissues surrounding the injured area speeds up the healing process and reduces pain. To start, slowly rotate your foot. If you are unable to do this or the movement is causing severe pain, it could be a sign of a broken bone. In this case, you should contact a traumatologist. If the situation is not so serious, give first aid for several days while using medicines.While the torn ligaments are healing, use a compression bandage or splint to support your ankle.

Personal injury prevention

Do not train on uneven or slippery surfaces. Also avoid grassy lawns, sandy and rocky surfaces. Use a bracing bandage to protect your ankle.

ANKLE FRACTURED

Trauma Sensation

A crunching sound from your ankle may be the first sign that your injury is more serious than a sprain.This sound is followed by sharp pain, swelling and subcutaneous hematoma. You will not be able to step on the injured leg.

Causes of injury

The tibia and fibula, the two bones that make up the ankle, break at their junction with the foot. Since the options for a fracture can be very different, an accurate diagnosis can only be made by a doctor after fluoroscopy. Depending on the severity of the fracture, you will be incapacitated from six weeks to three months.

Trauma treatment

First, do the fluoroscopy. Then a cast will be applied to your leg and you will walk on crutches. Surgery may be required.

Personal injury prevention

The only thing you can do is control your movements more carefully in the game.

STRESS FRACTURE OF THE BONES OF THE FOOT

Trauma Sensation

A stress (or fatigue) fracture is a small fracture or tear in the bone.It is accompanied by swelling and aching pain in the bones of the foot, especially the bones of the metatarsus – the long bones located in the middle of the foot behind each toe. The pain can be widespread, such as with tendon inflammation, or concentrated in one area.

Causes of injury

A small crack or tear in the bone results from excessive stress on the bone. This happens if you run too fast or don’t change your athletic shoes for a long time. When you very quickly increase the distance or run on a hard surface, a large load falls on the bones, and fatigue syndrome gradually develops – microcracks and tears are formed.

Trauma treatment

This type of injury cannot always be detected with fluoroscopy. You may need to have a CT scan or just treat the injury until the pain goes away. Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb. This will reduce pain and swelling. It is especially important to maintain immobility in order for the bones to heal. Once you resume jogging, increase the distance gradually 5 to 10% per week to avoid relapse.Try to run on soft surfaces such as smooth dirt paths or grassy lawns.

Personal injury prevention

Wear athletic shoes that provide shock absorption. Gradually increase your distance and running time.

LOW ARCH FOOT AND METATARSALGIA

Flat feet can develop over time or when the arch of the foot is initially low. It can cause pain in the ankle and foot area. Excessive exercise (such as long running) can irritate the tibialis posterior tendon, causing pain and swelling.Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb. Buy arch supports and fit into your shoes.

Pain in the toes, and not in the arch of the foot itself, may be a sign of metatarsalgia – severe pain in the metatarsal bones of the foot. This means that there is an excessive load on the bones of the foot. Often this problem occurs when wearing athletic shoes that are too narrow or when the arch of the foot is abnormally high.In the latter case, you will need special instep supports for shoes.

UPPER ANKLE EXTENSION

This injury occurs when you land on your toes unsuccessfully. In this case, the tibia and fibula are separated, as a result of which the ligaments that hold them together are stretched. The pain is felt above the tibia, and walking is difficult. Recovery takes longer than a normal ankle sprain and often requires prolonged immobilization (immobility).

Causes of injury

The muscles on the outer ankle may have been overstressed, or you may have twisted your leg with the ankle inward. The result is a rupture or stretching of the peroneal tendon located on the outside of the ankle.

Trauma treatment

Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.This will help reduce the swelling. Warm up before exercising to prepare your ankle for movement using the specific exercises described below. These exercises shouldn’t hurt you. They will help maintain the elasticity and mobility of the ankle joints. You may need to undergo physical therapy to strengthen your ankle muscles. Temporary immobility of the ankle with a splint can also be beneficial.

Personal injury prevention

Stretch and strengthen the joints and muscles of the ankle.

INFLAMMATION OF THE FRONT SHIN SURFACE

Trauma Sensation

This injury is described as inflammation of the tissues of the anterior surface of the tibia. With an injury, there is acute bone pain in the ankle or tibial muscles.

Causes of injury

Excessive stress is the cause of fatigue injury to the bone or muscles of the lower leg. Flat feet or running on hard surfaces may also be the culprit.

Trauma treatment

The site of pain will tell you the type of injury. Pain in the tibia indicates the initial stage of a stress (fatigue) fracture. If pain spreads along the inner surface of the tibia, then this is a sign of inflammation of the bone tissue. Swelling of the ankle muscles implies pain and stiffness on the outside of the ankle muscle. Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.This will reduce pain and swelling. Reduce the intensity and frequency of your exercise to avoid worsening the situation.

Personal injury prevention

Runners whose foot falls inward and touches the surface with the inner sole are more prone to ankle injuries. Use orthopedic shoe pads to even out the angle of the foot.

STRETCH OR RUPTURE OF THE SHIN MUSCLES

Trauma Sensation

First, you hear a loud tearing sound, then you feel a sharp pain in the lower leg.In some cases, pain may suddenly appear, after which it becomes stable, edema and subcutaneous hematoma appear.

Causes of injury

Excessive loads of the leg muscles. Sudden changes in direction on a tennis court or soccer field force the calf muscles to lengthen instantly. If the muscles are not ready for this, stretching or tearing of the muscle tissue occurs.

Trauma treatment

Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.Use nonsteroidal pain relievers and crutches as needed.

Personal injury prevention

Warm up to prepare your leg muscles for movement. The warm-up should be carried out for 5-10 minutes. Then do some stretching exercises.

FOOT COVER: WET TEST

Wet the sole of the foot. Step on a flat, level surface. Consider the remaining footprint: the absence of an internal bend of the foot indicates flat feet (low arch of the foot) and, accordingly, a disposition to inflammation of the tendons of the peroneal muscle.If the arch of the foot is too high, the body weight is distributed over the outer part of the foot, leading to ankle sprains and stress fractures.

Knee injury

The knee is complex. The lateral collateral ligament on the outside and the medial collateral ligament on the inside connect the femur to the shin bones. The anterior cruciate and posterior cruciate ligaments intersect within the knee joint, preventing the knee from moving forward or backward.The cartilage lining the inner surface of the joint acts as a shock absorber. Strengthening the muscles of the knee reduces the likelihood of injury.

AIR-TIBOUS SYNDROME

Trauma Sensation

This problem is common among runners and cyclists. At first, you feel general pain on the outside of your knee. The pain then gets worse, especially when you run downhill or down stairs. If you move without bending your knees, the pain disappears.

Causes of injury

The iliotibial tract is a massive conglomeration of muscles and tendons that runs from the pelvic region down to the knee. At the bottom of the femur, the iliotibial tract connects to the outside of the periarticular patella, a sac of synovial fluid that protects the bone. If you run or cycle for too long, the periarticular sac swells and rubs against bone.

Trauma treatment

Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.Such measures will reduce pain and swelling. After that, do stretching exercises to improve the elasticity of the iliotibial tract. Then work on strengthening the outer thigh muscles with exercise.

Personal injury prevention

Running on uneven sidewalks can injure the iliotibial tract.

KNEE PAIN

Trauma Sensation

You feel a throbbing pain behind the kneecap (patella).Felt after (and sometimes during) a run, after a squat, during a lunge, or when you get up after sitting for a long time.

Causes of injury

When you run or walk, the kneecap moves up and down. If you run a lot with poor running technique, the kneecap shifts slightly and starts rubbing against the protective cartilage behind it. Flat feet, muscle imbalances, or over-training can also cause this. If the knee muscles are tired, they cannot hold the patella in place.

Trauma treatment

First of all, ice must be applied to the knee. Reduce physical activity, as the constant displacement of the patella can cause chondromalasia, in which the articular cartilage is destroyed by friction. During recovery, use the cross-training method (including additional exercises in addition to the main ones).

Personal injury prevention

Eliminate machine squats, lunges, and leg extensions.Work to improve flexibility by doing stretching exercises and strengthen your leg muscles with exercise.

KNEE TENDINITE

Trauma Sensation

You feel pain in the front of the knee below the kneecap when squatting, running, jumping or kneeling.

Causes of injury

When landing after a jump, the main dynamic load, which is several times greater than your body weight, falls on the knees.Accordingly, a significant load falls directly on the tendons that connect the muscles and bones in the knee joints. Over time, inflammation of the patellar tendons develops, causing pain and swelling.

Trauma treatment

Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb. This will help reduce pain and swelling in the knee area. Build hip strength with partial leg extensions and different leg lifts.This will reduce the stress on the patella ligaments. If you have problems with the angle of the foot, you can try using orthopedic arch supports for shoes. You can also use a knee brace, a type of elastic band that tightens the knee and reduces stress on the joint.

Personal injury prevention

In the gym, do not perform full leg extensions on the machine. Instead of strengthening the muscles, you will only irritate the ligaments that support the knee and thigh muscles.Better do a variety of exercise options, such as the ball press, to help you strengthen your muscles with minimal stress on your knee.

Meniscus cartilage rupture

Trauma Sensation

By itself, this injury is not too painful. But over time, pains develop in and around the knee when you climb stairs or hills, or when doing a full squat. When moving, clicks can be heard in the knee joint.Sometimes there may be a feeling as if the knee joint “seizes” and does not act freely.

Causes of injury

While running or walking, you injured the cartilage tissue lining the inside of your knee joint. Normally, these cartilage tissues prevent the femur from rubbing against the shin bone. This cartilage can also be damaged over time or if the knee bends at an acute angle during movement.

Trauma treatment

The most important curative measure is rest.The meniscus will not recover without rest. Sometimes minor cartilage damage can heal on its own if you limit the stress on the knee. In other cases, surgery may be required. Doing leg lift exercise options will also aid recovery.

Personal injury prevention

Minimize the number of exercises that include squats and knee curls. Maintain flexibility with stretching exercises.

KNEE CAP OFFSET

If the knee is dislocated, the patella may be displaced.Its displacement is easily determined visually and is accompanied by severe pain. Often times, the kneecap snaps into place when the knee is repositioned on its own. Even so, see a traumatologist as soon as possible. Before that, put ice on your knee and try to bend it less.

STRESS BREAK

Trauma Sensation

Increasing persistent pain in the patella or tibia. The condition worsens during exercise.

Trauma treatment

Place ice on your knee and take pain reliever. This will help reduce pain and swelling. But the main thing is to stop training. Take at least a month off to give your bones time to heal. If the injury is severe enough, see a physical therapist to support the muscles surrounding the fracture site. In any case, you can return to training only after complete restoration of bone and muscles.

Personal injury prevention

Increase the loads gradually so that the bone can adapt.

BREAK OF THE FRONT CROSS LINK

Trauma Sensation

First, you hear the characteristic break sound. It feels like a rubber band has ripped inside your knee. The knee may bend and not support the weight of the body. Blood from the damaged ligaments enters the knee joint, the knee swells, the pain intensifies.

Causes of injury

The tibia is displaced relative to the knee, the anterior cruciate ligament cannot withstand the load and breaks.When skiing, this happens if the knee turns in the opposite direction to the movement of the ski (and lower leg). It also happens when you fall backwards and try to regain your balance and stay on the skis.

The cause of such an injury in tennis or football is a sudden change in direction of movement or a sudden stop.

Trauma treatment

Do not step on the injured leg. Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.It is especially important to raise the injured leg right away to reduce the swelling. If you have severe pain, the doctor will suck blood and fluid from your knee with a syringe, which will reduce pain and swelling. Wear a splint or bandage that will allow you to move around and support your knee.

Surgery is not always necessary. The decision to use it will depend on your age, physical activity level, and the general condition of your knee. In any case, physical therapy should be taken to help strengthen the muscles of the knee as well as increase the range of motion of the knee joint.Try not to load the knee in excess of the therapeutic one.

Treatment of a minor sprain of the anterior cruciate ligament lasts at least 4 weeks. A complete rupture of the ligament with subsequent surgery will incapacitate you for 4-6 months.

Personal injury prevention

Ask an experienced athlete to teach you how to land after a jump and to strengthen the hamstrings as they carry some of the stress of the anterior cruciate ligament of the knee.Exercises for the muscles of the back of the thigh should be supplemented with exercises for the quadriceps muscle of the front of the thigh. Stretching exercises can improve knee strength and flexibility.

MEDIAL COLLATER BOND BREAK

Trauma Sensation

Rupture of the medial collateral ligament is accompanied by acute pain on the inner side of the knee.

Causes of injury

Any blow to the outside of the knee can rupture the medial collateral ligament.Bending the knee in the opposite direction to normal can stretch the medial collateral ligament.

Trauma treatment

Place ice on the knee to reduce pain and swelling. Use a knee brace during your recovery period for several weeks to stabilize the joint. The brace will provide support for your knee without restricting movement, which will speed recovery. Physical therapy can help strengthen the muscles in the injured area and maintain joint flexibility.If the rupture is incomplete, surgery is not required. The severity of the rupture is measured on a 3-point scale, ranging from first (least severe) to third (most severe).

Personal injury prevention

While playing, wear a knee pad on the outside of the knee to protect the joint and reduce the severity of the injury. Exercise to develop strength and flexibility.

LATERAL COLLATER BOND BREAK

Trauma Sensation

Rupture of the lateral collateral ligament is accompanied by acute pain on the outside of the knee.

Causes of injury

This injury is less common than other knee injuries. The rupture of the lateral collateral ligament occurs with an abrupt stop or an unprepared start of movement, when the knee is twisted outward. In sports games, this also happens in a collision where the knee moves outward.

Trauma treatment

Provide first aid and ensure that four conditions are met: immobility, cooling, compression, and elevation of the injured limb.See your doctor – only in rare cases is a rupture of the lateral collateral ligament without additional damage. Most often, other ligaments are also affected, as well as articular cartilage. Wear a knee brace and get physical therapy to strengthen your knee and maintain your ability to move around normally. A rupture of the lateral collateral ligament will incapacitate you for 4-12 weeks.

Trauma prevention

Do exercises to develop strength and flexibility.

BREAKING OF THE REAR CROSS-LINK

Trauma Sensation

The main symptom is mild pain in the back of the knee.It moves more freely than it normally would. The pain can be tolerated.

Causes of injury

You fell on a bent knee or hit it on the dashboard of a car during an accident. The posterior cruciate ligament can also rupture if you hit the front of the knee, causing it to move backward.

Trauma treatment

Pain is usually an indicator of the severity of an injury – and the more intense it is, the more severe the rupture of the ligament.However, this approach does not work in the case of a hidden posterior cruciate ligament rupture. In general, even with moderate pain, you need to see a doctor, as it indicates a rupture of a fairly high degree of severity. If left unattended, the posterior cruciate ligament rupture can lead to arthritis. In some cases, surgery may be required to treat this injury. If you manage to avoid it, the treatment will take 4-8 weeks; after the operation, you will recover for 4-6 months.

Personal injury prevention

Develop strength and flexibility in your knee muscles.

Strong and healthy knees allow you to jump from great heights and land safely.

Injuries of the thigh and hip

The muscles of the thigh are of great importance for the runner. They need to be strong so you can take the workout and flexible so you can take a low start and run to the finish line. Many guys limit themselves to strengthening the quadriceps and stretching the hamstrings, but that is only part of the workout needed.You must strengthen and stretch all of your thigh muscles. By training the muscles in this area, you can avoid a lot of problems.

STRESS Fracture of the Femur

Trauma Sensation

This injury feels similar to a sprained groin. It is characterized by gradually increasing pain that spreads along the inner surface of the thigh. The pain can be severe and sometimes causes lameness.

Causes of injury

Excessive training can cause small cracks or tears in the thighbone that connects the hip to the knee.This injury is common in the sport of long-distance running. Fatigue of the thigh muscles leads to the fact that during movement they cease to absorb the shock load.

Trauma treatment

The tear or fissure in the bone may be so small that it cannot be detected by fluoroscopy. You may need to have a CT scan to confirm the diagnosis. If the injury is left unattended, a microcrack can develop into a full-fledged crack, and then surgical intervention will be required.

Personal injury prevention

The distance and running speed should be gradually increased.

BURSIT OF THE FEMORAL JOINT

Trauma Sensation

You feel pain on the outside of your thigh. The pain is worse when moving up stairs or on any incline, or when moving the injured hip. It can be painful to lie on this side.

Causes of injury

Bursitis is a purulent inflammation of the periarticular mucosa of the hip joint.This bag protects the thigh bones from constant friction with the surrounding muscles and ligaments.

If you put too much stress on your thigh muscles – for example, quickly lengthen your running or cycling distance – irritation of the periarticular sac, accompanied by edema, occurs. A similar problem is tendonitis, an inflammation of a tendon or ligament that also irritates the bursa.

Trauma treatment

To reduce swelling, ice and nonsteroidal pain reliever should be applied to the injured area.In the event of severe pain and extensive swelling, a cortisone injection may be required.

Personal injury prevention

Develop your thigh muscles.

SMELLING STRETCH

Trauma Sensation

Trauma is accompanied by sudden pain and swelling on the inner side of the thigh. The pain can be severe enough to cause lameness.

Causes of injury

You have stretched or tore the adductors of the thigh, located on the inside of the thigh from the hip down to the knee.These muscles allow the legs to be drawn together. An unprepared lunge can rupture or stretch these muscles.

Trauma treatment

Use ice, non-steroidal pain relievers and crutches if necessary. In addition, it is possible that your injury is not so serious and in reality you have a simple groin sprain. If you are involved in a contact sport that requires frequent stopping and starting without preparation, such as football or rugby, you may have a ruptured tendon that holds the abductor muscle to the hip.

Persistent pain in the hip and lower abdomen that does not go away after rehabilitation may be a sign of an inguinal hernia. This injury develops over time and often does not heal. If the pain persists, you may need surgery to tighten the lower hip wall.

Another similar injury is osteitis pubis (inflammation of the area where the bones of the hip region converge in its frontal part). This injury is common among long distance runners (and also among women who have recently had childbirth).Rest is the best treatment.

Personal injury prevention

Stretch the leg muscles for 5-10 minutes. For this, a run or exercise on a stationary bike is suitable. After warming up, start stretching. Don’t try to increase the depth of your stretch if you feel pain. Movements should be performed smoothly, without jerking. After stretching, you can practice your sport or work out in the gym.

FOUR-HEADS STRETCH

Trauma Sensation

You feel an unexpected stretch or a tearing of the muscles in the front of the thigh, accompanied by a characteristic sound.Sharp pain occurs, followed by swelling and burning. You find it difficult to walk, raise your knee, or even bend your knee.

Causes of injury

If you slip, stumble, kick or lunge, you can stretch your quadriceps. It connects the knee to the hip and is involved in providing a variety of movements, including running, kicking, and lifting from a seated position. Tears in this muscle usually occur in the middle part of it, but they also occur in the lower and upper parts.

Trauma treatment

Apply ice to the injured muscle. Stretch more often during injury recovery, focusing on your quadriceps.

Personal injury prevention

By developing your quadriceps muscles, you will be able to make sharp movements without injury. Warm up for 5-10 minutes with low-intensity aerobic exercise, then do stretching exercises.

EARS OF THE FOUR-HEADED MUSCLE

Trauma Sensation

First, pain and swelling appear at the site of injury, then subcutaneous bruising develops.Knee mobility is impaired.

Causes of injury

Received a direct hit with a ball, bat or helmet on the front of the thigh. Although bruising of the quadriceps is most commonly seen in contact sports, in alpine skiing, it can also occur with an unexpected fall –

Trauma treatment

Apply ice to the injured area to reduce swelling. On the first day after the injury, keep the injured leg bent at the knee as long as possible.Otherwise, the quadriceps muscle will become rigid and you will not be able to bend your leg. In this case, rehabilitation after injury will be significantly more difficult. Be aware that as the muscle heals, calcium deposits can form scar tissue in the area of injury. As a result, the quadriceps muscle will not be able to lift the knee normally and you will have to limp for a while. To avoid this, you should constantly ice the injured area and bend your knee. Nonsteroidal pain relievers can also help prevent calcium deposits from forming.

Personal injury prevention

If you are a contact sport, wear a padded guard to cover your thighs.

HIP STRETCH

Trauma Sensation

Stretching or tearing of the muscles that form the back of the thigh is accompanied by a characteristic tearing sound. Pain and burning appear. Difficulty walking or stepping on your injured leg. The injured muscles become swollen.After a couple of days, subcutaneous bruising spreads around the area of injury.

Causes of injury

A group of muscles that form the back of the thigh allows you to flex and push your leg, and jump. Any movement that drastically lengthens these muscles (such as a jump or stride) can stretch or break. This usually occurs in the midsection of the hamstrings.

Trauma treatment

Do not step on the injured leg, this will only worsen the condition.It is necessary to immediately put ice on the site of injury, wrap the muscle with an elastic bandage to reduce swelling.

See a doctor if you cannot stand and the pain gets worse. These signs may indicate a complete rupture of the muscle.

Rest is the best medicine in most cases. During the recovery period, it is important not to overload the injured leg. During this time, you will need to use crutches. In the case of minor sprains, full recovery will take from a week to a month.In the event of a muscle rupture, this period will increase. Make sure the injured muscles have fully recovered before returning to training.

Personal injury prevention

Warm up thoroughly before playing or training and remember to stretch afterwards. For her, use exercises such as stretching the hamstrings (lying) and stretching the hamstrings (sitting).

Back problems often appear as a result of prolonged and strenuous training, as well as engaging in tough contact sports.Back problems arise unexpectedly – yesterday your back could withstand any stress, and today you cannot bend to tie your laces. In the home, back injury can be avoided by following simple precautions. When lifting heavy objects, bend your knees slightly, tighten your abdominals, keep your back straight. Work to strengthen your mid-body, abdominal, and lower back muscles. Stretch your back and mid-body muscles regularly. Stretch especially well before exercising or playing.

LUMBAR PAIN

Trauma Sensation

You feel pain in the lower spine and surrounding muscles. The pain can be worse in the morning or evening, and after sitting, even for a short time. Pain may appear after exercise.

Causes of injury

Constant stress on the back due to poor posture can cause injury over time. Pain can also indicate a stretching or rupture of the corresponding muscles, displacement of the intervertebral discs.If you start training without a warm-up, you can injure the back muscles that are not prepared for stress.

Trauma treatment

Men between the ages of 30 and 50 often complain of back pain. Use ice to relieve pain. Rest your back muscles as often as possible. This means that you should get up from the table more often and take short walks. The same should be done during long journeys and flights. Simple stretching exercises (such as stretching your lower back muscles) will improve the elasticity of your back muscles.Strengthen your mid-body and abdominal muscles with exercise. Strong abdominal muscles will help to evenly distribute the load on the spine.

Learn to bend down and lift heavy objects so as not to injure your back. For example, you should not bend at the lower back to get a heavy object out of the trunk of a car. Instead, place one foot on the bumper, support your back, and bend your knees as you lift the object.

Personal injury prevention

There is no one simple solution.Take the following complex measures: watch your posture, develop the flexibility of your lower back with exercise. Strengthen your back and abdominal muscles.

STRESS Fracture of the vertebrae of the lumbar region

Trauma Sensation

A stress fracture is often accompanied by sensations similar to those described in the previous injury, but sudden pain spasms may also occur.

Causes of injury

You have injured one or more vertebrae in the lumbar spine as a result of repeated traumatic movements.Bending or twisting in the lower back can cause a stress fracture of the vertebrae over time. In addition, you may have a genetic predisposition to this injury. Therefore, you should not blame solely your training methods or sports.

Trauma treatment

The pain increases when you bend your back. You will have to give up the physical activity that caused the injury. Return to training is possible only after full recovery. Anti-inflammatory drugs can help reduce pain.Also apply ice to the injury site. It may also be worth wearing a brace to prevent further damage to the vertebrae. Physiotherapy will help strengthen and stabilize the back muscles surrounding the injured area. Recovery after injury will take from 2-3 months to a year.

Personal injury prevention

Begin by stretching the hamstrings. Then do a core lift to strengthen your mid-body muscles. Limit bending and twisting movements of the spine (this can be difficult if you need them in your sport).

INTERVERTICAL DISC HERNIATION

Trauma Sensation

With this injury, you feel acute pain in a specific area of the spine. The pain comes on suddenly or gets worse gradually. You may feel a painful spasm when you sit down, bend over, or sneeze. The pain in the spine may be tingling or numbness in one of the legs. This disorder is called sciatica. The muscles that support the spine can contract spasmodically, making you unable to stand upright, so your torso will tilt to the side.This way your body will find the most comfortable position. With an injury to the intervertebral disc in the cervical spine, you may experience severe pain trying to straighten your neck. Along the way, you may feel pain, tingling, or numbness in one of your hands.

Causes of injury

Intervertebral discs are located between the vertebrae and act as shock absorbers. If the disc is damaged, its center shifts and irritates the nerve endings surrounding the spine.In some cases, the disc can move even in the absence of significant external pressure.

Trauma treatment

Pain can be relieved with ice, hot compresses, or pain relievers. A back or neck immobilizer can help immobilize the injured area as well as relieve pain. Your doctor may refer you for a CT scan to confirm the diagnosis. You will then be given physical therapy to strengthen the muscles surrounding the injured area.You will also need to learn how to bend down and lift weights correctly.

Personal injury prevention

Do all stretching and muscle development exercises.

WHIP TRAUMA

Trauma Sensation

At first, there may be no pain. But gradually, within 1-2 days, the muscles of the neck become stiff and begin to hurt. As a result, you cannot turn your neck. The pain can spread to the area between the shoulder blades or the shoulders.A headache may also appear.

Causes of injury

As a result of an awkward movement, you have a tear or strain in several muscles in your neck. Whiplash is similar in symptoms to neck strain that occurs when the neck is not moved correctly in some sports. A cyclist who goes too fast over long distances may develop symptoms of whiplash.

Trauma treatment

Use non-steroidal anti-inflammatory drugs or over-the-counter pain relievers.You may need to wear a cervical immobilizer for a while – a kind of collar that fixes your neck in a stationary position. This measure will help prevent muscle cramps and speed up recovery. Your doctor may also prescribe a muscle relaxant to help relieve muscle spasms and pain.

Personal injury prevention

Strengthen your neck muscles and restore range of motion through exercise. Monitor your posture and body position throughout the day. If you have to talk a lot on the phone at work, use a set of headphones with microphone to free your hands.While sitting, try to put both feet on the floor. Sit so that the thighs are parallel to the floor or even make an acute angle with it (knees below the thighs). Do the following simple exercises to increase your neck range of motion:

1. Place your chin on your chest.

2. Tilt your head back and look up.

3. Turn your head from side to side so that your chin almost touches your shoulder.

MEDIUM BACK STRETCH

Trauma Sensation

You feel pain and cramps in the muscles of your mid-back.You can even pinpoint the exact location of the source of pain. Usually this area swells and the tissues become unnaturally soft.

Causes of injury

This injury is common among shot putters and windsurfers who have poor technique. In addition, you can injure your mid-back muscles by performing incline presses with too much weight and pushing one hip forward to complete the rep. In any case, this injury happens when you combine a pushing motion with an unnatural twisting of the body.This movement stretches the muscles located in the middle of the back.

Trauma treatment

Ice, nonsteroidal pain relievers, and rest should be used until the pain stops completely. Avoid twisting movements during the recovery period.

Personal injury prevention

Watch your movements carefully when working with weights. It is better to work with less weights, but do the exercises accurately than trying to impress with your strength and get injured.Repeated trauma to the muscles of the mid-back can lead to arthritis in the future.

NERVOUS STRAIN EXTENSION

Trauma Sensation

You feel a sudden numbness in one arm that lasts for several minutes. The hand may be numb. In some cases, you may feel something like a sudden electrical discharge traveling down the nerve endings down your arm.

Causes of injury

You have casually turned your head to the side, stretching the nerves from your neck to your arm.

Trauma treatment

Stop exercising until sensitivity and hand movement are fully restored. This often only takes a few minutes. If these sensations in both limbs are described, you should undergo fluoroscopy.

Personal injury prevention

Do stretching and strength-building exercises.

The range of motion of the shoulder joint is very wide. That is why a sprain or fracture of one of the shoulder bones leads to impaired movement.Any, even the smallest movement becomes painful. When training shoulder muscles in the gym, very few people pay attention to maintaining the flexibility of the corresponding joints. However, you can avoid common shoulder injuries by paying attention to this problem.

SHOULDER DISTRIBUTION

Trauma Sensation

In the case of incomplete dislocation, the pain is felt more strongly when the bones in the joint are displaced, and then, deforming the ligaments and articular cartilage, return to their place.The hand can become numb, weakness appears in it. With a complete dislocation, the pain is unbearable. You cannot move your hand. The head of the humerus is visible, protruding unnaturally forward or to the side.

Causes of injury

The ligaments holding the humerus break or stretch, causing the joint to lose bone. For some people, these ligaments are initially too elastic, and their shoulder joint dislocation is almost painless and does not lead to injury.

Trauma treatment

If the dislocation is incomplete in the early days, use ice and nonsteroidal pain relievers to relieve pain and swelling.In the event of a complete dislocation, do not try to set the joint on your own so as not to tear the ligaments or break the bone. The tissues that make up the joint swell quickly, and only a doctor can successfully cope with this task. Keep your arm in a comfortable position – closer to the body if the joint is turned back, or slightly if the joint is turned forward. Place ice on your shoulder and use anti-inflammatories to reduce swelling. Go to a traumatologist immediately.

Personal injury prevention

Do exercises to strengthen shoulder muscles (eg modified frontal arm lift, modified side arm lift, or other exercises).Complementing your workouts with these exercises can help prevent shoulder dislocation. In the event of repeated injury, surgery may be necessary.

Fractured key

Trauma Sensation

The injury is accompanied by pain and swelling. You can also feel for the fracture by running your finger along the front of the collarbone (be aware that this will increase the pain). In the event of an open fracture, the bone protrudes through the skin. In this case, you should immediately go to a traumatologist, as an infectious infection is possible.

Causes of injury

Striking concrete or other hard surface with your shoulder can break your collarbone (the thin bone that connects your sternum and shoulder). A collarbone fracture can also occur when you fall on a straight arm.

Trauma treatment

Do not move your injured arm. Get fluoroscopy to determine the severity of the injury. After that, you will be given a plaster cast called a figure eight that will pull your shoulders back (your posture will become truly devotional), or perhaps you will get by with a simple garter that holds your arm in place.This will help anchor the collarbone during recovery. After a certain period of time, you will be taken a second X-ray, as a result of which the doctor will decide on your return to the sport. After a fracture, the bone can easily break again.

Personal injury prevention

If you fall, try to group up and minimize the shock to your shoulder.

DIAGNOSTICS OF SHOULDER INJURY

You fell, hit the ground with your shoulder and experience severe pain in your shoulder.What could it be? One of two types of sprains or tears in the shoulder ligaments.

Sprain or rupture of the ligaments connecting the sternum and collarbone. It is accompanied by pain and swelling in the sternum. When the ligaments rupture, the connection of the sternum and the clavicle is disrupted, as a result of which the clavicle is displaced relative to the sternum. Displacement of the clavicle towards the upper sternum is accompanied by severe pain and swelling. The doctor will be able to put the collarbone back in place and apply a cast if necessary. If the collarbone is displaced behind the sternum, you will need surgery.This is a serious case.

Rupture of the ligaments connecting the clavicle and the shoulder joint. A small tear is accompanied by mild pain or stiffness in the arm. Apply ice to the injury site for 20 minutes for the first 4 hours for several days. Use anti-inflammatories to reduce pain and swelling. Your doctor will assess the severity of your injury and you may need to walk around with your arm tied for a while.

ROTATOR CUFF INJURY

Trauma Sensation

The first sign of injury is pain when raising an arm above your head.There may be a pinch in the shoulder area. Sometimes a crunch is heard in the shoulder joint, or the hand may protrude slightly from the joint. The pain extends to the biceps.

Causes of injury

Shoulder ligaments can be injured through repetitive movements such as swimming. You may have fallen on an outstretched hand.

Trauma treatment

Treatment depends on the severity of the injury. In serious cases, you may have surgery.However, the shoulder usually heals on its own. Eliminate movement while you are in intense pain. Use ice to relieve swelling – do this at least once a day. In severe cases, you will need a cortisone injection and physical therapy to restore the joint’s range of motion. When the pain is gone, start exercises to strengthen your shoulder muscles.

Personal injury prevention

Make sure your shoulder muscles are prepared for the physical activity you plan to do.Modify your training program to strengthen not only your rotator cuff muscles, but other muscles in your shoulder girdle as well.

Elbow pain is often a symptom of weak muscles in the forearm, wrist, or hand. In other words, if your elbow has to handle the stress that your wrist has to handle, it will rupture the tendons and inflame the nerves, requiring weeks of recovery. Athletes seeking a strong grip should pay particular attention to developing strength and flexibility in the hands and wrists.In addition, injuries to the elbows, wrists and hands that occur during falls should be avoided. When falling, never put out your hands. Better group and roll. Falling into your arms will inevitably result in a fracture of your elbow, wrist, or hand, and a plaster cast will be applied to the injured limb for several weeks. When skiing or snowboarding, where falls are frequent, learn to fall properly so as not to injure your elbows, wrists and hands.

“PLAYER’S ELBOW in GOLF”

Trauma Sensation

The site of attachment of the tendon to the bony protrusion on the inner side of the upper part of the humerus becomes inflamed.Pain and swelling of the inner surface of the elbow joint appear. Pain is also felt when moving.

Causes of injury

In the low phase of your golf stroke, your golf club unexpectedly hits turf, compressed sand, or a hidden root. You may be involved in a sport that involves repetitive swinging or throwing movements. As a result, you overload the flexor ligaments of the elbow that connect the medial epicondyle of the elbow to the forearm. Over time, micro-tears appear in the ligaments.

Trauma treatment

The first symptoms of trauma can be relieved with ice, non-steroidal and anti-inflammatory drugs. Try another sport to give your elbow time to recover. In the meantime, work on increasing the joint’s range of motion through exercise. Hire an instructor who can verify your golf or tennis technique is correct.

Personal injury prevention

Avoid overloading in golf or similar sports.Introduce exercises to strengthen the muscles of the hand and forearm into your training program. Watch for pain in the elbow by stopping exercise when the pain in the articular tendons becomes intense.

“TENNISIST’S ELBOW”

Trauma Sensation

Another name for the injury is epicondylitis of the elbow joint. Painful inflammation of the tendon of the ulnar muscle, resulting from its overexertion. The pain increases when you pick up objects, twist your hand in your wrist, or shake hands.Pain lumbago may be felt along the length of the extensor ligaments of the elbow.

Causes of injury

A swing hit with a tennis racket or golf club engages the ligaments in the forearm, especially the adductors of the wrist. With weak muscles of the forearm or with improper execution of a blow, most of the load falls on the ligaments. Over time, micro-tears develop in these ligaments. If, while doing a golf shot, you accidentally hit the root of a tree with your golf club, epicondylitis of the elbow joint can develop on your non-dominant hand (a similar mechanism works in the case of a poorly placed backhand in tennis).Epicondylitis can also be caused by working with too much weights in the gym, performing a large number of repetitions of exercises with poor movement technique. In some cases, a bruised elbow may be the cause of this injury.

Trauma treatment

There are many treatments for epicondylitis of the elbow. But you should always start with first aid measures: rest, ice, anti-inflammatories, and massage. If the pain comes back and becomes chronic, you may need a cortisone injection or acupuncture, physical therapy, or a splint to immobilize your elbow.Some healthcare providers believe that one cortisone injection is more effective than a month of other treatments. Surgery should be treated as a last resort.

Personal injury prevention

Strengthen your forearm muscles and develop elasticity through exercise. Pay particular attention to improving technique in your chosen sport.

ELBOW NEUROPATHY

Trauma Sensation

Feels pain, tingling, and numbness in the ring and little fingers.The source of this injury is not the fingers, but the elbow (the ulnar nerve, which crosses the elbow joint, goes to the very little finger). The injury can also be accompanied by pain and swelling on the inside of the elbow joint.

Causes of injury

The cause is a bruise on the inner side of the elbow or exceeding the range of motion in this joint. As a result of stretching, irritation of the ulnar nerve occurred, which runs along the inner side of the forearm from the elbow to the palm and participates in the movement of the little finger.The tissue surrounding the nerve swells, causing pain, tingling, or numbness in the little finger.

Trauma treatment

Discontinue the sport that caused the injury for the time being. Professional athletes with ulnar neuropathy may require surgery if non-surgical treatments fail. If you are a fan of your sport, then you will have to leave it from two weeks to a month. During this time, the ulnar nerve will be restored.You may need to wear a bandage to help reduce nerve irritation during rehabilitation.

Personal injury prevention

Carefully follow the technique of performing the movements and do not strain the inner surface of the elbow. If you have to bike for a long time, change the position of your hands on the handlebars more often or wear gloves with padded cushions to absorb shock.

ELBOW FRACTURE

Trauma Sensation

The pain is concentrated in the bones of the elbow, especially in the upper part.You may find it difficult to rotate the brush. The swelling can be so extensive that it is impossible to straighten the arm.

Causes of injury

The radius bone, which connects the elbow to the hand on the side of the thumb, breaks as a result of a fall on a straightened arm.

Trauma treatment

An x-ray should be taken first to determine the severity of the injury. A fracture can be of varying severity: from a simple crack to a complete fracture in several places.If the fracture is severe, you will have to walk with a cast for several weeks. Until the pain stops, you cannot begin rehabilitation exercises.

Personal injury prevention

Avoid falling and wear a protective elbow pad.

REAR ELBOW INJURY

Trauma Sensation

Pain is felt in the back (back) of the elbow, especially when straightening the arm or closing the elbow joint.In some cases, the injury may be accompanied by extensive swelling that makes it difficult to straighten the arm. When trying to throw an object, you will feel pain the moment you release it.

Causes of injury

Repetitive snapping of the elbow in excess of the allowable load could be the cause of injury – as in the case of ball throws. The pain is accompanied by swelling of the elbow joint.

Trauma treatment

Rehabilitation exercises combined with physical therapy will soothe pain.After the inflammation has passed, so will the pain. Try not to close your elbow during your recovery.

Personal injury prevention

Avoid painful movements and strengthen the muscles in your wrist and forearm.

WRIST SYNDROME

Trauma Sensation

The injury is accompanied by pain in the “heel” part of the palm – at the base of the thumb. You may also feel pain or numbness in the thumb and first three fingers of your hand, as well as in your forearm.The pain and numbness increase at night as the hand relaxes during sleep, which puts more stress on the medial nerve that connects the forearm to the palm through a channel in the wrist. This leads to the tingling sensation and pain that characterize carpal tunnel syndrome. Symptoms can be so severe that you shake your hand in the morning to restore sensitivity to your fingers. If these signs are left unattended for several months, you will find it difficult to hold objects and your hands will be more sensitive to cold.

Causes of injury

Carpal tunnel syndrome is typical not only for avid computer users, but also for athletes who have to keep their wrist and forearm in a fixed position for a long time, such as cyclists, tennis players and badminton players. You stress the medial nerve when you put your hands on something for a very long time, or squeeze an object too tightly in your hand, or perform repetitive movements, such as typing on the keyboard in an uncomfortable position for the hands.

By continuously irritating the medial nerve for several months, you may become inflamed and the tissues surrounding the nerve may swell.

Trauma treatment

First stop the movement that caused the injury. Wear a brace to keep your wrist still at night. If the situation does not improve, the doctor may inject cortisone into the carpal tunnel or recommend surgery. Your doctor will also likely prescribe a vitamin or nonsteroidal pain reliever.

Personal injury prevention

Find a comfortable wrist position while working at the computer, change the position of your hands on the handlebars more often when cycling. Take action at the first sign of injury.

FINGER JOINT STRETCH

Trauma Sensation

The finger is swollen and sore. Perhaps it is displaced, and the finger takes an unnatural position. In the latter case, a fracture or dislocation may be suspected.

Causes of injury

Pinching one of the fingers is accompanied by trauma to the metacarpophalangeal or interphalangeal joint. When dislocated, the phalangeal bones are pulled out of the joint.

Trauma treatment

Apply ice to a finger and restrict its mobility by bandaging it with an adjacent finger. If the pain persists for more than two days or even gets worse, take an X-ray of your finger. You may have broken one of the phalanx bones.

Personal injury prevention

The only way to avoid injury to your finger is to avoid exposing it to shock.

WRIST EXTENSION

Trauma Sensation

Pain in the entire wrist, swelling of the back of the wrist, difficulty moving. The swelling increases, the skin softens. You can hear a crunching sound when you move your wrist.

Causes of injury

The bones of the wrist are connected to each other, as well as to the bones of the palm and forearm, by means of corresponding ligaments.Excessive external stress, such as falling, grabbing, or hitting, can stretch or rupture one or more ligaments. bandage. Do not engage in contact sports until you have regained full wrist range of motion.

Personal injury prevention

Stay on top of your hands and wear a wrist support (wristband).

ELBOW COLLATER BOND TENSION

Feelings of trauma

Pain is concentrated in the area of the ulnar collateral ligament, which runs at the base of the thumb.The injured area is swollen and you find it difficult to move your thumb or hold objects. In severe cases, it seems that the thumb is not attached to the joint.

Causes of injury

The ligament holds the thumb in the joint. When you fall, your thumb flexes in the opposite direction and sprains the ligament closest to your index finger. In severe cases, the ligament can rupture. Ulnar collateral ligament sprains occur in skiers who often have their thumb tangled in the ski pole strap when falling.

Trauma treatment

Apply ice to the injured ligament for 20 minutes every 4-6 hours for 1-2 days to reduce swelling. Also use non-steroidal anti-inflammatory drugs to help reduce pain and swelling. As long as the sprain is not too severe, that is, there is no feeling that the finger is not supported by anything in the joint, this treatment is sufficient.

Fracture or Dislocation?

A fracture of a finger can be characterized by the same symptoms as a dislocation and sprain of the joint.The fact that you can move your finger will not help provide clarity comparable to fluoroscopy. Try to clench your fist. If the injured toe is misaligned, see a traumatologist. Most likely, this is a fracture.

CORTISONE INJECTION

Cortisone effectively relieves swelling in injured joints and tissues. This drug is injected into the soft tissue surrounding the injured ligament or tendon. As the swelling decreases, pain is lessened and the healing process is faster, allowing you to return to your workout faster.

However, cortisone does not work immediately. Moreover, the pain may even worsen one day after the injection. Then, within a week, there is a significant reduction in pain. In the meantime, keep using ice, immobilize and lift the injured limb.

90,000 Rectus abdominis muscle and hamstrings

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Acting as a group, these muscles expand the anonymous (nutation) [1, 2] [3] p409-424, while the long head of the biceps femoris provides some position-dependent sacral extension (counternutation).The short head of the biceps femoris may contribute to counternutation.

Rectus abdominis muscles: nutation
Higher attachment : xiphoid process
Lower attachment : pubic crest
Functions :

bends the barrel
expands the pelvis
counteracts shear stress in the lumbar spine
compresses the contents of the abdominal cavity
induces nutation by moving the pubis forward and upward, causing the ilium to move posteriorly and inferiorly

Bicep Femoris – two heads

Short head of the biceps femoris: counternutation (not shown)
Origin : linea aspera
Input : head of the fibula and lateral side of the head of the fibula.
Functions :

Flexes and rotates the knee joint
Observation shows that it can participate in counternutation by pulling up the head of the fibula, helping to rebound during shock absorption.

Long head of the biceps femoris: nutation and counternutation
Origin : sciatic tubercle with some fibers extending from the sacro-tuberous ligament.
Inserted : head of the fibula, lateral collateral ligament and lateral condyle of the tibia
Functions :

Bends and rotates laterally knee
extends and rotates the thigh laterally
observation shows that he can participate in a counter-mutation by pulling

on top of the fibula head, helping to absorb shock

expands the unnamed (nutation) by attaching to the ischial tuberosity
expands the sacrum (counternutation) by attaching to the sacro-tuberous ligament.

There is evidence that the long head of the biceps femoris has a dual function: it can promote both nutation and counternutation. Along with the other hamstrings that attach to the ischium, it rotates the ilium back into nutation. It also connects to the sacro-tuberous ligament and through it to the caudal sacrum, where its action can induce counter-rotation by pulling the apex of the sacrum down and forward [2].

This apparent contradiction was explained by Wingerden et al.[1] when he showed that the tension that develops in the sacro-tuberous ligament depends on the position of the body; a high percentage of force was transmitted to this ligament in a bent, stooped position. They reasoned that since the large forces act on the sacrum in a flexed position (causing nutation), additional balancing muscle strength is needed. Balancing muscle strength can also be provided by other muscles that attach to the sacro-tuberous ligament, such as the gluteus maximus and the erector spine, which, like the biceps femoris, promote nutation and which, when flexed, can contribute to counternutation.This is an example of a position-dependent function that is not uncommon in our musculoskeletal system. For example, the piriformis muscle is the external rotator of the hip when the hip is straight and slightly flexed, but when the hip is flexed nearly 90 degrees it becomes the internal rotator.

In addition, Wingerden et al. [4] combined a color echo doppler with an oscillating device and found that the biceps femoris caused a significant increase in sacroiliac joint stiffness when the patient was lying on his stomach.In this case, activation of the biceps femoris may have contributed to nutation by bringing the surfaces of the sacrum and ilium closer together through its effect on the ischium. However, in a bent and bent position, when a lot of weight is placed on the sacrum and the limits of nutation are reached, the biceps femoris helps to limit nutation by pulling the sacral base posteriorly into counter-rotation by pulling it. the apex of the sacrum through the sacro-tuberous ligament [5].

According to Vleeming [6], the long dorsal sacroiliac ligament is tense during counternutation and weakened during nutation.Loading the gluteus maximus reduced the tension on the ligaments, demonstrating that the gluteus maximus promotes nutation. However, in this study, the load on the biceps femoris did not increase or decrease the tension of the long dorsal sacroiliac ligament, without affecting nutation or counter-rotation; but there may be other factors that influenced this study. In other studies, Vleeming [7] and Van Wingerden [8] suggested that the long head of the biceps femoris prevents nutation by pulling the sacro-tuberous ligament (thus causing counter-rotation).

Semitendinosus: nutation
Origin: medial and posterior aspect of the ischial tuberosity.
Attachment: Proximal medial surface of the tibia just behind the sartorius attachment.
Function: pulls the ischium from below and forward, rotating the iliac crest posteriorly.

Semimembranosus: nutation
Origin: lateral and posterior aspect of the ischial tuberosity.
Inset: Posterior aspect of the medial tibial condyle, medial collateral ligament, oblique popliteal ligament and popliteal muscle.
Function: pulls the ischium from below and forward, rotating the iliac crest posteriorly.

Grey’s Anatomy [9] p570-571 states that the biceps femoris is a lateral rotator when the knee is semi-flexed and the hip is extended. However, the semitendinosus and semimembranosus muscles, both nutators, in these positions are the medial rotators of the thigh. This relationship helps to associate medial rotation with nutation and lateral rotation with counter-rotation, as demonstrated by other counter-rotation muscles that induce lateral rotation, such as the piriformis muscle and the external obturator muscle.

Large posterior adductor muscle: nutation
origin : sciatic tubercle
Introduced : adductor tubercle of the thigh.
Function : Extension of the pelvis (nutation).

Why are the hamstrings usually tight?
Obviously, both the Rectus Abdominis and the hamstrings cause pelvic extension, or nutation, so we would expect both to be depressed and relatively flaccid. While Rectus Abdominus is relatively simple, the hamstrings are much more complex.As nutation muscles, we would expect them to be inhibited and relatively sluggish, but we usually see them tense. Why? Because when we run, when we put our heels on the ground to pull forward, being depressed, they are not ready for force and tense, followed by a stretching reaction that keeps it in a compressed state; it is a secondary response or compensation compensation. The sequence can be expressed as: sprain – retarded muscle – delayed activation – muscle strain – stretch response – tense muscle.Muscles and ligaments protect themselves from injury that has just occurred and from future injury.

So, instead of stretching them, we should strengthen them using low-strength, high-rep exercises to train the proprioceptive system to maintain a relaxed state of tension and, even better, stabilize the SIJ. For more information see Principles of Rehabilitation But, be it stretching or strengthening, we can strengthen the SIJ without proper stabilization.The funny thing is, this causes the hamstrings to slow down, which causes relaxation, but triggers another stretch reaction in a vicious circle.

There are other considerations regarding hamstrings. A muscle tears off the long head of the biceps femoris, which attaches to the sacro-tuberous ligament. This slide induces counter-rotation, pulling the apex of the sacrum anteriorly. It is part of a mechanism that helps provide stability and added strength to the SIJ while lifting the pelvis as a whole from a hip flexion position.

References:

Wingerden, JV Functional-Anatomical Approach to the Spine-Pelvic Mechanism: Interaction between the biceps femoris and the sacro-tuberous ligament. European Spine Journal, 1993.2: p. 140-144.
Vliming, A. et al., The role of the sacroiliac joints in the junction between the spine, pelvis, legs, and arms. Movement, stability and low back pain, A. Vliming et al., Editors. 1997, Churchill Livingston. p. 53-71.
Neumann D.Kinesiology of the musculoskeletal system. Fundamentals of Physical Medicine. 2002: Mosby.
Wingerden, Jv, et al. Muscle Contribution to Force Closure: In vivo stabilization of the sacroiliac joint. at the 4th Interdisciplinary World Congress on Low Back and Pelvic Pain. 2001
Wingerden, JW, The role of hamstrings in pelvic and spinal function, Movement, stability, and low back pain, A. Vleeming, et al., Editors. 1997, Churchill Livingston: Edinburgh.
Vleming, A.et al, Function of the long dorsal sacroiliac ligament: its implications for understanding low back pain. Spine, 1996.21 (5): p. 556-62.
Vleeming, A., et al. Application of stress to the sacroiliac ligament: impact on the mechanics of the sacroiliac joint. in the proceedings of the First Interdisciplinary World Congress on Low Back Pain and Its Relationship to the Sacroiliac Joint.