 |  Essentials of Athletic Training, 5/e Daniel Arnheim
William Prentice,
University of North Carolina
The Ankle and Lower Leg
Chapter Overview- The movements that take place at the talocrural joint are ankle plantarflexion and dorsiflexion. Inversion and eversion occur at the subtalar joint.
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Many lower leg and ankle injuries, especially sprains, can be reduced by heel cord (Achilles tendon) stretching, strengthening of key muscles, improving neuromuscular control, choosing appropriate footwear, and when necessary, proper taping or bracing.
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Ankle sprains are very common. Inversion sprains usually involve the lateral ligaments of the ankle, and eversion sprains frequently involve the medial ligaments of the ankle. Dorsiflexion injuries often involve the tibiofibular ligaments and may be very severe.
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The early phase of treatment following ankle sprain uses ice, compression, elevation, rest, and protection, all of which are critical components in preventing swelling.
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Tendinitis in the posterior tibialis, anterior tibialis, and the peroneal tendons may result from one specific cause or from a collection of mechanisms. Techniques that act to reduce or eliminate inflammation, including rest, ice, and anti-inflammatory medications, should be incorporated into rehabilitation.
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Although some injuries that occur in the region of the lower leg are acute, the majority of injuries seen in an athletic population result from overuse, most often from running.
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Tibial fractures can create long-term problems for the athlete if inappropriately managed, whereas fibular fractures generally require much shorter periods for immobilization. Treatment of these fractures is immediate medical referral and most likely a period of immobilization and restricted weight bearing.
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Stress fractures in the lower leg are usually the result of the bone's inability to adapt to the repetitive loading response during training and conditioning of the athlete and are more likely to occur in the tibia.
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Care for medial tibial stress syndrome must be comprehensive and must address several factors, including musculoskeletal training and conditioning as well as proper footwear and orthotics intervention.
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Compartment syndromes can occur from acute trauma or from repetitive trauma or overuse. They can occur in any of the four compartments but are most likely to occur in the anterior compartment or deep posterior compartment.
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Perhaps the greatest question after an Achilles tendon rupture is whether surgical repair or cast immobilization is the best method of treatment. Regardless, the time required for rehabilitation is significant.
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Achilles tendinitis often presents with a gradual onset over time and may be resistant to a quick resolution.
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2002 McGraw-Hill Higher Education