Chronic Leg Pain in Athletes

Abstract

Chronic leg pain is commonly treated by orthopaedic surgeons who take care of athletes. The sources are varied and include the more commonly encountered medial tibial stress syndrome, chronic exertional compartment syndrome, stress fracture, popliteal artery entrapment syndrome, nerve entrapment, Achilles tightness, deep vein thrombosis, and complex regional pain syndrome. Owing to overlapping physical examination findings, an assortment of imaging and other diagnostic modalities are employed to distinguish among the diagnoses to guide the appropriate management. Although most of these chronic problems are treated nonsurgically, some patients require operative intervention. For each condition listed above, the pathophysiology, diagnosis, management option, and outcomes are discussed in turn.

MRI of Musculotendinous Injuries—Part I: “Non-strain” Injuries

“…For athletes with non-specific leg pain, the clinical differential diagnosis also can include medial tibial stress syndrome, stress fracture, tendinopathy, popliteal artery entrapment syndrome, and deep vein thrombosis (Fig. 5) [37].…”

Diagnosis of chronic exertional compartment syndrome in primary care

“…3 Pes planus and overpronation have been found in those with CECS. 9 GPs should examine the patient both before and after exertion to demonstrate a normal physical examination pre-exercise and a …”

Medial Tibial Stress Syndrome in Athletes: Diagnostic and Therapeutic Approach

“…Tibial periostitis following long-lasting traction from toe flexors and the tibialis posterior muscle, elevated muscle compartment pressures in the lower leg and bony resorption that outpaces bone formation of the tibial cortex, have proposed as possible sources of MTSS [2][3][4][5].…”

“…The incidence of MTSS is estimated between 13% and 22% of running and dance injuries [3]. This ailment has been associated with the presence of several risk factors such as training errors, decreased hip internal range of motion, increased ankle plantar flexion, positive navicular drop, female gender, increased body mass and foot hyperpronation [6][7][8][9][10][11][12][13].…”

“…The pain which usually has a dull character is commonly located along the posteriomedial border of the middle to distal third of the tibial bone over a length of five or more consecutive centimetres [1,3]. A mild oedema or erythema in this painful area may also be present [14,15].…”