Boyd W. Haynes III, MD
As we continue this journey up the leg to uncover the many causes for limping, our next stop will be the shins and calf muscles.
Shin splint syndrome is probably the first injury that comes to mind when we talk about this part of the body, and it is a very common injury that can cause a lop-sided gait. Most often associated with running or jogging too far while out of condition or simply with running too much, shin splint syndrome is a group of inflammatory symptoms that occurs in specific bones and muscles of the lower leg when they are over-stressed.
Symptoms are pain, tenderness in the shins, a lack of flexibility, and limping. The first treatment is rest, which no runner ever wants to do. Icing, elevation, foam-rolling, physical therapy, stretching, orthotics, new running shoes and the use of NSAIDs are recommended as we wait for the pain and inflammation to decrease.
The calf muscles (gastrocnemius and soleus) are the two large muscles that run down the back of our legs between our knees and heels. Because they are tightly strung muscle fibers between two joints, they can be easily injured, especially if not stretched before activity. People who are over 40, and athletes who play soccer, tennis and basketball are more at risk for injury, especially when muscles are fatigued. You can bruise, strain, sprain or tear your calf muscle(s).
Symptoms will be pain, limping can be mild or you may not even be able to bear weight on the affected leg, you may have bruising, swelling, a lack of strength in the leg and if the muscle is torn, you may see an actual divot in the leg. At the time of injury, you may have heard or felt a snap or a popping.
Treatment will be conservative, except in the cases of torn muscles and other complications, or for athletes and others who need quicker recoveries. Rest, elevation, intermittent icing, compression, anti-inflammatories, and crutches may be recommended if the injury is bad enough. I will probably put you in a supportive boot or brace to assist with healing. For those with worse sprains or partial or non-surgical full tears, crutches and non-weight bearing may be in order for several weeks. Physical Therapy will be important, at first to assist with healing and inflammation reduction and then later to assist with strengthening and range of motion increase.
Surgical patients will have an outpatient procedure and will be non-weight bearing for a few weeks while their muscle repair heals. Physical Therapy will start in earnest in about six weeks. The muscle will not be as strong as it once was and the patient should be prepared for the formation of some scar tissue. Full recovery and a return to the field can take up to a year for athletes, especially for basketball, football or soccer.