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Lower Limb

The hip, knee and ankle are the major weight bearing joints in the human body and over a lifetime a significant amount of load will pass through these joints which can unfortunately lead to a number of pathologies. It is increasingly common due to advances in medical technology and surgical technique to hear of people having both knees and hips replaced in the course of their lifetime.

The Hip

The major problem the hip faces as the major weight bearing joint in the body is degeneration due to a lifetime of use. As the hip is such a strong and stable joint, it is very rare to have a traumatic hip injury. The most common causes of hip pain are:

  • Degeneration due to age and osteoarthritis – this can lead to the need for a hip replacement.

  • Gluteus medius tendinopathy (one of the muscle in your backside)

  • Hip bursitis (bursa are structures that help deal with joint movement, and can become inflamed if overloaded)

  • A decrease in muscular control around the hip joint.

The Knee

The knee like the hip is a major weight and load bearing joint. Yet it is also a very likely joint to be involved in traumatic injury, as can be seen with professional sports people in rugby and soccer. The most common complaints of the knee are:

  • Osteoarthritis and age related degeneration – this may require surgery depending on the severity

  • Ligament and meniscal injuries: structures that are inside the knee joint that help provide stability and facilitate movement.

  • Patello-femoral or pain around the knee cap is also very common and can affect people of any age, with a common occurrence in people who run or spend a lot of time moving on their feet.

The Ankle

The ankle is the most likely area to suffer from a traumatic injury of the lower limb, with a strained or sprained ankle common amongst weekend sport players. Common injuries to the ankle are:

  • Ligament sprains

  • Ankle fractures and ankle stress fractures – a normal fracture will occur due to a traumatic injury, whereas a stress fracture will result from continual loading on a bone that is not allowed to fully recover after previous high levels of loading – a stress fracture is most commonly seen in people who a regular runners.

  • Shin splints, a painful condition where pain is experience along the length of the shin after activity on your feet.

  • Post injury stiffness and stress: Once you have hurt your ankle it can take time to recover from the injury. It is important to see your physiotherapist if you have injured your ankle to ensure that you regain as much range of movement as possible.

The Foot

The foot is an area of our bodies then we tend to under appreciate when it comes to injuries and concerns. We walk on very hard surfaces, and often in poor shoes (thongs and high heels are the main culprits) and tend to not think of what flow on effects these can have. The main concerns for the feet are:

  • Plantar fasciitis: the plantar fascia is a band of tissue that runs along the base of your foot, when it becomes irritated it can cause pain and discomfort along the entirety of the foot and into the leg.

  • Osteoarthritis: like osteoarthritis in the rest of the body the joints of the ankle and into the foot can be affect by this condition which can lead to pain and inflammation of the ankle and foot.

  • Poor foot biomechanics: Although we all have a natural walking pattern, due to our own individual make up we can sometimes cause our bodies to break down due to the way in which we walk. If you have flat feet, or your knees roll in as you walk you may be adversely loading other structures in your body. A combination of physiotherapy and podiatry will generally help fix these biomechanically issues and are often as simple as a new pair of shoes or orthotic insoles.

R – rest the affect area
I – apply ice to the affected area for around 20min every hour
C – try to apply a compression bandage to the area
E – if possible elevate the are slightly to prevent blood pooling
R – refer the injury to a medical or allied health professional asap

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