Leg Injuries
Topic OverviewMinor leg injuries are common. Symptoms often
develop from everyday wear and tear, overuse, or an injury. Leg injuries are
most likely to occur during: - Sports or recreational
activities.
- Work-related tasks.
- Work or projects around
the home.
Most leg injuries in children and teens occur during sports or
play or from accidental falls. The risk for injury is higher in contact sports,
such as wrestling, football, or soccer, and in high-speed sports, such as biking,
in-line skating, skiing, snowboarding, and skateboarding. Knees, ankles, and
feet are the most affected body areas. Any injury occurring at the end of a
long bone near a joint may injure the growth plate and needs to be checked by a
doctor. Older adults have a higher risk for injuries and fractures
because they lose muscle mass and bone strength (osteoporosis)
as they age. They also have more problems with vision and balance, which
increases their risk for accidental injury. Most minor injuries
will heal on their own, and home treatment is usually all that is needed to
relieve symptoms and promote healing. Acute (traumatic) injuryAn acute injury may occur
from a direct blow, a penetrating injury, a fall, or from twisting, jerking,
jamming, or bending a limb abnormally. Pain may be sudden and severe. Bruising
and swelling may develop soon after the injury. Acute injuries usually require
prompt medical evaluation and may include: - Bruises (contusions), which occur when small
blood vessels under the skin tear or rupture, often from a twist, bump, or
fall. Blood leaks into tissues under the skin and causes a black-and-blue color
that often turns colors, including purple, red, yellow, and green, as the
bruise heals.
- Injuries to the tough, ropey fibers (ligaments)
that connect bone to bone and help stabilize joints (sprains).
- Injuries to the tough, ropey
fibers that connect muscle to bone (tendons), such as a ruptured
Achilles tendon.
- Pulled muscles (strains), such as a hamstring strain.
- Muscle ruptures, such as gastrocnemius
rupture.
- Broken bones (fractures). A
break, such as a lower leg fracture, may occur when a bone is twisted, bent, jammed, struck directly, or used
to brace against a fall.
- Pulling or pushing bones out of the normal
relationship to the other bones that make up a joint (dislocations).
Overuse injuriesOveruse injuries occur when too much
stress is placed on a joint or other tissue, often by "overdoing" an activity
or doing the same activity repeatedly. Overuse injuries include: - Inflammation of the sac of fluid that cushions
and lubricates the bones (bursitis).
- Inflammation,
tearing, or fraying of the tough, ropey fibers that connect muscles to bones
(tendinitis).
- Hairline cracks in bones, such as stress fractures of the foot.
- Inflammation of the fibrous covering of the
bone (periosteum) where muscle fibers attach to it (shin splints).
- Inflammation of the plantar fascia, a broad, flat
ligament on the bottom of the foot (plantar fasciitis).
- Inflammation at the top of the shinbone (tibia)
where the patellar tendon attaches to a bony prominence (Osgood-Schlatter disease). This is more likely to
occur during rapid growth periods and is usually seen in athletic teenagers,
especially those who play football, basketball, or soccer, and those who are
involved with gymnastics and dance. Osgood-Schlatter disease involves both legs
about 25% of the time and is rarely a chronic, lifelong condition.
TreatmentTreatment for a leg injury may include
rest, ice, elevation, and other first aid measures (such as the application of
a brace, splint, or cast), or physical therapy. Some leg injuries are treated
with medicine or surgery, especially if a bone is broken. Treatment depends
on: - The location, type, and severity of the
injury.
- When the injury occurred.
- Your age, health
condition, and activities, such as work, sports, or hobbies.
Check your symptoms to decide if and when
you should see a doctor. Check Your SymptomsDo you have a leg injury? How old are you? Less than 5 years Less than 5 years 5 years or older 5 years or older 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 No Leg surgery in the past month Has it been more than a month since the leg injury? Yes Leg injury over a month ago No 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 No Major trauma in past 2 to 3 hours Do you have symptoms of shock? 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 No Difficulty moving leg for more than 2 days 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? 5 to 10: Moderate to severe pain Moderate to severe pain 1 to 4: Mild pain Mild pain 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 No 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 No 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 No Swelling or bruising within 30 minutes of injury Has swelling lasted for more than 2 days? Yes Swelling for more than 2 days No 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 No Numbness, tingling, or weakness for more than 1 hour Do you think that the injury may have been caused by abuse? Yes Injury may have been caused by abuse No 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 No 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 No 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, herbal remedies, and 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 TreatmentYou 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. Symptoms of shock (most of which will be present) 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. Symptoms of shock in a child may 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 NowBased 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 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Put direct, steady pressure on the
wound until help arrives. Keep the area raised if you can. Seek Care TodayBased 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 NowBased on your answers, you need
emergency care. Call911or 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 Home TreatmentFirst aid for a suspected broken bone- Control bleeding.
- Remove
all anklets or rings. It may be hard to remove the jewelry if your leg or
foot swells. Swelling without the removal of jewelry can cause other serious
problems, such as compression of nerves or restriction of blood flow.
- Do not
attempt to straighten an injured leg.
- Splint the injured
leg to protect it from further injury. Loosen the wrap around the splint if
signs develop below the wrap that mean the wrap is too tight, such as
numbness, tingling, increased pain, swelling, or cool skin.
- If a
bone is sticking out of the skin, do not try to push it back into the skin.
Cover the area with a clean bandage.
Cast and splint careIf a cast or splint is
applied, it is important to keep it dry and try to move the uninjured parts of
your extremity as normally as possible to help maintain muscle strength and
tone. Your doctor will give you instructions on how to
care for your cast or splint. Home treatment for a minor injuryIf your injury does
not require an evaluation by a doctor, you may be able to use home
treatment to help relieve pain, swelling, and stiffness. - Rest and protect an
injured or sore area. Stop, change, or take a break from any activity that may
be causing your pain or soreness.
- Ice will
reduce pain and swelling. Apply
ice or cold packs immediately to prevent or minimize swelling. Apply the ice
or cold pack for 10 to 20 minutes, 3 or more times a day.
- For the first 48 hours after an injury,
avoid things that might increase swelling, such as hot showers, hot tubs, hot
packs, or alcoholic beverages.
- After 48 to 72 hours, if swelling is
gone, apply
heat and begin
gentle exercise with the aid of moist heat to help
restore and maintain flexibility. Some experts recommend alternating between
heat and cold treatments.
- Compression, or wrapping
the injured or sore area with an elastic bandage (such as an Ace wrap), will
help decrease swelling. Don't wrap it too tightly, because this can cause more
swelling below the affected area. Loosen the bandage if it gets too tight.
Signs that the bandage is too tight include numbness, tingling, increased pain,
coolness, or swelling in the area below the bandage. Talk to your doctor if you think you need to use a wrap for longer than 48 to 72
hours; a more serious problem may be present.
- Elevate the injured or sore area on pillows while applying ice
and anytime you are sitting or lying down. Try to keep the area at or above the
level of your heart to help minimize swelling.
- Remove all rings, anklets, or any other jewelry that goes around a leg. It will be
harder to remove the jewelry later if swelling
increases.
- Gently massage or rub the area to relieve pain and
encourage blood flow. Do not massage the injured area if it causes
pain.
- Use a crutch or a cane for the 24 to 48 hours after the
injury if it makes you more comfortable and supports the injured area. If you
feel you need to use a crutch or cane for more than 48 hours, discuss your
symptoms with your doctor.
- Do not smoke or use other tobacco
products. Smoking slows healing because it decreases blood supply and delays
tissue repair. For more information, see the topic
Quitting Smoking.
Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
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Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow these
safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Pain or swelling develops.
- Signs of infection develop.
- Numbness;
tingling; or cool, pale skin develops.
- Symptoms become more severe or more
frequent.
PreventionThe following tips may prevent leg
injuries. General prevention tips- Wear your seat belt in a motor
vehicle.
- Don't carry objects that are too heavy.
- Use a
step stool. Do not stand on chairs or other unsteady objects.
- Wear
protective gear during sports or recreational activities, such as
roller-skating or soccer. Supportive splints may reduce your risk for
injury.
- Stretch before and after physical exercise, sports, or
recreational activities to warm up your muscles.
- Use the correct
techniques (movements) or positions during activities so that you do not strain
your muscles.
- Use equipment appropriate to your size, strength,
and ability.
- Avoid overusing your leg doing repeated movements
that can injure your
bursa or
tendon. In daily routines or hobbies, think about the
activities in which you make repeated leg movements, and modify the way you do
the activities, if possible, to prevent leg injuries from
developing.
- Consider taking lessons to learn the proper technique
for sports. Have a trainer or person who is familiar with sports equipment
check your equipment to see whether it is well-suited for your level of
ability, body size, and body strength.
- If you feel that certain
activities at your workplace are causing pain or soreness from overuse, talk to
your human resources department for information on alternative ways of doing
your job or to discuss equipment modifications or other job assignments.
Reduce fallsKeep your bones strong- Eat a nutritious diet with enough
calcium and
vitamin D. (Vitamin D helps your body absorb calcium.)
Calcium is found in dairy products, such as milk, cheese, and yogurt; dark
green, leafy vegetables, such as broccoli; and other
foods.
- Exercise and stay active. It is best to do weight-bearing exercise for at least 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. In addition to weight-bearing exercise, experts recommend that you do resistance exercises at least 2 days a week. Weight-bearing exercises stimulate new
bone growth by working the muscles and bones against gravity. Exercises that
are not weight-bearing, such as swimming, are good for your general health but
do not stimulate new bone growth. Talk to your doctor about an
exercise program that is right for you. Begin slowly, especially if you have
been inactive. For more information, see the topic
Fitness.
- Don't drink more than 2 alcoholic
drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman.
People who drink more than this may be at higher risk for weakening bones
(osteoporosis). Alcohol use also increases your risk of
falling and breaking a bone.
- Do not smoke or use other tobacco
products. Smoking puts you at a much higher risk for developing osteoporosis.
It also interferes with blood supply and healing. For more information, see the
topic
Quitting Smoking.
Possible abuseBodily injuries such as bruises,
burns, fractures, cuts, or punctures may be caused by
abuse. Suspect possible abuse when an injury cannot be
explained or does not match the explanation, when repeated injuries occur, or
when the explanations for the cause of the injury change. You may be able to
prevent further abuse by reporting it and seeking help. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to
answer the following questions: - What are your main symptoms?
- How long
have you had your symptoms?
- How and when did an injury occur? How
was it treated?
- Have you had any injuries in the past to the same
area? Do you have any continuing problems because of the previous
injury?
- What activities related to sports, work, or your lifestyle
make your symptoms better or worse?
- Do you think that activities
related to your job or hobbies caused your symptoms?
- What home
treatment have you tried? Did it help?
- What nonprescription
medicines have you tried? Did they help?
- Were alcohol or illegal
drugs involved in your injury?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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