A sprained ankle is the most common injury in sport, typically when we twist or go over our ankle awkwardly. The ‘sprain’ refers to the ligaments of the ankle being torn or partially torn, leading to pain, bruising and swelling.

The most important thing to do following a sprain is to get assessed immediately by an expert. Depending on the severity it may be necessary to see an orthopaedic consultant for a scan or X-ray, to ensure there will be no long term repercussions

In the majority of cases, the next step will be to reduce the acute pain and inflammation in order to be able to identify whether there were any factors which caused the sprain, example weakness at the ankle, dysfunction in the hip or lack of flexibility in the leg in general.

Once identified a thorough and accurate rehab course can commence to ensure the injury will not recur. Without proper rehabilitation the  majority of ankle sprains will recur and can cause other injuries to the knee, groin, hip and low back.

The Achilles Tendon is the large tendon which connects the calf muscle (gastrocnemius) to the heel bone (calcaneus). Pain in this tissue may arise due to increased training volume or intensity or without any known cause as a result of degeneration.

This degeneration means that the Achilles Tendon does not possess its normal tensile strength and may be liable to rupture with continued sporting activity.

Factors which contribute to Achilles Tendinopathy include years of running, increase in activity, reduced recovery time, poor footwear, weak calf muscles, excessive pronation (collapsed arches) and poor muscle flexibility.

Damage to the Achilles Tendon typically causes symptoms of pain and stiffness in the area.

Osteopathic intervention can help by reducing muscle tightness in the calves, improving the range of movement of the ankle and providing a workable strengthening programme to avoid recurrence.

Patellofemoral Dysfunction or Pain Syndrome is a common cause of pain around the kneecap (patella). When the knee bends or straightens, the knee cap glides in a special groove on the thigh bone called the ‘patellofemoral groove’. Patello-femoral dysfunction occurs when this gliding becomes compressive or in the wrong direction, which causes an irritation on the underside of the kneecap.

Thorough examination can identify why this is occurring, at which point treatment and rehabilitation can be geared to removing these factors, reducing the pain and ensuring the injury does not recur.

Runner’s knee or “Iliotibial band syndrome” is a painful overuse knee injury, affecting the lateral side of the knee. It is fairly common in runners and cyclists.

A thorough assessment of movement patterns and mechanics of the foot, ankle and hip in particular are required to identify exactly what is causing the issue to occur. Once identified, with a combination of treatment, rehab and a degree of rest the issue will resolve quickly and normal activities can be resumed.

Hamstring Strain

The hamstrings are the one of the most frequently strained muscle in the body. Once strained they are prone to re-injury making early diagnosis, treatment and rehabilitation very important. Sports commonly responsible for these strains are running, football, rugby and sprinting. A sudden violent stretch or rapid muscle contraction can lead to varying degrees of tearing with the muscle.

The treatment of a hamstring strain varies in accordance with the severity of the injury. In general following the RICE protocol of rest, ice, elevation, compression is important in the first 48 hours. Once relatively normal pain-free walking is manageable, work can be started on gently strengthening the injured hamstring. Soft tissue massage, interferential and ultrasound can also help at this stage. Upon the strength returning to the hamstring, stretches to improve the flexibility can be commenced. Once reasonable flexibility is reached, light jogging and more dynamic hamstring stretches can be considered.

Groin Strain

A groin strain is one of the most common injuries in sports. In particular, they occur in sports that involve sudden changes in direction such as tennis and football. The term describes a strain of the Adductor muscles that are located on the inside of the thigh. The injury usually occurs when the muscle is forcibly stretched beyond its limits and the muscle tissue tears. The onset is usually acute and the location is easy to identify.

The immediate treatment for a groin strain is to reduce the initial internal muscle bleeding and swelling following the RICE protocol – rest, ice, compression and elevation. Early stretching is not recommended with a groin strain. Instead, a gentle and progressive rehabilitation programme with strengthening exercises is advised. Once full range of hip movement is available again, sport-specific running activities can be rehearsed.

If left untreated or poorly rehabilitated, chronic exercise-related groin pain can develop. Osteopathy can help address muscle tightness and weakness in the groin and pelvic stiffness which can contribute to this persistent injury.

‘Shin Splints’ is a common term for pain felt in the front lower legs. The medical name for it is Medial Tibial Stress Syndrome. It is a common injury in runners and stop-start sports like tennis and basketball. Those who run on hard surfaces being particularly affected.

People suffering from this condition will feel pain on the inner border of the shin during and following exercise. At first it will feel like a dull pain but over time it can be excruciating. It is important to distinguish Medial Tibial Stress Syndrome from other causes of shin pain such as Compartment Syndrome or a Stress Fracture. This can involve x-rays and compartment pressure tests.

The cause of shins splints is believed to be repetitive overuse of the muscles of the lower leg that pull on the tibia (shin bone) and cause localised inflammation.

One of the most important things to do when suffering from shin pain is to not ignore it. Two weeks of active rest through swimming, cycling or rowing can be enough to allow the symptoms to settle.

Most patients with Medial Tibial Stress Syndrome respond to soft tissue massage, stretching and regular icing. Arch Supporting Insoles (orthotics) can also help to remedy this problem.

Plantar Fasciitis is a common injury that causes heel pain and pain on the sole of the foot. Plantar Fasciitis is inflammation of the Plantar Fascia, a fibrous sheath that runs most of the length of the sole of the foot. During walking and running, as you ‘toe-off’, the Plantar Fascia becomes taut and helps the foot act as a lever to push off with force.

The key to treatment is to identify what has caused there to be too much strain in the fascia- whether this is just overuse (i.e. rapid increase in training volume), or due to port mechanics in the feet, ankles or calves for example.

Osteopathy, massage and rehabilitation are key disciplines in the successful treatment of plantar fasciitis and in the prevention of its recurrence.