The document describes the anatomy and common injuries of the back of the leg. It outlines the bones, muscles, ligaments, tendons, nerves, arteries and common pathologies in the region including ankle fractures, stress fractures, shin splints, Achilles tendinitis, and Achilles tendon ruptures. Rehabilitation focuses on strengthening, flexibility, proprioception training, and addressing biomechanical factors.

1. BACK
OF
LEG
MRS NIDHI SHARMA

2. Tibia
Medial mallelous
Fibula
Lateral mallelous
Talus
Calcaneous

4. Ligaments
Lateral aspect
Anterior tibiofibular
Posterior tibiofibular
Anterior talofibular
Posterior talofibular
Calcaneofibular

5.  Medial aspect
 deltoid
 Tendons
 Achilles
 Peroneus longus
 Peroneus brevis
 Anterior tibialis
 Tibialis posterior
 Flexor digitorium
 Flexor hallicus longus

6.  Muscles
Gastrocnemius
Soleus
Tibialis anterior
Tibialis posterior
Flexor digitorium longus
Flexor hallicus longus
Peroneus longus
Peroneus brevis

8.  These muscles connect the tibia or fibula to
the femur or pelvic girdle.
 The muscles either flex or extend the knee.
 The muscles include the hamstring group and
the quadriceps femoris group.

9. superficial/
calf:
gastrocnemiu
s, soleus,
plantaris

10. Gastrocnemius -is a very powerful
superficial muscle .It runs from its two
heads just above the knee to the heel, and
is involved in standing, walking, running
and jumping. Along with the soleus
muscle it forms the calf muscle.
Its function is plantar flexing the foot
at the ankle joint and flexing the leg at the
knee

11. . The Lateral Head originates from the
Lateral Condyle of the femur, while the
Medial Head originates from the Medial
Condyle of the femur. Its other end
forms a common tendon with the soleus
muscle; this tendon is known as the
calcaneal tendon or Achilles Tendon
and inserts onto the posterior surface of
the calcaneus, or mountain bone.

12.  the soleus is a powerful muscle in the back
part of the lower leg (the calf). It runs from
just below the knee to the heel, and is
involved in standing and walking. It is
closely connected to the gastrocnemius
muscle.

16.  The tibial nerve is a branch of
the sciatic nerve. The tibial
nerve passes through the
popliteal fossa to pass below
the arch of soleus.
 In the popliteal fossa the nerve
gives off branches to
gastrocnemius, popliteus,
soleus and plantaris muscles,
an articular branch to the knee
joint, and a cutaneous branch
that will become the sural
nerve. The sural nerve is joined
by fibres from the common
fibular nerve and runs down
the calf to supply the lateral
side of the foot.

17.  Lateral plantar nerve
 The lateral plantar nerve supplies
quadratus plantae, flexor digiti
minimi, adductor hallucis, the
interossei, three lumbricals. and
abductor digiti minimi. Cutaneous
innervation is to the lateral sole and
lateral one and one half toes

19.  The posterior tibial
artery –it is the large
terminal branch of
popliteal artery begins at
the lower border of the
Popliteus, opposite the
interval between the
tibia and fibula; it
extends obliquely
downward, and, as it
descends, it approaches
the tibial side of the leg,
lying behind the tibia,

.

20.  and in the lower part of its course is
situated midway between the
medial malleolus and the medial
process of the calcaneal tuberosity.
Here it divides beneath the origin
of the Adductor hallucis into the
medial and lateral plantar arteries.

21.  In anatomy, the
fibular artery (also
known as the
peroneal artery)
supplies blood to
the lateral
compartment of the
leg and is typically
a branch of
posterior tibial
artery

23.  Achilles Tendon Stretching
 A tight heel cord may limit dorsiflexion and may
predispose athlete to ankle injury
 Should routinely stretch before and after practice
 Stretching should be performed with knee extended
and flexed 15-30 degrees
 Strength Training
 Static and dynamic joint stability is important in
preventing injury
 A balance in strength throughout the range,
incorporating all muscles of the lower leg is critical

25.  Ankle Fractures/Dislocations
 Cause of Injury
 Number of mechanisms – often similar to those seen in
ankle sprains
 Signs of Injury
 Swelling and pain may be extreme with possible
deformity
 Care
 Splint and refer to physician for X-ray and examination
 RICE to control hemorrhaging and swelling
 Once swelling is reduced, a walking cast or brace may be
applied, w/ immobilization lasting 6-8 weeks
 Rehabilitation is similar to that of ankle sprains once
range of motion is normal

29. Post reduction

32.  Acute Leg Fractures
 Cause of Injury
 Result of direct blow or indirect trauma
 Fibular fractures seen with tibial fractures or as the result
of direct trauma
 Signs of Injury
 Pain, swelling, soft tissue insult
 Leg will appear hard and swollen (Volkman’s
contracture)
 Deformity – may be open or closed
 Care
 X-ray, reduction, casting up to 6 weeks depending on the
extent of injury

34.  Stress Fracture of Tibia or Fibula
 Cause of Injury
 Common overuse condition, particularly in those with
structural and biomechanical insufficiencies
 Result of repetitive loading during training and
conditioning
 Signs of Injury
 Pain with activity
 Pain more intense after exercise than before
 Point tenderness; difficult to discern bone and soft tissue
pain
 Bone scan results (stress fracture vs. periostitis)

35.  Care
 Eliminate offending
activity
 Discontinue stress
inducing activity 14 days
 Use crutch for walking
 Weight bearing may return
when pain subsides
 After pain free for 2 weeks
athlete can gradually
return to activity
 Biomechanics must be
addressed

36.  Medial Tibial Stress Syndrome (Shin Splints)
 Cause of Injury
 Pain in anterior portion of shin
 Stress fractures, muscle strains, chronic anterior
compartment syndrome, periosteum irritation
 Caused by repetitive microtrauma
 Weak muscles, improper footwear, training errors, varus
foot, tight heel cord, hypermobile or pronated feet and even
forefoot supination can contribute to MTSS
 May also involve stress fractures or exertional compartment
syndrome

38.  Achilles Tendonitis
 Cause of Injury
 Inflammatory condition involving tendon, sheath or
paratenon
 Tendon is overloaded due to extensive stress
 Presents with gradual onset and worsens with continued
use
 Decreased flexibility exacerbates condition
 Signs of Injury
 Generalized pain and stiffness, localized proximal to
calcaneal insertion, warmth and painful with palpation,
as well as thickened
 May progress to morning stiffness

40.  Achilles Tendon Rupture
 Cause
 Occurs w/ sudden stop and go; forceful plantar flexion
w/ knee moving into full extension
 Commonly seen in athletes > 30 years old
 Generally has history of chronic inflammation
 Signs of Injury
 Sudden snap (kick in the leg) w/ immediate pain which
rapidly subsides
 Point tenderness, swelling, discoloration; decreased
ROM
 Obvious indentation and positive Thompson test

41. Normal
Achilles Defect

43.  Rehabneuromuscular
 proprioception