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Injuries to the legs Othon Molina, Ph.d.c, LMT First of all I want to make it clear that this information is not to diagnose nor prescribe, and it should not take the place of the advice of your doctor. This is intended to complement conventional medicine, not to replace it. Consult with your doctor before starting any kind of nutritional or physical program. The Quadriceps Muscle; This muscle usually injured in the thigh is called the Rectus Femoris. Runners, football players and dancers can injure this muscle. This muscle is the main hip flexor, in other words it helps you lift the knee. The rest of the quads (see knee) only extend the leg at the knee (straighten the leg). The higher it hurts the more likely you injured the tendon or attachment. If is down on the middle of the leg, you may have some micro tears in the muscle tissue. This tissue can be injured in contact sports (football, rugby or soccer). It can also be inured in a slip or fall. Of course overuse in running can injure this muscle, it can also be overstretched by novice runners pulling too hard on their ankles, stretching it cold. Treatment This injury responds well to MICE (Movement Ice Compression Elevation). Movement with the ice bag would consist of slight extensions and contractions of the leg, while sitting. This could last four to six weeks if the injury is severe. Of course DTF (Deep Transverse Friction; a specialized form of massage) is great for this muscle. If the tendon is injured DTF is very painful, so be careful go easy. You may need to hang the leg off the table to get a good stretch on it, as it is a deep tendon. Deep tissue massage should never be done directly on the lesion, because you will separate the tear further. However, all around the area is great as it increases circulation and aids in reducing the edema (swelling). For a serious tear you may need to see a doctor. A corticosteroid injection to the tendon can work wonders and can reduce unwanted scar tissue. Remember you need to bench the athlete after these injections, as it softens the tissue, and could injure further. Inner thigh or groin pull These groin pulls can be very serious, and take a long time to heal. Most athletes at sometime or another have injured these adductor muscles. They pull your legs together. Sometimes you can spread them too far, as in reaching for the bag at first base, or just running too hard before you warmed up correctly. Racquetball or tennis comes to mind, as many people rarely stretch enough when playing these sports. It can be a mild injury and only hurt when you push the body, or if you stretch too far. It can also be serious enough to hurt for years, especially with re-injury. Other injuries to this area can be caused by horse back ridding too much when you are not use to it. Treatment RICE will help if you start right away, never stretch a groin pull, or any muscle pull for that matter. DTF will help accelerate the healing as well, you need to be very precise with the location of the lesion or it will not help much. Deep massage later will help increase circulation as well as DTF deep transverse fiber work. Of course if that doesn't help an injection will increase the healing, as well as be good for chronic problems. Because of the location prevention of further injuries it's good to squeeze a ball with the knees to strengthen this group after the acute stage. Hamstrings These muscles at the back of the leg are very often injured in track and field, running and in football. In fact, any all out running sport can injure a hamstring. The actual muscles we are talking about are the Biceps Femoris, Semimembranosis, and the Semitendinosus. I have heard this injury pop very loud. Often it's because of improper warm-up. It can also be caused because the Quads are so much stronger that the muscles become out of balance for proper control or action. Often the quads are twice as strong as the hamstrings, and it should be closer ratio of 60 to 40%. It can hurt right in the middle of the back of the leg, in the buttocks all over the back of the thigh or at the back of the knee. Treatment NO STRETCHING. MICE (Movement, Ice, Compression, Elevation) is great for accelerating the healing of this injury, the sooner the better. You may have seen football games where there is a guy with an ice bag, and an ace bandage standing on the sidelines. You can reduce the healing time by days if you ice it right away. Keep it moving too, as his will create a subtle scar tissue, and keep it flexible after it heals. DTF is the best on these tissues as they are easy to get to and will respond well to the therapy. Later you can do deep tissue massage, to increase circulation and separate the muscles from each other. The key is to not let improper scar tissue form there or you can have a chronic injury. Many runners hurt it over and over again, because they don't get the proper treatment. You will see a big hematoma on it in a day or two, you can still work on it just be careful. If left alone and if it's not severe, it will heal in three to four weeks. However it can plague an athlete for years if it heals improperly. Prevention is to strengthen them with weight training, do twice the workout on the hamstrings than you do on the quadriceps. Lunges are also a good way to strengthen as well as lengthen the hamstring group. Othon Molina, Ph.d.c, LMT P.O. Box 1231 Kamuela, HI 96743 Cell: (808) 895-2688 www.molinamassage.com
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