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Lower Leg

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Lower Leg Complaints

The lower leg region connects the knee and the ankle joint, consisting of two bones and twelve muscles. These muscles are primarily used for foot and ankle movement. Throughout the day, a person makes countless ankle and foot movements, so it’s not hard to imagine that lower leg complaints are very common. For the same reason, lower leg issues can be highly limiting – your freedom is strongly connected to the use of your feet!


There are three main causes that underlie complaints in this region:

  • Acute Injuries: Acute complaints often arise due to inadequate warm-ups, leaving the tissue insufficiently elastic to absorb large forces, or due to excessive force beyond what the calf or tendon can withstand, leading to damage or even rupture.
  • Overuse Injuries: Overuse occurs when muscles and tendons do not have enough time to recover from exertion before being strained again. This interrupts the healing process, resulting in pain and possible inflammation. It's essential to take enough rest, especially when engaging in a new activity or increasing training intensity. This is common among athletes such as runners, people with physically demanding or repetitive jobs, or even individuals who suddenly walk long distances on vacation when they usually don’t cover many kilometers per week. Connective tissue, like tendons, heals much slower than muscle tissue, making repeated overuse and worsening pain a significant risk.
  • Technique, Posture, and Mobility: The ankle and foot often compensate for issues elsewhere in the body, such as hip weakness, lower back stiffness, or inward collapsing knees. This can lead to excessive strain on the lower leg, resulting in overuse injuries. Poor movement technique in activities like running or weightlifting can also contribute. Improper technique places excessive strain on tissues that are not designed or trained to handle such loads.
Complaints

Common Lower Leg Injuries

A calf muscle tear is an acute muscle rupture, often occurring when accelerating into a sprint during sports or running to catch a tram. The forceful push-off creates a tear in the calf muscle, making it extremely painful and difficult to use. This injury is more common in middle-aged athletes.


A sudden increase in training intensity or duration without proper progression, insufficient rest between sessions, or skipping warm-ups can contribute to this injury. Recovery time depends on the severity of the tear, ranging from 3 to 8 weeks, while full return to explosive sports can take several months. Recurrence is common, as people often return to sports too soon—when the pain is gone, but the tissue has not fully recovered.

Achilles tendon issues are undoubtedly the most well-known tendon injuries. Explosive movements on the forefoot, such as running, jumping, or climbing stairs, can put forces of 3 to 7 times your body weight on the Achilles tendon!


Other tendon issues can occur around and just above the ankle in the lower leg. Almost all lower leg tendon injuries are caused by overuse. Contributing factors include improper training load and rest balance, poor posture (involving the back, pelvis, leg, or foot), changes in footwear, or different training surfaces.


Achilles tendon problems usually develop gradually and cause pain and stiffness, particularly in the morning and at the start of activities. The pain often decreases during movement but returns in the evening or the next morning. Because the pain temporarily subsides, many people don’t take it seriously, allowing irritation to develop into inflammation, which significantly prolongs the healing process. Do not ignore early signs of tendon pain!

Commonly referred to as shin splints or periostitis, this condition results from repeated overuse of the shinbone’s outer layer, typically on the inside but sometimes on the outside of the shin. Tendons attach muscles to the bone via the periosteum, placing significant stress on this area, which requires adequate recovery.


Like tendon injuries, shin splints are an overuse injury caused by improper training load and rest balance, poor posture, changes in footwear, or new training surfaces. This condition is common in military personnel and athletes, especially runners who cover long distances without sufficient recovery. It also appears more frequently in teenage girls.


In team sports, shin splints often occur after summer or winter breaks when training resumes at full intensity after a period of reduced activity. In children, symptoms may resolve naturally, but continuing to train through pain is risky – shin splints can progress to stress fractures, significantly prolonging recovery!

Physiotherapy begins with a proper diagnosis and creating a clear plan so you know what to expect. As you’ve hopefully understood, balancing load and rest is crucial—not only for exercises that promote healing but also for modifying sports activities. Treatment also includes improving posture, technique, mobility, strength, and coordination.
Here are some tips to help prevent lower leg injuries:
  • Warm-up properly: Spend at least 15 minutes warming up before engaging in explosive sports. Tendons take longer to warm up than muscles! Include dynamic stretches, mobility exercises, and stability drills.
  • Gradually increase training intensity and volume: If you're unsure how to progress safely, seek professional guidance.
  • Take enough rest between training sessions.
  • Alternate between long and short distances if you’re an avid runner.
  • Wear appropriate footwear.
  • Seek help early: If you repeatedly experience stiffness in tendons or muscles after exercise, consult a physiotherapist instead of pushing through the discomfort.