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(FAQs) Leg Pain & Leg Injuries

Leg Pain: Causes, Symptoms, Treatment & Exercises


We treat all kinds of leg pain presentations at North Shore Spine and Sport, from quadriceps or hamstring strains, to shin splints, achilles tendinitis, and more.


What are some leg pain causes?

Leg pain causes can range from acute or repetitive strain scenarios to leg tissues, or referred pains from the lower back and hip.  Dr. Melander treats leg pain varieties every day and is happy to discuss your situation anytime!


What are some leg pain symptoms?

Leg pain symptoms are varied and dependent on the type of leg pain, mechanism of injury, and the individual experiencing the leg pain.  Generally speaking, a pain experience that can be readily related to an activity, range of motion, or event is not likely too serious.  Conversely, pain that involves numbness, tingling, weakness, loss of sensation, or is of a completely unknown origin warrants evaluation by a trained healthcare provider.

Leg Pain Relief and Treatment


What are some ways to get leg pain relief (leg pain treatment)?

Most of the time pain is a fairly transient process and will go away without any change to activity or need for treatment.

If leg pain does not go away on its own, it is usually recommended that someone review the circumstances that contribute to their experiencing leg pain and modify anything they can to see if the leg pain improves. If that doesn’t work or if someone is not sure what to do and how to modify their activity, we highly recommend seeking a consultation with a trained healthcare provider.

At North Shore Spine and Sport, Dr. Melander will evaluate your leg pain to determine what the most likely pain generator is, then craft a unique approach that may combine hands-on manual therapy and exercise to help rid you of the pain you are experiencing as quickly as possible.

Leg Pain Exercises


What are some leg pain exercises?

Leg pain exercises are entirely dependent on the type of leg pain.  If someone is suffering a thigh area pain due to a recent strain from exercise, then perhaps some mindful stretching, foam rolling, and weightlifting within pain-free parameters could be helpful.

If someone is experiencing calf or achilles region pain, often eccentric training is recommended to help boost the load bearing capacity of the tissue and improve mobility (stand on toes on the edge of a stair facing up the staircase, stand up tall with both feet, remove the unaffected foot, and slowly lower your body using the affected side foot/ankle/calf.

Leg Pain (Related Conditions)


Muscle Strain in Leg: Causes, Treatment, Stretches & Common Questions


What is a muscle strain?

From an injury perspective, a muscle strain is caused by any situation involving a stress on a muscle tissue that exceeds the motion potential or load capacity of the tissue.  These events are actually tears to the muscle, but are most commonly only microscopic tears for which the body’s own healing mechanisms will quickly solve.

In exercise situations for example, muscles get bigger and stronger based on an intentional stress imposed on the tissue and the body’s self regulated attempt to adapt to that stress.  That is to say, not all muscle strains (tears) are a bad thing.


What are some leg muscle strain treatments?

Pretty much any muscle strain in the entire body can be treated with some combination of movement and exercise.  Dr. Melander treats more muscle strains than any other type of injury and he will be able to thoroughly and quickly guide you on the path to recovery.

It is important to consult with a trained professional for the treatment of any muscle strain that does not resolve within a few days as certain exercise variations have been demonstrated to be more effective depending on the type of strain that has occurred.


What are some leg muscle strain stretches?

Stretching can be beneficial provided a stretch is held for a long enough period of time and with enough repeated efforts over time to create a true tissue level adaptation.  However, Dr. Melander is more likely to recommend positional isometric strengthening or eccentric strengthening for muscle strains as either option has been shown to improve strength, control, and range of motion more efficiently than stretching alone.


Common muscle strain questions: 


How long does it take for a muscle strain to heal?

This is completely dependent on the type of strain (acute vs. chronic), the severity of strain (mild to severe), and the individual who suffered the strain.  For example, a mild acute strain in a healthy 15 year old athlete (like a “pulled muscle”) will likely resolve within a week or so and is not likely to require any intervention.

An acute strain in a 70 year old sedentary person may take weeks or months to fully heal because that person’s general physical preparedness is poor.  In Dr. Melander’s experience, muscle strains that warrant treatment are amongst the easiest conditions to manage and rarely require more than a few treatment sessions to resolve.


How do I know if I strained a muscle?

In an acute situation, there is usually a moment where you will feel something unusual, or perhaps painful, occur in the muscle area that has been strained.  In a cumulative strain scenario, there is more apt to be a gradual tensioning over an extended period of time that may eventually lead to a localized discomfort and pain.


What is the best treatment for a muscle strain?

Movement and exercise, as these require the affected tissue to work through large ranges of motion and adapt back to the healthy, pre-injury state.


Should you stretch a strained muscle?

Unless stretching clearly aggravates pain associated with a strain, then yes, stretching can be utilized.  Dr. Melander prefers to use isometric and eccentric exercises more than stretching for strains though.

Iliotibial Band Syndrome  & FAQs


What is iliotibial band syndrome?

Iliotibial band syndrome is near the top of the list of the most poorly diagnosed and most poorly understood diagnoses that Dr. Melander encounters with any regularity.

The iliotibial band (ITB) is a taut cord of connective tissue running from the lateral hip to the lateral knee.  There is debate as to whether the ITB is actually a contractile tissue or whether it just functions to help stabilize the leg from any kind of lateral failure.

Many people experiencing pain in the lateral thigh and the lateral knee are default diagnosed with Iliotibial band syndrome, but except in rare cases Dr. Melander disagrees with this diagnosis.  Just because pain is experienced in the lateral thigh does not mean the ITBand is relevant.

In order for the ITBand to be relevant, one must further understand that current research indicates greater than 2000lbs of force is needed to “manipulate” the IT Band.  There is no human’s touch or any exercise yet conceived that can dictate 2000lbs of force to the ITBand.

That all being said, pain in the lateral thigh or lateral knee is more likely due to strain to the vastus lateralis component of the quadriceps, strain in the biceps femoris component of the hamstring, lateral meniscus or lateral knee joint capsule dysfunction, or referred pain from the hip.  (phew, soapbox moment from Dr. Mike there…)


Common IT Band questions: 


How long does IT Band syndrome take to heal?

Lateral thigh and lateral knee area pain improves based on the activity preceding any strain or pain, as well as the extent of tissue damage or inflammation.  As an example, Dr. Melander has treated countless people over the years with lateral knee pain that has developed within 6-8 weeks of training for a marathon.

Usually these patients were not long-distance runners prior to signing up for a marathon, and upon increasing their mileage rapidly, they began feeling pain in the lateral knee that worsens with additional running.

There is no sugar coating it, these are tough cases to treat as they are due to a combination of poor tissue level adaptation, poor recovery or load management, increasing inflammation, and increasing “sensitivity” of the brain to that region of the body, further complicated by the emotional stress of reaching a lofty goal that person set for themselves.

In many cases a careful approach to load management (IE: running volume or intensity reduction), coupled with certain exercises to strengthen the legs can be quite impactful.  


How do you relieve pain from the IT Band?

This is a common kind of question, but, pain does not originate from a tissue.  Pain is extremely complicated but it an experience that is output from the brain, sometimes due to a stimulus from the tissue.  For IT Band area pains, Dr. Melander utilizes a combination of hands-on manual therapy, mobility training, and strength training.

Shin Splints & FAQs


What are shin splints? - Shin splints, aka medial tibial stress syndrome, is due to a strain having occurred to the muscles in the front of the lower leg or deep behind the shin bone and is most commonly due to running with minimal cross-training.

Shin splints symptoms usually involve pain along the front of the lower leg or just behind the shin bone that may radiate into the ankle/foot area.

Shin splint treatments include activity modification, hands-on manual therapy, and strengthening of the affected tissue.  Shin splints recovery is generally not too complicated, and in Dr. Melander’s experience will take just a few weeks for total resolve (unless there is a persistent aggravation to the tissue due to poor activity modification).

Shin splints prevention may be attained by cross-training, being mindful of shoe wear and support, and adequate recovery/load-management of training volume.


Common Shin Splints questions:


How do you heal shin splints?  
Dr. Melander recommends a combination of training load management (reduce or modify running mileage and intensity), strengthen the lower leg and hip, and seek treatment should those efforts not work.

Can you still run with shin splints?  Most likely yes, but you must be careful not to exceed the distance threshold or intensity threshold that clearly aggravates pain.

Do shin splints go away? Almost always yes, except in situations of poor load management and patient compliance.

What causes shin splints? Usually related to running, shin splints develop due to strain to the muscles in the front of the lower leg and just behind the shin bone.

our Chiropractic
Approach


Dr. Melander has often described his work as new-school rehab, which is to say, an amalgamation of current best practices regarding pain or injury management, hands-on manual therapy or strength/mobility training, and endless advocacy and support for his patients.

In Dr. Melander’s opinion, the best providers in the field of musculoskeletal injury are able to draw from multiple disciplines to create the most efficient and impactful care strategy for their patients.  If you are injured or hurting and not sure what to do, please reach out, it will be our greatest pleasure to help you. 

Chiropractic FAQs


We've compiled a list of common chiropractic questions to help you get all the answers you are looking for. If you have additional questions if our chiropractic and treatment services in North Shore would be a good fit for you, please contact our team. 

How do I know if I should see a chiropractor?

Chiropractors are trained in the evaluation and management (IE: treatment) of issues affecting the neuromusculoskeletal system (muscles, joints, connective tissue, nerves).  Many people associate chiropractic care with the spine only, but this is an inaccurate reflection of many chiropractors in the 21st century who are experts in treating spinal issues AND extremity issues (arms and legs).  As a general rule of thumb, if you have a painful condition that does not get better given a few days of activity modification you may want to consult a professional like a chiropractor.  Your chiropractor should be able to evaluate your painful condition, offer you some perspective and guidance relative to the painful condition, and help you care for the painful condition if treatment is warranted.  Like any profession though, each chiropractor has different clinical experience and different post-graduate education that may lend their practice toward a focus on sports injuries or pregnancy/neonatal care or neurologic issues or nutritional issues to name just a few.  If you are considering seeing a chiropractor, make sure that their experience and skill set seems like a proper match for your complaint and your ultimate goals.

How do I choose a good chiropractor?

Choosing a good chiropractor does not have to be a complicated process.  To begin with, ask your friends or family if they know someone they trust and can vet for you.  Next, check online as most chiropractors should have fairly informative websites relative to their clinical interests and experience that may help indicate whether they are a good fit for your issue.  If you are still not sure who to see after taking those steps, call your prospective chiropractor’s office as either the staff or the chiropractor will be more than happy to answer any questions and tell you if your issue is something commonly treated in that office.  Many people also like to read online reviews and while some online reviews can be misleading, if the significant majority of a chiropractor’s reviews are super positive then chances are you can trust the expertise of that provider.  Lastly, and arguably the most important step in choosing a good chiropractor, remember that you are in total control of your healthcare decision making.  If you go to an initial or follow-up appointment and you are not absolutely confident in the assessment and plan your chiropractor has rendered, then seek a second opinion.

What can a chiropractor fix?

A chiropractor can help you fix a wide variety of painful conditions related to the neuromusculoskeletal system such as headaches, back/neck pain, shoulder/elbow/wrist/hand pains, hip/knee/ankle/foot pains to name just a few.  Injuries of actual orthopedic compromise like fractures are best handled by orthopedists, but chances are if your pain/injury is non-surgical in nature then a chiropractor may be a great option to help you.  The best chiropractors will explain what they can about your pain/injury, offer guidance and likely treatment as efficiently as possible (days to weeks, maybe months in extreme situations), and then remove themselves and let your brain/body do the rest.  A great deal of research these days indicates that in many healthcare interactions providers should try and limit their patient’s dependency on them, opting instead for interventions and language that fosters resiliency and self-efficacy (independence).

What happens at your first chiropractic appointment?

Your first chiropractic appointment should include a detailed discussion of your health history and presenting complaint(s), an examination of your complaint(s), a discussion regarding what is indicated by the examination relative to prognosis and treatment plan, and finally some form of treatment/intervention assuming time permits.  Many painful conditions can be evaluated thoroughly and completely in a matter of minutes and certain treatment interventions could yield immediate relief, while other conditions may require more complex evaluations and more lengthy treatment plans.  Above all, you should leave your first chiropractic appointment feeling confident that your chiropractor is the best option to help you with your problem and you should leave feeling confident that you are on the road to recovery.

How often should you see a chiropractor?

You should see a chiropractor as often as you want or need.  Perhaps the most common criticism of chiropractors is that chiropractors “need to see you for the rest of your life”, and while there are unfortunately examples of chiropractors who advocate for this kind of dependency, the significant majority of chiropractors today want to help you as quickly as possible with no long-term commitments of any kind.  The best chiropractor will see you the minimally necessary number of times to help you overcome your issue and suggest you follow-up if there are any residual issues or new complaints sometime in the future.  Many patients however recognize how good they feel after chiropractic care and therefore wish to see their chiropractor with some kind of recurring frequency (IE: once/month, twice/year, or more).  These examples though should be dictated by the patient based on their assessment of their body’s needs and absolutely not dictated by the chiropractor based on some kind of pseudoscientific reasoning.

Does insurance pay for chiropractor?

In many cases, yes, insurance will help pay for chiropractic care assuming the chiropractor is participating with your health insurer.  If your chiropractor is not participating with health insurance, then it is still possible you have an out-of-network benefit with your insurer and can seek reimbursement that way.

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North Shore Spine and Sport
13 1/2 Pond St, Newburyport, MA 01950
Phone: (978) 406-9700
Email: info@northshorespinesport.com


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