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Leg Injuries: Research, Stress Fractures, Questions

February 16, 2005 03:59 PM

By Jim Brown, Editor, Sports Performance Journal (athletesperformance.com)

Hamstring-Quadriceps Imbalance
A study reported in Knee Surgery, Sports Traumatology, and Arthroscopy has shown that there may be a relationship between hamstring and quadriceps strength ratio in female athletes and the rate of leg injury. Several risk factors for leg injuries were examined in 146 Swedish soccer players. During a six-month season, the leg injury rate was 5.49/1000hrs of play. Among the variables that significantly increased the risk of traumatic leg injuries were joint laxity, hyperextension of the knee joint, and a low hamstring-to-quadriceps strength ratio (indicating an imbalance in strength). The five players who suffered anterior cruciate ligament injuries had a greater imbalance in hamstring-to-quadriceps action on the injured leg than on the noninjured side.

Preventing Stress Fractures
The American College of Sports Medicine gives the following recommendations for preventing stress fractures in the feet and ankles.

• Wear lightweight, activity-specific athletic shoes and replace them after approximately 500-700 kilometers of running.
• Increase training intensity gradually over a period of weeks, introducing hills, interval training, jumping exercises and high-strain, sport-specific activities only after approximately six weeks of graduated training.
• If various surfaces will be encountered, begin training on surfaces that absorb shock well, such as level asphalt. Then progress to man-made track, grass, sand or uneven terrain, thereafter varyingthe training surface.
• Maintain adequate dietary calcium intake (at least 1,000 mg/day for men and women 19-50; 1,200 mg for men and women over 50) to allow healthy bone mineralization during remodeling.
• Female athletes should maintain normal concentration of circulating estrogen, using menstrual dysfunction as a warning flag.

Questions to Anticipate
It’s difficult to remember all of the things that are important for a doctor to know about your leg injury. Here are some questions to anticipate. Writing down the answers ahead of time may help you and your physician.

• Did the pain develop suddenly or gradually?
• What caused the pain?
• Is the pain limited to your leg?
• Is the pain in one place or in an entire area?
• Does it hurt only when you are playing tennis or exercising?
• Is the pain worse at night?
• Does anything relieve the pain?
• Has anything about your training recently changed?

© 2004 HMS Publishing, Inc.
Jim Brown will be contributing new content to this site on a monthly basis. If you have a question for Dr. Brown please feel free to email him at




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