Muscular Injuries in the Posterior Leg: Assessment and Treatment PDF
Preview Muscular Injuries in the Posterior Leg: Assessment and Treatment
Muscular Injuries in the Posterior Leg J. Bryan Dixon Editor Muscular Injuries in the Posterior Leg Assessment and Treatment 2123 Editor J. Bryan Dixon, MD Sports Medicine Advanced Center for Orthopedics Marquette, MI, USA ISBN 978-1-4899-7649-9 ISBN 978-1-4899-7651-2 (eBook) DOI 10.1007/978-1-4899-7651-2 Library of Congress Control Number: 2015960247 Springer Boston Heidelberg New York Dordrecht London © Springer Science+Business Media New York 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer US is part of Springer Science+Business Media (www.springer.com) In memory of Dr. Bo Michael Rowan. Preface Recorded sports medicine dates to the advent of the Olympic Games. Schol- ars have suggested that Hippocrates himself learned his orthopedics from treating athletes. Sports injuries are unmistakable in the chiseled sculptures of ancient athletes—centuries of weathered wear still reveal the corpulent auricular hematoma of the grappler and saddle nose deformity of the pugi- list. The notable absence of muscle injuries enshrined in marble reflects the devastating effect of muscle injuries on performance. The victor and veteran may be marred by their craft, but they must be fit to function in order to compete. Like ancient Greece, we are seeing a modern resurgence of physical cul- ture and a renewed appreciation for the intertwined nature of exercise and health. If exercise is medicine, then sports medicine is medicine sine qua non. As muscle is the engine of movement and movement is the basis for sport and health, then a detailed knowledge of muscle should be foundational to sports medicine. As sports medicine professionals, we must consider that muscle injuries are arguably the most important injuries for our patients’ health and performance. Muscles make up almost half of our bodies; it is the stratum of sport, a remarkable engine for our ingenuity. With muscles, we do, we move and react, we rally and retreat. In professional sport, we see the headlines report- ing the sprinter laid low or pitcher lost from the lineup due to muscle injuries. But the greatest burden of muscle injuries is not found on the sports pages, rather it is the countless recreational athletes unable to run, cycle, and play basketball or soccer. This book is dedicated to the colossal toll muscle inju- ries have on physical activity and to the hobbled masses yearning to run free. Through a dedicated and detailed examination of muscle injuries of the pos- terior leg, I hope this book also provides a robust foundation to understand muscle injuries more generally. Muscular injuries of the posterior leg have a rich history. Originally, it was termed “tennis leg,” a reference to the lawn tennis of the 1800s, not the Wim- bledon of the Williams sisters. Tennis leg is emblematic of modern sports injuries and perhaps the first sport-specific injury described in the medical literature. At one time, tennis leg prompted spirited investigation and profes- sional debate, but the focus on muscular injuries has slowly faded, replaced by more glamorous injuries that are amenable to heroic treatments. Today, beyond the brief refrain of rest, ice, compression, and elevation (RICE) and rehab, little is found in medical texts about tennis leg or other muscle injuries. vii viii Preface Yet, muscle injuries continue to be a source of significant morbidity for our patients. Message boards and blogs abound with stories of patients suffering from the lasting effects of muscle injures and requests for help. This book aims to put the focus back on muscle injuries, to restore the pri- macy and place of these widespread maladies, long displaced by the pathol- ogy popularized by our peers and in the press. Anterior cruciate ligament (ACL) tears and Tommy John’s repairs represent the modern paradigm of sports medicine, and their treatment brings professional prestige and public notoriety, as evermore heroic treatments are performed by physicians utiliz- ing novel procedures backed by remarkable technological innovation. I think you will find that the optimal evaluation and treatment of muscle injuries has all the subtlety and gratification of the more heroically treated injuries that currently dominate sports medicine. Skeletal muscle is the para- digm for the biological structure–function relationship. At any scale, skel- etal muscle intricately links structure and function. Appreciating this link between structure and function forms the basis for diagnosis, treatment, and prevention of muscle injuries. With increased knowledge of the basic science of muscle and muscular injuries, we are entering a new era of understanding and innovative treatment options. It is time to revisit our roots to acknowledge and appreciate the tremen- dous consequence muscle injuries have on athletes and active people, to take back professional pride in the thoughtful treatment of muscular malfunction, and to collaborate and not delegate the care of this important class of injuries. Your interest in this book shows you care about muscle injuries and I com- mend your commitment to learning more about these failures of the flesh. I know from experience that your commitment will be rewarded by thankful patients and excited collaborators in treatment of these injuries. I welcome your feedback on this book or specific questions on the optimal care of your patients. I look forward to joining you in future discussion and investigations on the assessment, treatment, and prevention of muscular injuries. Marquette, MI J. Bryan Dixon, MD Contents Part I Underlying Principles in the Assessment and Treatment of Muscular Injuries of the Posterior Leg 1 Anatomy of the Leg .......................................................................... 3 Julia C. Bisschops and Mark E. Lavallee 2 Physiology of Skeletal Muscle ......................................................... 13 Scott N. Drum, Ryan Weatherwax and J. Bryan Dixon 3 Structure and Organization of Skeletal Muscle ............................ 27 J. Bryan Dixon, Scott N. Drum and Ryan Weatherwax 4 Pathophysiology of Skeletal Muscle Injury ................................... 35 Andrew Swentik 5 Neurophysiology of Musculoskeletal Pain ..................................... 49 Erich N. Ottem Part II Assessment of Muscular Injuries in the Posterior Leg 6 Clinical Assessment of the Posterior Leg ....................................... 63 J. Bryan Dixon and Christopher Robert Faber 7 Imaging and Tests for Posterior Lower Leg .................................. 81 Eric P. Sturos and J. Bryan Dixon Part III Treatment of Muscular Injuries in the Posterior Leg 8 Acute Injuries in the Posterior Leg ................................................ 93 Stephen M. Simons and Jeremy L. Riehm 9 Sub-acute and Chronic Injuries in the Posterior Leg ................... 99 Stephen M. Simons and Christopher C. Jordan ix x Contents 10 Surgical Treatment of Posterior Leg Injuries................................ 111 Zachary C. Leonard 11 Rehabilitation of Injuries in the Posterior Leg .............................. 121 John Baldea, Manoj K. Dhariwal, Brock McMillen, Casey Chrzastowski, Stacey M. Hall, Jordana Weber, Conan Von Chittick, Premod John and Morhaf Al Achkar 12 S pecial Population Considerations in the Treatment of Posterior Leg Injuries.................................................................. 141 Ryan R. Woods and Jeffrey S. Brault 13 C omplementary Medicine Practices for Muscular Injuries of the Posterior Leg .......................................................................... 153 Bo M. Rowan† and J. Bryan Dixon Index ........................................................................................................ 169 Contributors Morhaf Al Achkar, MD Clinical Family Medicine, Indiana University— Methodist Hospital, Indianapolis, IN, USA John Baldea, MD Clinical Family Medicine, Indiana University School of Medicine, Family Medicine IU Health, Indianapolis, IN, USA Julia C. Bisschops, MD, MSc Sports Medicine Institute, Family Medicine Department, Memorial Hospital, South Bend, IN, USA Jeffrey S. Brault, DO Department of Physical Medicine and Rehabilita- tion, Mayo Clinic, Rochester, MN, USA Conan Von Chittick, MD Family Medicine/Sports Medicine, IU Health Methodist Hospital, Indianapolis, IN, USA Casey Chrzastowski, DPT Outpatient Orthopedics, Rehabilitation Ser- vices, IU Health West, Avon, IN, USA Manoj K. Dhariwal, MD Millennium Physician Group, Port Charlotte, FL, USA J. Bryan Dixon, MD Sports Medicine, Advanced Center for Orthopedics, Marquette, MI, USA Scott N. Drum, PhD ACSM-CES, CSCS, FACSM School of Health and Human Performance, Northern Michigan University, Marquette, MI, USA Christopher Robert Faber, MD Emergency Department, Baraga County Memorial Hospital, L’Anse, MI, USA xi
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