Health Library Leg InjuriesFrom Healthwise

Minor leg injuries are common. Symptoms often develop from everyday wear and tear, overuse, or an injury. Leg injuries are most likely to occur during:

• Sports or recreational activities.
• Work-related tasks.
• Work or projects around the home.

Most leg injuries in children and teens occur during sports or play or from accidental falls. The risk for injury is higher in contact sports, such as wrestling, football, or soccer, and high-speed sports, such as biking, in-line skating, skiing, snowboarding, and skateboarding. Knees, ankles, and feet are the most affected body areas. Any injury occurring at the end of a long bone near a joint may injure the growth plate and needs to be checked by a doctor.

Older adults have a higher risk for injuries and fractures because they lose muscle mass and bone strength (osteoporosis) as they age. They also have more problems with vision and balance, which increases their risk for accidental injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve symptoms and promote healing.

Acute (traumatic) injury

An acute injury may occur from a direct blow, a penetrating injury, a fall, or from twisting, jerking, jamming, or bending a limb abnormally. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries usually require prompt medical evaluation and may include:

• Bruises (contusions), which occur when small blood vessels under the skin tear or rupture, often from a twist, bump, or fall. Blood leaks into tissues under the skin and causes a black-and-blue color that often turns colors, including purple, red, yellow, and green, as the bruise heals.
• Injuries to the tough, ropelike fibers (ligaments) that connect bone to bone and help stabilize joints (sprains).
• Injuries to the tough, ropelike fibers that connect muscle to bone (tendons), such as a ruptured Achilles tendon.
• Pulled muscles (strains), such as a hamstring strain.
• Muscle ruptures, such as gastrocnemius rupture.
• Broken bones (fractures). A break may occur when a bone is twisted, bent, jammed, struck directly, or used to brace against a fall. See an illustration of a lower leg fracture.
• Pulling or pushing bones out of the normal relationship to the other bones that make up a joint (dislocations).

Overuse injuries

Overuse injuries occur when too much stress is placed on a joint or other tissue, often by "overdoing" an activity or doing the same activity repeatedly. Overuse injuries include:

• Inflammation of the sac of fluid that cushions and lubricates the bones (bursitis).
• Inflammation, tearing, or fraying of the tough, ropelike fibers that connect muscles to bones (tendinitis).
• Hairline cracks in bones (stress fractures). See an illustration of fractures of the foot.
• Inflammation of the fibrous covering of the bone (periosteum) where muscle fibers attach to it (shin splints).
• Inflammation of the plantar fascia, a broad, flat ligament on the bottom of the foot (plantar fasciitis).
• Inflammation at the top of the shinbone (tibia) where the patellar tendon attaches to a bony prominence (Osgood-Schlatter disease). This is more apt to occur during rapid growth periods and is usually seen in athletic teenagers, especially those who play football, basketball, or soccer, and those who are involved with gymnastics and dance. Osgood-Schlatter disease involves both legs about 25% of the time and is rarely a chronic, lifelong condition.

Treatment

Treatment for a leg injury may include rest, ice, elevation, and other first aid measures (such as the application of a brace, splint, or cast), or physical therapy. Some leg injuries are treated with medicine or surgery, especially if a bone is broken. Treatment depends on:

• The location, type, and severity of the injury.
• When the injury occurred.
• Your age, health condition, and activities, such as work, sports, or hobbies.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• Signs of shock occur:
  • In children.
  • In adults and older children.
• Severe bleeding does not slow during the first 15 minutes of steady direct pressure.
• Partial or complete amputation of an extremity occurs.
• Pieces of bone are visible in a wound or a bone is sticking through the skin. Do not try to push the bone back into the skin. Cover the area with a clean bandage.
• Your leg is suddenly pale, white, blue, or cold after an injury.
• Your leg is completely numb.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Bleeding: Go to the topic Cuts or Puncture Wounds.
• A burn on a leg: Go to the topic Burns or Sunburns.
• An injured joint: Go to the Check Your Symptoms section of the topic that most closely describes the area of your injury for a more complete evaluation.
  • Knee Problems and Injuries
  • Toe, Foot, and Ankle Injuries

	Yes	Is your leg twisted, bent out of shape, or out of its normal position?
When to See a Doctor See significance of a leg that is twisted, bent out of shape, or out of its normal position if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: Take the following first aid steps while transporting the injured person for medical evaluation of a broken bone or dislocation: Use a splint to limit movement. Keep the leg elevated, if possible. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Does your leg look twisted, bent out of shape, or out of its normal position after a recent injury? Yes Do you have a bump or break in the skin at the site of a suspected broken bone or dislocation? Call your health professional today if you answer "Yes" to the following question. Yes Did your leg pop, move, or get pulled out of its normal position and then return to its normal position? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have pain or tenderness after an injury?
When to See a Doctor See significance of pain or tenderness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have severe pain? Yes Are you unable to stand or walk? Yes Is a young child unable or unwilling to walk? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have pain with swelling or bruising that began within 30 minutes of an injury? Yes Do you have moderate pain that is getting worse? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Do you have mild to moderate pain that has not improved after 24 hours of home treatment? Yes Do you have mild pain when you move or lift your leg after 48 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Is your leg pale, white, blue, or cold?
When to See a Doctor See significance of pale, white, blue, or cold skin at or below the site of an injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Has your leg gradually become pale, white, blue, or cold after an injury? Yes Are your toes or foot pale, white, blue, or cold after having a brace, cast, or splint applied? Note: See first aid for a cast or splint that may be too tight. If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have numbness or tingling after a leg injury?
When to See a Doctor See significance of numbness or tingling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have new steady numbness without other symptoms after an injury? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had steady tingling in your leg, without other symptoms, for 1 hour or longer? Yes Has tingling gotten worse? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had numbness or tingling that comes and goes (intermittent) for 24 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Are you unable to move your leg normally after an injury?
When to See a Doctor See significance of inability to move a leg normally after an injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Are you unable to move your injured leg? Yes Do you have limited leg movement with severe pain? Yes Are you unable to move your leg normally after having a brace, cast, or splint applied (not because the splint is in the way)? Note: See first aid for a cast or splint that may be too tight. Yes Is a young child carefully protecting his or her leg? Yes Is a young child unable or unwilling to walk? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Are you unable to move your leg normally or do you have decreased leg strength after 24 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have swelling after a leg injury?
When to See a Doctor See significance of swelling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Has swelling caused the skin below an injury to become cold or pale? Call your health professional today if you answer "Yes" to the following question. Yes Do you have a lot of swelling within 30 minutes of an injury? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you have moderate swelling after 48 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Did you feel or hear a snap or pop at the time of a painful leg injury?
When to See a Doctor See significance of feeling or hearing a snap or pop if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Has a lot of swelling developed within 30 minutes of the injury? Yes Does your leg look twisted, bent, or out of its normal position? Yes Are you unable to move your leg normally? Call your health professional today if you answer "Yes" to any of the following questions. Yes Did you feel or hear a snap or pop in your injured leg, but you do not have any other changes in appearance or movement? Yes Since feeling or hearing a snap or pop, does your injured leg feel loose or unstable? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think an injury may have been caused by abuse?
When to See a Doctor See significance of abuse if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Did someone hurt you on purpose? Yes Do you think that a child's injury may have been caused by abuse? Yes Do you think that a vulnerable adult's injury may have been caused by abuse? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think you have an infection?
When to See a Doctor See significance of an infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have diabetes? Yes Do you have peripheral arterial disease? Yes Do you have a disease or take medicine that causes problems with your immune system? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have increased pain, swelling, redness, or warmth around the injured area? Yes Do you have red streaks extending from the injured area? Yes Do you have pus in or around the injured area? Yes Do you have a fever or think you have a fever? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild pain and swelling with redness less than 1 in. (2.5 cm) around the injured area for 24 hours or longer? Yes Have you had swollen lymph nodes in the groin for 1 week or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Is your leg bruised after an injury?
When to See a Doctor See significance of bruising if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Did a large (the size of the injured person's palm), painful, swollen bruise develop within 30 minutes of an injury? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Are you worried about how easily you bruise? Yes Have bruises from an injury lasted longer than 2 weeks? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• A leg problem not related to an injury: Go to the topic Leg Problems, Noninjury.
• A bite: Go to the topic Animal and Human Bites.
• Bruises or blood spots under the skin: Go to the topic Bruises and Blood Spots Under the Skin.
• A cut: Go to the topic Cuts.
• A puncture wound: Go to the topic Puncture Wounds.
• Scrapes: Go to the topic Scrapes.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

First aid for a suspected broken bone

• Control bleeding.
• Remove all anklets or rings. It may be difficult to remove the jewelry if your leg or foot swells. Swelling without the removal of jewelry can cause other serious problems, such as compression of nerves or restriction of blood flow. See an illustration of removing a ring that is stuck.
• Do not attempt to straighten an injured leg.
• Splint the injured leg to protect it from further injury. Loosen the wrap around the splint if signs develop below the wrap that indicate the wrap is too tight, such as numbness, tingling, increased pain, swelling, or cool skin.
• If a bone is sticking out of the skin, do not try to push it back into the skin. Cover the area with a clean bandage.

Cast and splint care

If a cast or splint is applied, it is important to keep it dry and try to move the uninjured parts of your extremity as normally as possible to help maintain muscle strength and tone. Your health professional will give you instructions on how to care for your cast or splint.

Home treatment for a minor injury

If your injury does not require an evaluation by a health professional, you may be able to use home treatment to help relieve pain, swelling, and stiffness.

• Rest and protect an injured or sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
• Ice will reduce pain and swelling. Apply ice or cold packs immediately to prevent or minimize swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day.
  • For the first 48 hours after an injury, avoid things that might increase swelling, such as hot showers, hot tubs, hot packs, or alcoholic beverages.
  • After 48 to 72 hours, if swelling is gone, apply heat and begin gentle exercise with the aid of moist heat to help restore and maintain flexibility. Some experts recommend alternating between heat and cold treatments.
• Compression, or wrapping the injured or sore area with an elastic bandage (such as an Ace wrap), will help decrease swelling. Don't wrap it too tightly, as this can cause more swelling below the affected area. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage. Talk to your health professional if you think you need to use a wrap for longer than 48 to 72 hours; a more serious problem may be present.
• Elevate the injured or sore area on pillows while applying ice and anytime you are sitting or lying down. Try to keep the area at or above the level of your heart to help minimize swelling.
• Remove all rings, anklets, or any other jewelry that goes around a leg. It will be more difficult to remove the jewelry later if swelling increases.
• Gently massage or rub the area to relieve pain and encourage blood flow. Do not massage the injured area if it causes pain.
• Do not smoke or use other tobacco products. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Tobacco Use.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Signs of infection develop.
• Numbness, tingling, or cool, pale, skin develops.
• Symptoms do not improve with home treatment.
• Symptoms become more severe or more frequent.

The following tips may prevent leg injuries.

General prevention tips

• Wear your seat belt in a motor vehicle.
• Don't carry objects that are too heavy.
• Use a step stool. Do not stand on chairs or other unsteady objects.
• Wear protective gear during sports or recreational activities, such as roller-skating or soccer. Supportive splints may reduce your risk for injury.
• Stretch before and after physical exercise, sports, or recreational activities to warm up your muscles.
• Use the correct techniques (movements) or positions during activities so that you do not strain your muscles.
• Use equipment appropriate to your size, strength, and ability.
• Avoid overusing your leg doing repeated movements that can injure your bursa or tendon. In daily routines or hobbies, examine activities in which you make repeated leg movements, and modify the way you do the activities, if possible, to prevent leg injuries from developing.
• Consider taking lessons to learn the proper technique for sports. Have a trainer or person who is familiar with sports equipment check your equipment to see whether it is well-suited for your level of ability, body size, and body strength.
• If you feel that certain activities at your workplace are causing pain or soreness from overuse, talk to your human resources department for information on alternative ways of doing your job or to discuss equipment modifications or other job assignments.

Reduce falls

• Make your home safe to reduce the chances of falls
• Keep your baby or toddler safe from falls

Keep your bones strong

• Eat a nutritious diet with enough calcium and vitamin D. (Vitamin D helps your body absorb calcium.) Calcium is found in dairy products, such as milk, cheese, and yogurt; dark green, leafy vegetables, such as broccoli; and other foods.
• Exercise and stay active. It is best to do weight-bearing exercise (walking, jogging, stair climbing, dancing, or lifting weights) for 45 to 60 minutes at least 4 days a week. Weight-bearing exercises stimulate new bone growth by working the muscles and bones against gravity. Exercises that are not weight-bearing, such as swimming, are good for your general health but do not stimulate new bone growth. Talk to your health professional about an exercise program that is right for you. Begin slowly, especially if you have been inactive. For more information, see the topic Fitness.
• Avoid drinking more than 1 alcoholic drink per day. People who drink more than this may be at higher risk for weakening bones (osteoporosis). Alcohol use also increases your risk of falling and breaking a bone.
• Do not smoke or use other tobacco products. Smoking puts you at a much higher risk for developing osteoporosis. It also interferes with blood supply and healing. For more information, see the topic Quitting Tobacco Use.
• Cut down on caffeine. Caffeine in coffee and soda pop may increase calcium loss from your body and puts you at risk for osteoporosis.

Possible abuse

Bodily injuries such as bruises, burns, fractures, cuts, or punctures may be caused by abuse. Suspect possible abuse when an injury cannot be explained or does not match the explanation, when repeated injuries occur, or when the explanations for the cause of the injury change. You may be able to prevent further abuse by reporting it and seeking help.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms?
• How long have you had your symptoms?
• How and when did an injury occur? How was it treated?
• Have you had any injuries in the past to the same area? Do you have any continuing problems because of the previous injury?
• What activities related to sports, work, or your lifestyle make your symptoms better or worse?
• Do you think that activities related to your job or hobbies caused your symptoms?
• What home treatment measures have you tried? Did they help? Be sure to include any prescription or nonprescription medications you have taken. Did they help?
• Were alcohol or illegal drugs involved in your injury?
• Do you have any health risks?

• Animal and Human Bites
• Back Problems and Injuries
• Bruises and Blood Spots Under the Skin
• Burns
• Bursitis
• Cuts
• Groin Problems and Injuries
• Hip Problems, Age 11 and Younger
• Hip Problems, Age 12 and Older
• Knee Problems and Injuries
• Leg Problems, Noninjury
• Male Genital Problems and Injuries
• Puncture Wounds
• Quitting Tobacco Use
• Scrapes
• Toe, Foot, and Ankle Injuries

Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated: August 31, 2006
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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