Leg Injuries

Topic Overview

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 in 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, ropey fibers (ligaments) that connect bone to bone and help stabilize joints (sprains).
  • Injuries to the tough, ropey 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, such as a lower leg fracture, may occur when a bone is twisted, bent, jammed, struck directly, or used to brace against a fall.
  • 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, ropey fibers that connect muscles to bones (tendinitis).
  • Hairline cracks in bones, such as stress 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 likely 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.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a leg injury?
Yes
Leg injury
No
Leg injury
How old are you?
Less than 5 years
Less than 5 years
5 years or older
5 years or older
Are you male or female?
Male
Male
Female
Female
Have you had surgery on the leg in the past month?
If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.
Yes
Leg surgery in the past month
No
Leg surgery in the past month
Has it been more than a month since the leg injury?
Yes
Leg injury over a month ago
No
Leg injury over a month ago
Have you had a major trauma in the past 2 to 3 hours?
Yes
Major trauma in past 2 to 3 hours
No
Major trauma in past 2 to 3 hours
Do you have severe bleeding that has not slowed down with direct pressure?
Yes
Severe bleeding
No
Severe bleeding
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Are you having trouble moving the leg?
Pain and swelling can limit movement.
Yes
Difficulty moving leg
No
Difficulty moving leg
Can you move the leg at all?
Yes
Able to move the leg
No
Unable to move the leg
Have you had trouble moving the leg for more than 2 days?
Yes
Difficulty moving leg for more than 2 days
No
Difficulty moving leg for more than 2 days
Is there any leg pain?
Yes
Leg pain
No
Leg pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
5 to 10: Moderate to severe pain
Moderate to severe pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is increasing
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is improving
Do you have any pain in your leg?
Yes
Leg pain
No
Leg pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Has the pain:
Gotten worse?
Pain is getting worse
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is getting better
Has the pain lasted for more than 2 days?
Yes
Pain for more than 2 days
No
Pain for more than 2 days
Is the leg blue, very pale, or cold and different from the other leg?
If the leg is in a cast, splint, or brace, follow the instructions you got about how to loosen it.
Yes
Leg is blue, very pale, or cold and different from other leg
No
Leg is blue, very pale, or cold and different from other leg
Is there any swelling or bruising?
Yes
Swelling or bruising
No
Swelling or bruising
Did you have swelling or bruising within 30 minutes of the injury?
Yes
Swelling or bruising within 30 minutes of injury
No
Swelling or bruising within 30 minutes of injury
Has swelling lasted for more than 2 days?
Yes
Swelling for more than 2 days
No
Swelling for more than 2 days
Do you have numbness, tingling, or weakness in your leg that has lasted more than an hour?
Weakness is being unable to use the leg normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness.
Yes
Numbness, tingling, or weakness for more than 1 hour
No
Numbness, tingling, or weakness for more than 1 hour
Do you think that the injury may have been caused by abuse?
Yes
Injury may have been caused by abuse
No
Injury may have been caused by abuse
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Do you think the problem may be causing a fever?
Some bone and joint problems can cause a fever.
Yes
Possible fever
No
Possible fever
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Have you had symptoms for more than a week?
Yes
Symptoms for more than a week
No
Symptoms for more than a week

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Symptoms of shock (most of which will be present) include:

  • Passing out.
  • Feeling very dizzy or lightheaded, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Symptoms of shock in a child may include:

  • Passing out.
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Leg Problems, Noninjury

Pain in children 3 years and older

  • Severe pain (8 to 10): The pain is so bad that the child can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and sleep, but the child can tolerate it for hours or days.
  • Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.
Postoperative Problems

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

With severe bleeding, any of these may be true:

  • Blood is pumping from the wound.
  • The bleeding does not stop or slow down with pressure.
  • Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

  • The bleeding slows or stops with pressure but starts again if you remove the pressure.
  • The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

  • The bleeding stops on its own or with pressure.
  • The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Major trauma is any event that can cause very serious injury, such as:

  • A fall from more than 10 ft (3.1 m) [more than 5 ft (1.5 m) for children under 2 years and adults over 65].
  • A car crash in which any vehicle involved was going more than 20 miles (32 km) per hour.
  • Any event that causes severe bleeding that you cannot control.
  • Any event forceful enough to badly break a bone.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Home Treatment

First aid for a suspected broken bone

  • Control bleeding.
  • Remove all anklets or rings. It may be hard 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.
  • 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 mean 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 doctor 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 doctor, 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, because 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 doctor 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 harder 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.
  • Use a crutch or a cane for the 24 to 48 hours after the injury if it makes you more comfortable and supports the injured area. If you feel you need to use a crutch or cane for more than 48 hours, discuss your symptoms with your doctor.
  • 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 Smoking.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Pain or swelling develops.
  • Signs of infection develop.
  • Numbness; tingling; or cool, pale skin develops.
  • Symptoms become more severe or more frequent.

Prevention

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, think about the 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

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 for at least 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. In addition to weight-bearing exercise, experts recommend that you do resistance exercises at least 2 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 doctor about an exercise program that is right for you. Begin slowly, especially if you have been inactive. For more information, see the topic Fitness.
  • Don't drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman. 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 Smoking.

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.

Preparing For Your Appointment

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

You can help your doctor 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 have you tried? Did it help?
  • What nonprescription medicines have you tried? Did they help?
  • Were alcohol or illegal drugs involved in your injury?
  • Do you have any health risks?

Credits

By Healthwise Staff
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
H. Michael O'Connor, MD - Emergency Medicine
Last Revised September 19, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

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