Lower body injuries are common in athletes but happen in non-athletes as well.

We will consider any injury that begins at the level of the lumbar spine (low back) or below as a lower body injury.

Some examples of injuries that affect the lower body are muscle, tendon, ligament, cartilage, joint and bone injuries. These injuries can be acute or chronic as well as traumatic or non-traumatic. Acute injuries are recent injuries that have occurred within the past few days. A chronic injury is one that has been present for a period of time.

Examples of traumatic injury would be falling off your bike or a collision with the ground while snowboarding. An example of non-traumatic injury would be a pain that develops in your knee while running or a pain that develops in your glutes while sitting.

Below are the most common lower body injuries that we diagnose and treat successfully at San Diego Running Institute.

Lower Back Injuries

Lumbar Disc Injuries – Can be acute or chronic, traumatic or non-traumatic. Typically affects the L4-L5 Disc or L5-S1 Disc and results in either;

  1. Lumbar Disc Bulge/Swelling – Stage 1 disc injury is easily treated and can be reversed.
  2. Lumbar Disc Protrusion – Stage 2 disc injury is treatable conservatively and will typically not require surgery.
  3. Lumbar Disc Herniation – Stage 3 disc injury that is treatable with conservative methods but may require extended treatment.
  4. Lumbar Disc Extrusion – typically will require surgery to correct.

Lumbar Ligament Injuries – Are usually acute but can chronic, traumatic or non-traumatic. Lumbar ligaments are usually sprained/torn while lifting something in an awkward way or position. Lumbar ligament injuries will typically respond to the correct conservative treatment.

Lumbar Muscle Injuries – Are usually acute but can chronic, traumatic or non-traumatic. Lumbar ligaments are usually strained/torn while lifting something in an awkward way or position. Lumbar muscle injuries will typically respond well to correct conservative treatment.

Gluteal/Hip Injuries

  1. Gluteus Medius Syndrome – Gluteus Medius Syndrome is often misdiagnosed as Sciatica, Ischial Bursitis and Hamstring sprain/strain otherwise known as hamstring tendonitis or tendonosis. There are some obvious signs and symptoms that can help accurately diagnose Gluteus Medius Syndrome while differentiating it from the others. https://www.sdri.net/running-injuries/how-to-differentiate-and-diagnose-hip-gluteal-back-pain/gluteus-medius-syndromea-k-a-runners-butt/
  2. Piriformis Syndrome – Piriformis Syndrome is a condition where the Piriformis muscle irritates the sciatic nerve. This can result in pain in the glute area, as well as possible pain down the back of the leg, which is similar to pain resulting from sciatica. https://www.sdri.net/running-injuries/piriformis-pain/
  3. Ischial Bursitis – The pain will usually start with the runner feeling a sensation of weakness, stiffness, locking or catching in the involved hip. The sensation is often difficult to locate appearing in the front and/or back of the hip joint. The pain will often get progressively worse as the runner continues to run and cause a deep throbbing or ache in the hip joint. https://www.sdri.net/running-injuries/ischial-bursitis/
  4. Trochanteric Bursitis – The pain will usually start with discomfort on the outside of the thigh and might be painful during walking, running or jumping activity. The pain will typically increase if you lie on that side and can cause a deep throbbing or ache in the hip joint.
  5. Hip Stress Fracture – A common injury that presents in those newer to impact activities such as long distance walking, hiking or running. Other risk factors are being female, overweight, low bone density and sudden increase in mileage. The pain will usually feel deep inside the hip and may at first feel muscular. As the injury progresses patients will report that they limp after activity.
  6. Hip Flexor Strain – Pain will be felt in the lower abdominal and/or groin while walking, running or hiking. Pain can be reproduced with manual muscle testing by the doctor resisting attempted hip flexion. The prime hip flexor is the Psoas muscle also known as the Iliopsoas muscle.

Thigh Injuries

  1. High Hamstring Tendonitis – An acute condition causing pain in the high posterior thigh that can radiate down the thigh towards the back of the knee. The pain will usually increase while walking uphill or running faster and can hurt while sitting or driving. Most runners mistakenly interpret this hamstring pain as “hamstring tightness” or spasm. They attempt to stretch the area and massage it often only aggravating the problem.
  2. High Hamstring Tendonosis – Tendonosis is a chronic condition as opposed to tendonitis which is an acute condition. Pain is usually reported in the high posterior thigh that can radiate down the thigh towards the back of the knee. The pain will usually increase while walking uphill or running faster and can hurt while sitting or driving. Most runners mistakenly interpret this hamstring pain as “hamstring tightness” or spasm. They attempt to stretch the area and massage it which often causes long term tendonosis and scarring of the hamstring origin attachment at the Ischial Tuberosity.
  3. High Hamstring Tendonopathy – Is a chronic hamstring injury that usually affects the origin near the Ischial Tuberosity. The term “opathy” simply means pathological. The diagnostic name implies that the tendon is damaged and weakened in some fashion. Pain is usually reported in the high posterior thigh that can radiate down the thigh towards the back of the knee. The pain will usually increase while walking uphill or running faster and can hurt while sitting or driving. Most runners mistakenly interpret this hamstring pain as “hamstring tightness” or spasm. They attempt to stretch the area and massage it
  4. High Hamstring Tendon Tear – The hamstring can tear at its attachment on the Ischial Tuberosity. Hamstring tears come in 3 degrees of severity.
    1. Grade 1 – Small tear that will typically respond well to conservative therapy
    2. Grade 2 – partial rupture. May respond to conservative therapy but typically prolonged treatment and healing time is anticipated.
    3. Grade 3 – A rupture of the hamstring tendon will require surgical intervention.
  5. Hamstring muscle strains/tears – Tears in the Hamstring muscle belly are also called strains and come in 3 degrees of severity
    1. Grade 1 Strain – Will normally respond well to conservative treatment.
    2. Grade 2 Strain – Typically responds well to conservative therapy but prolonged treatment and healing time is anticipated.
    3. Grade 3 Strain – May require surgery.
  6. Distal Hamstring Tendonitis – Tendonitis can develop on the distal insertion of the hamstring near the outside (lateral) back of the knee. Often this is confused with Iliotibial Band Syndrome.
  7. Hip F