Common Lower Body Injuries in Athletes: What You Need to Know
Introduction:
As physiotherapists, we see firsthand how much wear and tear athletes put on their bodies, especially their lower limbs. Your lower extremities bear the brunt of athletic performance. Whether you're a weekend warrior, a seasoned professional, or just starting out in sports, understanding the common lower extremity injuries can help you prevent them and recover smarter if they do occur.
In this blog, I’ll walk you through the most common lower extremity injuries in athletes, why they occur, how to recognize them early, and most importantly, how to manage and prevent them.
1. Ankle Sprains
What it is: One of the most frequent injuries in sports, an ankle sprain occurs when the ligaments supporting the ankle stretch or tear, usually due to a sudden twist, roll, or awkward landing on the foot.
Common in: Basketball, soccer, trail running, pickleball, volleyball, dance, cheerleading, gymnastics, and any sport involving quick changes in direction.
Symptoms: Swelling, bruising, pain around the ankle, instability, limited movement, and difficulty to put weight through the foot or ankle.
Risk Factors: Uneven surfaces/turf/terrain, poor footwear, lack of ankle stability, inadequate warm-up, previous ankle injuries/sprains, poor balance, weak ankle and foot muscles.
2. ACL Tears
What it is: The anterior cruciate ligament (ACL) helps stabilize the knee. A tear is a serious injury that often occur during sudden stops, changes in direction, or awkward landings. It can require surgery depending on the severity of the tear and a long rehab.
Common in: Soccer, football, skiing, snowboarding, basketball, volleyball, rugby, and sports with pivoting or jumping.
Symptoms: A “pop” sound, rapid swelling, knee giving out or feeling unstable, pain, and diffculty weight-bearing.
Risk Factors: Uneven surfaces/turf/terrain, poor landing and cutting mechanics, lack of neuromuscular control, weak hamstrings/glutes/or quads, female athletes (due to anatomical and hormonal differences).
3. Patellofemoral Pain Syndrome (Runner’s Knee)
What it is: Pain around or behind the kneecap, often due to overuse or poor tracking of the kneecap.
Common in: Running, cycling, soccer, basketball, volleyball, hiking, dancers and athletes in jumping sports.
Symptoms: Dull ache around the knee, especially after sitting, squatting, or using stairs.
Risk Factors: Weakness of hip abductors and external rotators, overpronation of the the feet (flat feet), tight hamstrings or calves, muscle imbalance around the knee, sudden increase in running volume or intensity, poor biomechanics during squats or lunges.
4. Hamstring Strains
What it is: A tear or stretch in the hamstring muscles at the back of the thigh, especially during high-speed movements.
Common in: Sprinting, football, track and field, soccer, rugby, and sports involving explosive running.
Symptoms: Sudden sharp pain in the back of the thigh, swelling, and bruising, muscle tightness.
Risk Factors: Muscle imbalances (weaker hamstrings vs quads), inadequate warm-up or flexibility, fatigue or overtraining, poor sprinting/running mechanics, history of previous hamstring injury.
5. Shin Splints (Medial Tibial Stress Syndrome)
What it is: Inflammation of the muscles and tendons around the tibia (shinbone), typically due to overuse and repetitive impact.
Common in: Runners (particularly long distance runners), dancers, and athletes in running sports.
Symptoms: Dull, aching pain along the shin that worsens during or after activity.
Risk Factors: Rapid increase in training load, poor footwear or inadequate arch support, running on hard or uneven surfaces, flat feet or abnormal walking patterns/gait mechanics, weak or tight calf muscles.
6. Achilles Tendinopathy
What it is: Overuse of the Achilles tendon, causing pain and stiffness, and sometimes swelling at the back of the ankle. This occurs especially in the morning or after exercise.
Common in: Running, basketball, volleyball, soccer, jumping sports, tennis pickleball, and sports requiring frequent acceleration.
Symptoms: Gradual onset of pain in the back of the ankle, thickening of the tendon, stiffness, especially in the morning or after exercise.
Risk Factors: Tight calf muscles, sudden spikes in activity or training volume, poor ankle mobility, previous Achilles injury, training on hard or inclined surfaces.
Physiotherapist’s Approach to Low Extremity Injuries:
As physiotherapists, our approach to managing lower extremity injuries in athletes goes far beyond simply addressing pain. It's about restoring optimal function, preventing recurrence, and supporting the athlete’s return to performance—physically and mentally. Each injury is unique, but the foundation of our approach remain consistent:
1. Comprehensive Assessment
Every athlete's injury tells a story. First we want to understand how it happened, what movements triggered it, and how it’s affecting performance. This is followed by a full physical assessment, which includes: range of motion testing, strength assessment, functional movement screening, gait and biomechanics analysis
By identifying not just the injury, but also the contributing factor, like poor motor control, imbalanced strength, or faulty mechanics, we can build a more targeted plan.
2. Individualized Rehabilitation Plan
No two athletes recover the same way. We create a personalized rehab program based on the athlete’s sport, position, goals, and injury severity. This typically includes:
- Early mobility and pain management
- Progressive loading of the injured tissue
- Neuromuscular re-education
- Sport-specific drills and return-to-play protocols
We also focus on restoring kinetic chain function, how the ankle, knee, hip, and core all work together, because isolating one joint often overlooks the real cause.
3. Load Management & Return-to-Sport
One of the biggest risks of reinjury is returning to play too soon or too aggressively. We work closely with athletes to guide load progression:
- Monitoring weekly training volume
- Balancing rest and recovery
- Setting objective performance milestones (e.g., strength benchmarks, hop tests, agility tests)
- Ensuring both physical readiness and mental confidence
- Return-to-sport is not just a date, it’s a process.
4. Education & Empowerment
Education is a cornerstone of physiotherapy. We want every athlete we work with to walk away understanding why their injury occurred and how to reduce the risk moving forward. We’ll cover:
- Prehab exercises to build resilience
- Proper warm-up routines
- Recovery strategies
- Technique corrections in running, jumping, or lifting
5. Ongoing Support
Even after return-to-sport, physiotherapy doesn’t stop. We often provide maintenance check-ins, screen for early warning signs of overuse or compensation, and adjust programs as performance demands increase.
Top 6 Injury Prevention Tips:
Prioritize movement quality over volume.
Integrate strength training into your routine.
Gradually progress training loads.
Don’t skip your warm-up and cool-down.
Listen to your body—pain is information, not a weakness.
Work with a physio or coach to address biomechanical faults early.
Conclusion:
Lower extremity injuries can sideline even the most dedicated athlete, but they don’t have to bench you for your entire season. As a physiotherapist, our job isn’t just about rehab; it's about education, prevention, and helping you move.
Call to Action:
If you're suffering from or at risk of lower extremity injuries including ankle sprains, ACL injuries, patellofemoral pain syndrome, shin splints, hamstring strains or Achilles tendinopathy, don’t wait for it to become a bigger problem and have you benched. Contact Integrative Physiotherapy and Wellness today to book an assessment and start your recovery journey. Our physiotherapists are here to help you move better and stay active!
References:
Kelley, E. A., Hogg, J. A., Gao, L., Waxman, J. P., & Shultz, S. J. (2023). Demographic factors and instantaneous lower extremity injury occurrence in a National Collegiate Athletic Association Division I population. Journal of Athletic Training, 58(5), 393–400. https://doi.org/10.4085/1062-6050-0673.21
Murphy, D. F., Connolly, D. A. J., & Beynnon, B. D. (2003). Risk factors for lower extremity injury: A review of the literature. British Journal of Sports Medicine, 37(1), 13–29. https://doi.org/10.1136/bjsm.37.1.13
Prieto-González, P., Martínez-Castillo, J. L., Fernández-Galván, L. M., Casado, A., Soporki, S., & Sánchez-Infante, J. (2021). Epidemiology of sports-related injuries and associated risk factors in adolescent athletes: An injury surveillance. International Journal of Environmental Research and Public Health, 18(9), 4857. https://doi.org/10.3390/ijerph18094857
Ross, L. K., Tuffiash, M., Robell, K., & Hunt, K. J. (2021). Epidemiology of lower extremity injuries in collegiate student-athletes: Insights from the Pac-12 Health Analytics Program. University of Colorado Anschutz Medical Campus. https://medschool.cuanschutz.edu/docs/librariesprovider31/education-docs/research-track/35th-research-forum-2021/abstracts-session-3/ross-lexis---abstract-research-forum-updated.pdf
Verywell Health. (2016). Common types of sports injuries. https://www.verywellhealth.com/sports-injuries-4013926
