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Old 11-25-2011, 04:54 AM   #1
Jessica Dell'Aquila
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chronic calf pain

Hello all-
Anyone else with this problem?
I injured both calves whilst on an intense run 5 years ago. Both, at the same time, and I could barely walk home. 2 rounds of physical therapy, acupuncture, MRI, medical grade orthotics, NSAIDS, venous/arterial ultrasounds and stress test for chronic compartment syndrome later, I have had 3 different doctors shrug their shoulders at me.

I had pain and difficulty walking (the muscles mid-calf were very, very tight and painful to the touch) for quite some time, and deep tissue massage was the only thing that really got me back into action, albeit limitedly. Thankfully, I can do a lot now, but have NOT been able to get back into running; that and too much jumping causes a few day relapse in pain.

I suspect I have a defect now in soleus and gastroc, maybe a chronic shortening, perhaps because of being ridiculously non-compliant with stretching before my injury.

I would LOVE any thoughts on this.....running was my passion and I thought CF might help me condition my calves to improvement as well as thorough stretching, but after about 6 months still a no-go.

Thanks!
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Old 11-25-2011, 08:31 AM   #2
Mike Booth
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Re: chronic calf pain

Have you ever tried cycling? Does that aggravate the symptoms or is it only running & jumping?
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Old 11-26-2011, 06:20 AM   #3
Jessica Dell'Aquila
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Re: chronic calf pain

I am good with cycling. Just propulsive activities. I have a limited amount of time with these types of activities before the pain comes.
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Old 11-26-2011, 10:25 AM   #4
Mike Booth
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Re: chronic calf pain

If the pain arises after 10-15min you might have fatigued gastroc/soleus and recruiting deeper muscles. Chances are when you have had deep tissue treatment the pressure is broad and the focus is general?...Find a therapist that does ART.
Next time you have soft tissue treatment have the therapist do some specific work to tib posterior. The tendon does inversion of the foot and plantar flexes the foot at the ankle. This is the same action that is performed when running. When you cycle the foot is mainly doing plantar flexion. So there is a slight distinction that might point you to tib posterior as being the culprit.
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Old 11-26-2011, 05:43 PM   #5
Steven Low
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Re: chronic calf pain

What did your physical therapy focus on?


The fact that deep tissue massage helps likely means there's some general limited ability of the gastroc/soleus to respond well to exercise -- they fatigue and then likely cramp up and stay cramped up much like trigger points do. Some of that could be due to tighter compartments, or dysfunction at the ankle as well.

I'd likely think that a bunch of what Mike Booth said is true, and it also may be a good idea to generally just get in some myofascial work on your plantar fascia, calves, and hammies just to see if loosening up the whole posterior chain helps a bit.

Then start implementing some exercise that focuses on eccentrics to work your endurance back up after your muscles are a bit better.
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Old 11-27-2011, 05:53 AM   #6
Jessica Dell'Aquila
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Re: chronic calf pain

I hope I'm answering this correctly, but the PT focused on stretch, massage and strengthening the calf muscles. He thought that my abnormal spinal curvature may be trickling down, so he worked that some with back strengthening. Some ultrasound was used, and stim was tried. Strengthening of the calf really only caused additional pain and near muscle spasm sometimes. Only at the very end did he assess my running mechanics, but really only identified very short stride....and didn't do much with that in the way of further therapy. I'm not sure if it was ART, but the massage was pretty localized to one area of my calf - just below the meaty part of the gastroc and a couple of knots in the gastroc. And the pressure was so intense I would be nearly crying every time. I haven't had treatments for a few years. I've been maintaining by either staying away from certain activities, or resting a few days after overdoing it.

I appreciate the feedback. It seems that another trip to a physical therapist might be of some benefit based on your comments. Physicians didn't seem to offer all that much in the way of mechanical assessment. Since no one has told me officially that my running/jumping days are over, I might as well keep trying.
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Old 11-27-2011, 11:48 AM   #7
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Re: chronic calf pain

Try to get in to see an ART practitioner.
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Old 11-28-2011, 04:51 PM   #8
Aaron Gainer
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Re: chronic calf pain

Seek an ART practioner or a massage therapist who is highly skilled in deep tissue and/or cross-frictional massage. Learn to spot treat(massage and gentle stretch) your calves everyday before and after exercise if you want to make change.

Google Dick Hartzell's ankle routine. I found that along with the 6 foot drills really help keep the calf strains and cramps down!
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Old 11-29-2011, 05:15 AM   #9
Jessica Dell'Aquila
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Re: chronic calf pain

thanks guys.
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Old 11-29-2011, 08:17 AM   #10
Sheldon Victorine
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Re: chronic calf pain

i have this exact same problem and it comes from running/high impact activities (ex: plyometrics). I would be interested into how you are progressing in recovery, so be sure to keep us posted! Thanks
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