Calf strain or Hamstring Tendonitis

[Brian_C]

Hi,
I'm at my wits end. I strained the back of my knee in Feb 2006 (almost 18mths) while out for a run, approx. 15 stone at the time, now 17stone. Stopped, stretched it and kept going. The next morning while swimming (preparing for the triathlon season) the back of the knee became very sore. Rested for 2-3weeks but the pain presisted.

It was at about this point I seen a physio, and am still seeing, who said it was a strain of the two hamstring tendons as they join the shin bone, 4 weeks you'll be fine. I've since had an knee MRI, spine MRI (with some disc compression, but nothing to be concerned about), X-Ray, Ultrasound scan, steriod injection and a Nerve conduction test of the left leg. I've seen a Ortapedhic and a sports injruy specialist. It's not a Bakers Cyst, ligaments and tendons are fine in the MRI. Nerve test was clear. But nothing has changed. I still have this constant dull pain with a little swelling at the back of the knee, just at the point where the skin folds, and below, in the centre not to the sides. When phsyio presses on the hamstring tendons at top of the calf, below the knee line it's very very sore in one little area, no bigger than a 10p peice.

If I do any cycling, running or swimming it gets very sore, but only after, not too bad during. Worst is a spinning class, very very sore for 2-3 days. Probably caused by all the out of saddle cycling. I can do hamstring curls and calf raises without pain, maybe a little but nothing major. We (physio and sports injury specialist) thought maybe a popliteal strain of the muscle or tendon or tight neural tissue. When I do a neural stretch, (sitting on bench, chin in chest, back straight, toes pointing up, and I straighten the knee the left leg does not have as much movement as the right.

Physio has noted I have hyper-extending knees. Not a big amount, he thinks this is not letting the injury heal.

We've tried RICE, strapped it up for about 5 days, slight improvement, but then back to normal constant dull pain. Next step is to stick in a camera and look at the popliteal, hamstring tendons and that general area.

Can anyone HELP!! Any idea's or suggestions??

The only thing apart from sticking in a camera I can think of is to put it in a brace for 2-4 weeks to let things settle down, or purposely make it very very sore for the camera going in.

Cheers

Brian

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[Brian_C]

Hi.

Physio 1 - month 0 to month 12-14
Physio 2 - month 14 for one month.

When it's sore I can stretch it no bother without making it worse. It's not like a torn muscle pain. It's like a warm/burny feel. Never get a sharp shooting pain. No numbness or pins and needles. Even when it is sore I can do weights on it.

1) Physio 2 sessions on the back were about 30-40mins of a chat at the start followed by only working on T10-12, followed by having me running on toes in the hallway to see if there is any change. She said she'd build up the time spent and pressure applied working on the joints over the weeks. (Yeah right I thought, so you can get paid more, more weeks = more money)

2) Physio 1 who I'd been seeing for about 12 months worked on the lumbar region after 8-9months of a sore knee. He worked the area because I'd been getting sore lumbar. He was doing a kinda bouncing/pushing movement on both sides of spin, L2 to L5. Some joints where more tender than others.

3) No Stork test or ASLR test. He did get me to bend from the waist with straight legs while looking at the spine.

4) While starting running/triathlons I did have terrible trouble with shin splints (or at least sore shins). Sorted this by get 2 x gait analysis and changing shoes. Eventually got it under control using a cushioned neutral shoe. I had been using various motion-control shoes. But once under control I had very little bother with it.

5) I think it's no coincidence that being a "big lad" is causing some of the problem. I've always had big shoulders, even when I was a 12stone 1st Cat cyclist 10 years ago. More recently while 15stone I would have been pretty muscular with a bit of fat, while at 17stone it's mostly fat. Having taken up triathlon, swimming would have bulked my shoulders a little. Note: when I did cycle racing people aIways mentioned I sat far back on the saddle. This was from the age of 14-26.

6)


7)
a. aggravating activities: Swimming, Cycling (gym and road), lunchtime power walks of 20-30mins make it pretty sore, everyday strolling/walk make it a little sore but calm down after 3-4hours, sometimes even sitting in work will make it sore.
b. easing activities: Rest.
c. wake up, during the day, and what happens at night: Morning is generally always sore/stiff for the first 10-15mins. During the day I sit at a computer screen, sometimes it's sore with a straight/crossed leg, at night time there is no real pattern.
d: ALL the treatments: Physio 1 seen for 12months approx, treated the knee with friction, laser and ultra sound. then got a knee MRI and sent me to a International Rugby Orthopedic (he's at the World Cup now)(I don't wanna mention any names here) who only really looked at the cartilage and ligaments and said no problems. He asked me to get blood tests, which were clear. I then got a Ultrasound Scan and an X-Ray. This was clear.
Next was a Sports Injury Specialist he looked at the body as a whole, posture, alignment, range of motion. He thought maybe a nerve was being compromised. Then I started getting lumbar discomfort (8months after sore knee). Returned to Physio 1 when he treated the lumbar, eventually he fixed that. While then he started looking at the knee again when he only gave it laser and ultrasound. He also mobilized the head of tibia joint which made no difference, thinking behind this was trapped nerve. Then I got a spin MRI (see above for results) and Nerve Conduction Test (all clear).
Then he mentioned going back to Orthopedic to get a camera into the knee, at which point I thought, wow, get a second Physio.
Physio 2 has only ever worked on T10-12. 3 Sessions of about 30-40 mins. She did some range of movement and stretching tests.

e. What do I think is wrong. Oh God.... Sometimes I think it's some kind of scar tissue where a nerve, muscle or tendon is going under the belly of muscle or other structure. But this would not explain why at times it would get sore with very little movement or first thing in the mornig or just sitting in work. Does this sound possible to you? Don't forget there is still a little swelling behind the knee. I kinda feel if a surgeon went in and opened a space to release pressure it would be fine. But I'm not qualified to say. Now, all that said I don't think it's a coincidence I'm getting trouble with my back.

[Brian_C]

I'll try to get a video of me cycling on my turbo from side and back. I'll also get a vid of me walking, fromfront and back including both the knee (looking for hyper-extending effect) and the biomechanics of the foot.

BTW, Physio 1 had thought it was tendonitis more recently, which I don't entirely except.

Thanks for everyones feedback, very very much appreciated.

[Trishark]

Hi,
I'm at my wits end. I strained the back of my knee in Feb 2006 (almost 18mths) while out for a run, approx. 15 stone at the time, now 17stone. Stopped, stretched it and kept going. The next morning while swimming (preparing for the triathlon season) the back of the knee became very sore. Rested for 2-3weeks but the pain presisted.

It was at about this point I seen a physio, and am still seeing, who said it was a strain of the two hamstring tendons as they join the shin bone, 4 weeks you'll be fine. I've since had an knee MRI, spine MRI (with some disc compression, but nothing to be concerned about), X-Ray, Ultrasound scan, steriod injection and a Nerve conduction test of the left leg. I've seen a Ortapedhic and a sports injruy specialist. It's not a Bakers Cyst, ligaments and tendons are fine in the MRI. Nerve test was clear. But nothing has changed. I still have this constant dull pain with a little swelling at the back of the knee, just at the point where the skin folds, and below, in the centre not to the sides. When phsyio presses on the hamstring tendons at top of the calf, below the knee line it's very very sore in one little area, no bigger than a 10p peice.

If I do any cycling, running or swimming it gets very sore, but only after, not too bad during. Worst is a spinning class, very very sore for 2-3 days. Probably caused by all the out of saddle cycling. I can do hamstring curls and calf raises without pain, maybe a little but nothing major. We (physio and sports injury specialist) thought maybe a popliteal strain of the muscle or tendon or tight neural tissue. When I do a neural stretch, (sitting on bench, chin in chest, back straight, toes pointing up, and I straighten the knee the left leg does not have as much movement as the right.

Physio has noted I have hyper-extending knees. Not a big amount, he thinks this is not letting the injury heal.

We've tried RICE, strapped it up for about 5 days, slight improvement, but then back to normal constant dull pain. Next step is to stick in a camera and look at the popliteal, hamstring tendons and that general area.

Can anyone HELP!! Any idea's or suggestions??

The only thing apart from sticking in a camera I can think of is to put it in a brace for 2-4 weeks to let things settle down, or purposely make it very very sore for the camera going in.

Cheers

Brian

What did you finally do? Did you find out what it was? What you describe I am going through for 3 months and Im frustrated and watching my Tri season go by...?