unexplained calf injury. please help!!!!

[winners]

hi ive had this calf injury for 2 years (im now 17) and basically who ever ive seen no one has been able to sort it. and i have seen tons of physios, consultants and chiropracters.

the calfs are very heavy and stiff and theres always this dull ache, this gets worse with sport but not terribly worse. ie i can play sport if i only do it once or twice a week, if i do more than that the calfs get alot worse. the pain is the same in both legs. (The pain is worst the minute i get out of bed and then eases from then, when i first stand up in the morning my hips shake and i have no balence.)

the thing is ive had loads of tests and all that and no one has really found anything wrong.
as a sports mad kid im sure you can aprreciate im really struggling at the moment and evreyone has run out of ideas as to what it could be.

the current thinking is that this could be something to do with my feet and the way i walk.my feet turn inwards, and my arches are collapsed. i wear insoles but the physio didnt think these were doing much so i have changed to some new insoles.

do you think this could be causing my calf pain? if so how long do you think it would be from changing insoles to see a difference in the calf stiffness?
please offer any advice on what u think this could be or what i should try.
thank you.

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[IceMan]

Your symptoms of decreased balance in the morning is a little disturbing to say the least. Have you ever fallen because of this?

Also do you have any numbness or tingling in the groin and/or loss of bowel or bladder control?

[winners]

i only have the terrible balence for like the first couple of mins when i get up and then it goes and the calfs ease a bit. umm have never really fallen but have defiantly stumbled alot.
nope had none of those symptons, no ones really been able to find out what it is or do anything do relieve it. thx

[alophysio]

Hi,

Has your physio checked you back or pelvis for a problem?

It is rare for both calves to "go" at the same time and be both bad for the same amount of time.

It sounds like possible referred pain, likely from the back. Might even be from the SIJ.

let us know what all the different people you have seen say...

[winners]

yea for a while was sure it was the back
i had an MRI done on the back and it showed i have a slightly narrow spinal cord and i disc buldge in the lower back. at first i was told this was what was causing it but when i saw the specialist consultant about it he said it wasnt causing the injurys so have given up on it being a back injury. not to sure whether should go and get a second opinion on that but he was a specialist.

have had nerve conduction studies which were all fine
and a muscle biopsy which was fine which i guess rules out a nerve problem and a muscle problem.

[IceMan]

yea for a while was sure it was the back
i had an MRI done on the back and it showed i have a slightly narrow spinal cord and i disc buldge in the lower back. at first i was told this was what was causing it but when i saw the specialist consultant about it he said it wasnt causing the injurys so have given up on it being a back injury. not to sure whether should go and get a second opinion on that but he was a specialist.

have had nerve conduction studies which were all fine
and a muscle biopsy which was fine which i guess rules out a nerve problem and a muscle problem.

My first inclination when reading your original post was that it was referred pain from the back and with your symptoms of imbalance in the morning a possible cauda equina syndrome. Your MRI results appear to have ruled that out though.

Just because one specialist has ruled out the back as the cause of the symptoms doesn't mean it isn't coming from the back. Also a negative nerve conduction test doesn't necessarily rule out a "nerve problem". Electrodiagnostic testing does not assess the smaller nerve fibers which are typically responsible for pain transmission.

You mentioned in your original post that you use "insoles". It amazes me that arch supports are prescribed as a solution for overpronation because the arch is not a weight bearing structure. Posted orthotics or wedges on the heel and/or forefoot would be the better solution because this addresses the actual cause of the foot overpronating in most cases.

cptnsausage refers to this in more detail in an answer on an earlier thread:
Just as a quick additional to this - A lot of the time Flat feet are indeed the cause of such problems and I've found certainly that it is misdiagnosed (as fallen arches) and mismanaged in the vast majority of cases. Most Flat feet problems are not fallen arches but are simply due to an everted calcaneous an as such have the secondary effect of causing the longitudinal arch of the foot to disappear. Now Knowing that I find it scary that for almost every flatfoot problem is simply to prescribe arch supports - unless u happen to be uber flexible then the arch supports will simply cause pain and in some extreme cases can compound the problem further and cause damage - this is because a simple arch support in the case of an everted calcaneous will recreate your arch but will do absolutely nothing for the heel problem, which means your foot is being twisted further out of alignment (forefoot will end up in excess suppination with the calcaneous still everted = pain and damage)

Now taking that into account the answer is quite simple. I believe that in your case you would benefit from a pair of insoles with medial wedges added to the heel (3/4 length with MINIMAL arch support and probs about 10-15 degrees of medial wedging at the heels) this will essentially treat the cause and not the symptom. I not only speak as an orthotist who see's this just about every day but also as a patient! - my doctor tried for years to fix me flat feet with arch supports etc but all it did was cause pain and like yourself i found that particularly when I was active i got pain in my shins (sometimes my knees as well - Im Very flat footed lol) - After i finished my degree and started working i made myself a pair of insoles similar to what I've suggested for you and the pain has pretty much disappeared - even during sports etc. Thats just my suggestion based on the info you have given us but I'd strongly reccomend as others have that you get a full assessment first - the fast way to tell if u have everted calcaneous' is to stand straight with your back to a mirror - if the line of the back of your foot where the achilles tendon runs splays outwards at your heel then its a positive test and the problem is definitely not a fallen arch and is an everted calcaneous.

I agree with whats been said here 100% that you need to treat the biomechanical problem and not just try to get rid of the pain, and the above is how I'd go about it as an Orthotist but i know a vast number of podiatrists who treat numerous patients using the same rationalle with great success so it might be worth giving it a try in your case.

hope that maybe gives u another option to explore - although theres not a lot of literature on this particular subject but I will be happy to answer any questions you have

[alophysio]

Hi,

just because MRI is negative, it doesn't mean it is not the back referring the problem.

find someone who makes sense. i really believe that when you hear an explanation that is right, it will make sense. At the moment, what people have told you doesn't sit quite right which is why you are asking a bunch of annonymous physios!

Good luck in finding that person i hope it goes well for you...

[Yarok]

Hi

i agree with guys before, you need proper holistic assessment, spine, pelvis, hip, knees, feet, structure and functions

all the best

[winners]

thanks all for the replies