Pain on inside of calf

Hi there

I really hope someone can help me with some chronic calf pain I have been experiencing for the last 9 months. I am (was!) a keen cyclist, I had been really putting the miles in and ramping up my training last year, I bean experiencing some knee pain and subsequently tore my gastrocnemius muscle, in the very middle of the back of my calf. I saw a physiotherapist, when I came back to cycling I experienced some dull aches in my lower leg muscles, but these gradually reduced with the exception of a pain on the inside of my calf which still persists (since Oct 2008).

The pain comes on only when I cycle (I have tried changing my cleat positions but to no avail). It is not a sharp pain but more of a cramp / fatigue type pain that comes on relatively quickly after about 20 minutes of reasonable exertion. This pain is specifcially felt about 1/3 of the way between my knee and ankle, just on the inside of the gastroc / soleus area. The pain reduces if I drop down a gear and stops when I stop cycling. I will not feel anything for a few hours but I will then gradually experience some mild pain when moving around, when laying in bed on my back with my feet relaxed and pointin outwards I will feel some pain/aching on the inside of my foot which seems to only occur on the night or two after this, I also get some pain on the inside at the top of my tibia and along the inside of the lower portion of the tibia.

I have been to a physio who thinks it may be a weak tibialis posterior muscle, but I have been working at this (bent leg calfraises and strectches) for 3-4 months with no improvement. I have also had a knee mri and a lateral release about 2 months ago as the consultant thought it may be to do with this, but getting back into cycling now on a static bike I get the same sensation.

If anyone has any thoughts this would be much appreciated.

Thanks

Phil

I would suggest that you add in correct stretches for the flexor hallucis longus and flexor ditorum longus muscles, these are muscles that are deep to the calf muscles and you use them to press the pads of your toes downwards. To stretch these muscles you do the same as a calf muscle stretch but firt place a phone book or block in front of your toes so that your toes are at 90 degrees to your foot.

I would also add very regular deep massage to this area either yourself or by a sports masseur.

Alternate ideas would be to see a sports physician to test for posterior compartment syndrome. This is where there is a restriction of the venous blood flow out of the muscle compartment after exercise thus high pressure. There is a pressure test that can be done to diagnose this condition.

It would be great to hear back if any of these ideas are helpful