Mid calf pain...

Good day all!

I currently have a patient that is suffering from Mid-calf pain. Patient is a long distance runner, and has one year of recurring shine splints which was later diagnosed to stress fracture. And recently patient is complaining of "muscular" pain on the medial side of the calf (Between tibia and the calf muscle.) This is happening bi-laterally.

I have tried needling that area, but it was not successful, but does feel release, but it comes back after a few days. And also that area is starting to get stiff/hard.

I know it's a little vague, but I don't really know how else to describe this situation. See if anyone can give some ideas, or if more information is needed. I can provide.

Thank you

Kind regards
Tak Wing

Hi Tak Wing,
Clearly you have used Acupuncture but you have not indicated any other form of treatment. I have had good results from treating the Lumbo-Sacral area and the Gluteal muscles. My observations are that the problems start in the lower back caused by some minor injury which may or may not have been caused by the excessive running. The symptoms in the lower back may have been low grade but eventually the inflammation radiates into the Gluteal(s) muscles. This causes a developing muscle spasm in the Gluteals resulting in stress / compression / spasm of the muscle with consequent pressure on the Lumbo-Sacral nerves with resultant referred symptoms in the posterior Knee area, Calf and Foot.

So my suggestion is to concentrate your Physiotherapy treatment on the source of the problem and "mop up" any palpable inflammation in the referred pain sites. The inflammation in the Gluteals is very important. Its time for your patient to bite the bullet and have a break from running. In my experience it should only take about 2 to 3 weeks of the correct treatments methods. Spinal Mobilisation and Manipulation pus TENS for the muscle problems. I am not an advocate for stretching which may give short term relief but not a fix.
Good luck,
Tony Woodall. Physiotherapist - Retired

Quote:

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Originally Posted by tonywoodall

Hi Tak Wing,
Clearly you have used Acupuncture but you have not indicated any other form of treatment. I have had good results from treating the Lumbo-Sacral area and the Gluteal muscles. My observations are that the problems start in the lower back caused by some minor injury which may or may not have been caused by the excessive running. The symptoms in the lower back may have been low grade but eventually the inflammation radiates into the Gluteal(s) muscles. This causes a developing muscle spasm in the Gluteals resulting in stress / compression / spasm of the muscle with consequent pressure on the Lumbo-Sacral nerves with resultant referred symptoms in the posterior Knee area, Calf and Foot.

So my suggestion is to concentrate your Physiotherapy treatment on the source of the problem and "mop up" any palpable inflammation in the referred pain sites. The inflammation in the Gluteals is very important. Its time for your patient to bite the bullet and have a break from running. In my experience it should only take about 2 to 3 weeks of the correct treatments methods. Spinal Mobilisation and Manipulation pus TENS for the muscle problems. I am not an advocate for stretching which may give short term relief but not a fix.
Good luck,
Tony Woodall. Physiotherapist - Retired

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Good day Tony,

Thank you very much for the advice, I will speak to my patient again, and we will work from the lumbo-sacral region and down.

While the lines at the gym are sure to be extra-long in January, one place that will have lots of sitting room is the sauna. An often overlooked perk of the gym or pool, the sauna is much more than a hot room, rick willianen.No one truly knows the benefits of regular sauna visits more than the Finnish. The history of the sauna and Finland stretch back thousands of years to when the first settlers dug a hole, placed heated rocks in it and poured water on them to release a warm steam and vapour that the Finnish refer to as Loyly.

Interesting stuff. Do you have any references to empirical studies about the benefits of sauna in this respect? I have been enjoying reading about the formation of heat shock proteins lately and would love to buff up my sauna-benefits knowledge even more.

Try physiotherapy . If bruising or swelling is visible consult a therapist asap. I suffered from calf strain and had similar symptoms in the beginning stages. Deep vein thrombosis and hairline fractures can also be the reason for mid calf pain so don't eliminate the probability for that too.I tried massage therapy and physiotherapy for my calf strain and it really helped. Massage therapy soothes pain as well as tightness in calf. Since acupuncture gave you a small relief from the pain before trying it again consider consulting a physician and enquire more on it. Even though walking and such small exercises will be helpful, its much better to get expert advice before any of that.