little help with a leg injury?

Hi, I hope someone can help. Some months ago while struggling through some particularly slushy mud on my mountain bike (mtb), I felt something pop/pull/tear (not sure) in the back of my calf muscle. I walked for a few mins then was good to get back on and ride back to my car being careful not to induce anymore spasm type feelings. Since then I've been training on off with weights, on my bike and running a bit (with a reasonable amount of stretching as well) but the feeling still persists. I've read lots of muscle strain articles but they all talk of swelling/bruising if it's a serious, long term injury. I have suffered niether, nor any real pain. It just comes on as a numbness like if you squat for too long then try to stand up quickly. Neither does it effect the muscles function (strength/endurance ability). I did a 40 mile race in the Cotswalds some weeks back and it wasn't too bad, yet just lately it's gotten worst again.

The main problem is at the back of my knee area, just above the main calf muscle. On the section of the calf (I think it's still the calf up there?) that runs up into the back of the knee. I really want to sort this out and as of yet I'm not entirely convinced that I know what the problem is. If nobody can offer advice, can I get a physio consultation for free on the NHS or is that not possible? Any help would be great

Numbness is related to your nerves, could be over stretched, compressed, but really it's hard to give you an answer that based on what you wrote or without actually assessing you in person.

As far as seeing a Physio on the NHS is concerned, you need to visit a GP who will refer you on. Both physio on the NHS and your NHS GP will be free.
The only downside, is that as your complaint doesn't seem to be too bad, you might have a quite a wait on the NHS, as they prioritise based on severity. As the waiting lists are pretty long, you might be kept waiting a while.

Hope this helps

thanks for the advice. I was aware that it could have been nerve problem, but not being particularly medical/scienifically minded I wasn't too keen on tackling any articles on the subject. But now I think I will. If anyone else can elaborate based on the limited details I've given that'd be very helpful.

Do u have Back pain??

No, the pain is localized directly in the area mentioned. The very top of the calf muscle/at the back of the knee area. I'm wondering if perhaps the problem is that I (absolutely definately) suffered the injury while biking and since then I've had no significant time off the bike, so perhaps I'm constantly aggrevating the damaged part.

Also I heard that strengthening a damaged muscle helps to avoid further injury, so last thurs, before doing my weekly hour of circuit training at the gym, I did a large amount of sets of my calves. On the leg press, the calf press, standing on my tip-toes with a barbell on my shoulder etc, etc. Since sat morning I have had to walk on my toes as it's too painful to let my calves extend, but I'm hoping that this will help. I do naturally have quite skinny calves compared to my upper body, so strengthening/bulking them up seems like it may be beneficial. I'll have to wait and see how it goes. Maybe I'm doing all the wrong stuff!

Hi - i agree - it is hard to diagnose with such limited information...

Why don't you consider paying for 2 treatment sessions with a physio who has an interest / speciality in cycling? Explain your situation and sort it out.

The reasons why are:
1. I know the NHS is free but sometimes you get what you pay for...
2. You won't have to wait long to get in to see a private physiotherapist
3. What price do you place on your recreational activities?
4. You will get expert advice - at the moment, you are trying to help yourself using things you have read on the internet etc. It is kind of like servicing your car on your own - it is fine when there are routine things like changing oil, etc but when something goes wrong, you will need to take the car to the mechanic. It is the same with your body - most people don't have a problem taking their car to a mechanic for hundreds of dollars just for a tune up but they baulk at doing it for their own bodies - and the bits of your body aren't really replaceable!!

My tip is to seek professional help. I personally would like to help but i ned to see your knee in action to be helpful.

When you do see a physio, make sure you tell them up front that you don't want to be stuck on machines but worked on by experienced manual therapists.

Thanks

Hey I guess you're right. Perhaps I will have to go and see a private physio - I think that's some good advice. I guess the problem is money - I like to spend my hard earned cash on things I can enjoy and although getting medical help is related to enjoyment in a way, I dont think a date with a physio is a calender entry I'll count down to with excitement! But thanks for the good advice (and the tip on what to ask for with regard to manual therapy). I will get professional help.

No problems garjagan. The rest of this comment is not really directed at you but a musing for further comment - i am not "preaching" but if you think i am, i am sorry and you can tell me to get of my soap box! But i would like to hear opinions on what others think about asking people to get to physio and pay for it themselves...

Over the years, i have noticed that people who are used to getting something for free (like treatment) have difficulty going to private practices because if they wait, it will be for "free". Kinda of like saying "why go to the movies on a Saturday when tuesday is half-price" - yet people still go on Saturdays because of the convenience of the time.

I think it is a false economy because waiting weeks can actually mean you are longer off work and sport and spend more time (which is money) getting better because it wasn't sorted in the first week.

Do others have any thoughts on how to encourage people to seek treatment they have to pay for before getting into NHS physio?

Thanks

I would definitely encourage you to seek professional help to explore the condition of your hamstring and knee joint.
A tight hamsting (subjected to an overstretch) may lead to posterior knee pain around the area you descrbing. When stretching the hamstring do they feel the same on both sides or do you feel the stretch earlier on the affected side?

Actually, just to be awkward, I have to say that the unaffected side is less flexible - but I think (maybe) that is a long running condition. Although I have spent years surfing, skateboarding, bmxing/mtbing and just generally treating my body like a crash-test dummy! I do also wonder about the effect cycling has on the body as on a bike the right leg has to do more work because it is directly engaging the drivechain and creating the large part of the power. When I was racing not long ago I was behind a very fit looking rider, but I was amazed to see that his right leg muscles were noticably larger that his left, almost like atrophy had set on on left leg. I guess in terms of a symmetrical workout running or something which distributes the load evenly is better.

And thanks for the general advice alopyhsio. As for getting people to see a private physio, I sometimes think the average person with a niggling injury is like a drug addict, they can get all the advice they want but ultimately, it's their decision which gets the ball moving. Plus, I think most people are in fear of being told what's wrong with them - full stop - let alone with the thought that they'll have to pay to recieve the ominous write-up of their ailment!

thanks for that garjang - i think you definitely have it right about people not wanting to know!

As for the hypertrophy of the right leg, i think it may be dependent on the rider's dominant leg - the way a bike is set up, i wouldn't think that the left pedal is different to the right pedal since they have to go through the same joints to the cogwheels. When you get tired, you tend to drop the power in the non-dominant leg (weaker leg for want of a better term) and so exercise the "stronger" leg longer and so over time set-up a bulk difference.

Alternatively, the pelvis might also be overworking on the dominant side when you get tired and setting up a similar pattern where the dominant side is overworking. The lists can go on and on!

Good luck and let us know how you go...

I am not a physiotherapist nor trained in any other medical discipline. I am a practitioner of EFT.

Rather than get in to a lengthy discussion about what EFT is I'll just send you to a couple of web sites and you can decide if it works for you.

Good Luck

www.emofree.com/ (search this site for calf or knee injury)

www.emofree.com/articles/range-of-motion.htm

Al Rodee

Hi Al,

Are you able to comment on how you and your particular techniques might be beneficial for garjagan - otherwise it just looks like an ad on a forum...

Alophysio. Just a quick note to say that I totally agree with you regarding people not willing to pay to look after their own body and I often that very same example of paying whatever a mechanics asks for them to fix your car! I am the very same. I would also say that some of it comes from the fact that the mechanic will ask for a one off payement whereas looking after your body may require multiple visits. I know some alternative practioners create a dependancy, and sadly some physios just wack a machine on patients and leave the patient, so I guess patients are warey of that type of practice and therefor would rather not enter into it at all.

J

Sorry, I'm new to this. First there is no charge to help yourself with EFTso I'm not trying to sell something and, in fact, the founder, Gary Craig, gives away the manual and thousands of anecdotal testimonials because his hope is that the world will learn the value in these techniques.

Go to www.emofree.com and/or www.tapping.com to learn more about it.

Second. EFT is based on the premise that ALL negative emotions are CAUSED by a block in the body's energy system. Many of you practise acupuncture, acupressure, massage therapy and other disciplines that stimulate energy systems as practised in ancient Chinese medicine. EFT is the art of tapping on specific meridians while focusing on a specific emotional or physical issue. The idea is to balance the energy flow and release the block that is causing the negative emotion.

In this case the emotion (or block) might have been created at the time of injury. When we injure ourselves we know it. Usually, there is anger, fear or frustration around the injury. "Will I recover"? "How painful will this be"? "That was dumb"....all the things we think of at the moment of trauma. This block can impede full recovery. The other possibility is that the tissue, ligaments and muscle surrounding the injury all went into protection mode when the injury occurred. Now that the knee is mostly repaired the cellular memory of protection may remain. EFT is particularly effective at dealing with both of those issues.

There is too much to be more specific here, this is a deep and multifaceted subject. Suffice it to say, I have had remarkable success practising EFT on myself and many of my friends with problems ranging from..."when I was little and my mother locked me in the closet..." to elliminating heartburn, headaches and improving my basketball and golf game.

I believe ALL range of motion restrictions can be improved by using EFT

Hope this is more enlightening.

Al

THanks Al for the information - i didn't think you were trying to sell anything, just that it may lok like it - some people do try to advertise that way on here...

So what you are saying (so i get this clear...) is that ALL negative emotions are caused by injury/physical blocks? I might have a problem with such a strong statement using the word ALL.

I don't have any doubt that emotions and physical injury / trauma etc are linked. In fact, this has been described for some time. I think you said earlier that you aren't a physiotherapist or other medical therapy. Perhaps you have heard of Waddell and his biopyschosocial model of pain? Or Lee/Vleeming et al's integrated model of function which has emotions as one part of the possible domains that need to be addressed (see attached).

Is EFT like NLP (neuro linguistic programming) in any way? EFT sounds like it uses kinaesthetic modalities to reorganise the processing of the emotions.

I know as a physio that people develop abnormal/dysfunctional/less efficient motor patterns often from just one event. It is not a stretch of imagination to consider that emotions get attached as part of that pattern.

Some questions if you wouldn't mind...

To use EFT, would you ask the patient to get materials and DIY or have us learn some or just refer off?

What is an example of using EFT - a case study you may be able to present relevant to this case perhaps?

Have you worked with any health professionals before?

Thanks

Hi ClinicServer,

We would be happy to learn more about EFT. I have tried going thru the link that you mentioned about tapping. And I think that am quite pretty open to any ideas as long as it benefits the patients. Forgot to mention that reiki also helped my patients eps. to those who are having arthritis.

Thanks ClinicServer for your post.:)

Cheers!!!

charlize29:D

"The premise of EFT" is that ALL negative emotions are created by a blockage in the energy systems of the body. I really need to refer you to their website www.emofree.com as i don't have a lot of time to commit to forum minding. There is more info on that website than anyone could possibly absorb as the founder and other practitioners regularly post anecdotal testimonials (including several on knee injuries) through the search function. My goal was to offer a possibility of help to Garjang.

Practising EFT is simple in it's initial understanding and learning the basic steps. Dealing with people's emotions, feelings and illnesses, as you know requires creativity, compassion, study and excellent listening skills. I recommend anyone who considers themselves a healer should learn about this important tool for your tool kit and try it on everything. It doesn't hurt and I know it works.
al

I need to refer your questions to Emofree.com. They have everything and more you need to know about EFT. My goal was to help gargajan with his knee problem. EFT will likely do that if it's properly applied.
I'm not able to devote too much time to a forum as I am really busy with other stuff.
EFT works for me and it does no harm. Any one considering themselves a healer would be well served to add EFT to their tool kit.
al

Hmmm...

Garjang, i am sure that there is an emotional aspect to your problem, especially since you have had it for some time.

To say that ALL negative emotions are caused by blocks in your system is a little too hardline and extreme for me.

There doesn't seem to be much research apart from testimonial evidence (which is the lowest form of evidence) so it may or may not help you.

A useful thing to consider for your toolkit - i think so. Solving ALL negative emotions and physical restrictions - i think not.

Just one point for clarity. How do we remember to feel a certain emotion under a certain circumstance? Correct me if I'm wrong but I think it's fairly well documented that our thoughts, activities and feelings all begin with some electrical activity in the brain I'm not sure it's a big leap to say that a specific neural path is necessary to revisit an emotion.. negative or positive.

I did not suggest that EFT could solve all physical restrictions but improve all restricted range of motion issues...a big difference, i think, and one I'll stand by.

I agree about the testimoiails being the lowest form of evidence. Somewhere, I'm not sure how to direct you, there has been scientific work performed by a Dr. Callahan and others from which, Gary Craig, the founder of EFT developed his more universal system. Those who are interested could track doqwn this research. For me it's enough to know it has helped me in more ways than I am prepared to share on a public forum.
al/clinicserver

Hi Clinicserver,

I understand your point of view and respect your beliefs. I think emotions ahve a large part to play in how we move and execute our motor patterns.

From a scientific point of view, the levels of evidence are:

Level 1 - Systematic review of all relevant randomised controlled studies (RCTs)
Level 2 - Well conducted RCT
Level 3 - Well designed trials with aspects of good RCTs missing - e.g. randomisation
Level 4 - Opinions of respected practitioners, clinical experience, case studies etc

We are currently trying to increase the number of quality Level 2 evidence we have so that the Level 1 evidence improves as well...currently there are more systematic reviews on back pain than there are RCTs!!!

With respect to my objection to EFT improving ALL restricted range-of-motion (ROM) issues, i still stand by it because i think that EFT only deals with a subgroup of patients who have restricted ROM - that is, the cause of their restriction is able to be dealt with by using EFT.

For example, restrictions in ROM can be from non-contractile tissue. We know that non-contractile tissue is unable to be changed without a change in the physical loading of the tissue - either external or internal forces. By changing the muscular forces using EFT, you may be able to help these people. However, sometimes it is not the muscle tesion causing these restrictions. I have a patient with an ACL reconstruction. She had done everything right. however, we wouldn't get her last 10degrees of extension at the knee, no matter what. I relayed this to her surgeon who went back in and confirmed our suspicion - she had a 'cyclops lesion' which is where the stump of the old ligament was blocking the ROM. Now, with all respect, i don't think EFT was going to help her out there.

There are also bony reasons why ROM can be restricted over time. The development of osteophytes can lead to gradual decreases in ROM and postural changes etc. Again, i don't think EFT will help these people.

The lists of conditions can go on and on.

I think something that deals with a person's emotions and psychology - be it traditional or alternative - is useful for a lot of our patients. However, i think it is only responsible NOT to sell our patients false hopes by saying "ALL restricted ROM issues" can be improved with EFT - it is simply not true at this stage given the body of evidence that we have. I am not saying that it doesn't work, just that it works in patients who have been carefully selected and classified - much like the rest of our physiotherapy treatment!

Thanks

As much as I enjoy the discussion this will have to be my last post on it as I feel compelled to reply even though work is piling up behind me (I should tap on that).
Anyway. Next time someone is stuck try EFT on them before surgery. My point is you might not have achieved the ellimination of all 10% of the restriction but maybe 5% or 2% and you don't need to be an expert to try it and achieve pretty credible results. We may not be evolved fully enough to REALLY understand where emotional restrictions and mechanical restrictions part ways. After all, there was a significant body of evidence that man couldn't fly and that the world was flat before someone came along and looked at it differently..."If change the way you look at things the things you look at will change"...Wayne Dyer.
Much of our modern science is based on Newtons theories and laws but there now is a rapidly growing body of evidence that Quantum Physics will prove much of that work obsolete.
I'm curious, after all this talk if gargajan actually has tried EFT on his knee and what the results might have been since the whole reason I got involved here was to help him/her out. I am prepared to do a phone session with him/her at no expense just to see what happens. It doesn't always work but it doesn't hurt to try. Let me know if there is interest there.
It has been a pleasure but i must move on.
al

Hi clinicserver,

Thank you for posting. We are all busy people so we understand your position.

Personally i would be happy to try EFT. Like i said, i think it will help a lot of people.

However, the point of "debate" has been whether EFT can help *ALL* restricted ROM issues. I can appreciate how Newtonian physics has been shown by quantum physics not to be applicable in all situations however i think i would be correct in saying Newtonian physics apply on Earth nearly 99.9% of the time - the other plies close to the speed of light. In the same way, it is likely that a stump of the ACL is physically blocking and causing a restriction. Scar tissue and fibrosis is likely to cause the mechanical properties of the surrounding tissues to change. etc etc.

Therefore, EFT is very useful when seeking to change the input into the central nervous system associated with certain emotions and motor patterns - you are seeking to break a cycle. However, it simply cannot account for ALL restricted ROM issues.

Wouldn't a more reasonable statement be that "EFT may help a significant amount of soft tissue restrictions"??

Thanks

What about a politeus injury? This will change the knee movements and as so could well effect nerves. another localised problem area could be syndesmosis of tibia/fibula.

I respect your opinion we may be engaging in symmantics at this point.
What about Garjagan?
Al