little help with a leg injury?

[garjagan]

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

[i'm "fein"]

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

[garjagan]

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.

[arkesh_physio]

Do u have Back pain??

[garjagan]

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!

[alophysio]

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

[garjagan]

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.

[alophysio]

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

[habashneh]

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?

[garjagan]

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!

[alophysio]

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...

[ClinicServer]

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

[alophysio]

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...

[janecam]

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

[ClinicServer]

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

[alophysio]

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