Calf muscle pain ?soleus?

[guy909uk]

Hi,
I am looking for some advice. Over Christmas whilst sprint training for rugby, I felt a sharpish pain in my calf/achilles. I stopped the session and hobbled home. The next day it was sore but bearable and went skiing 2 days latter with hardly any discomfort. After christmas, the fist rugby session back, I felt some discomfort in my calf but completed the whole session. The next morning I was in real pain, and was limping around. The top part of my achilles was sore aswell as the mid calf. I rested and was unablt to return to rugby for 7 weeks. I played for a month with very, very occasional discomfort but nothing else. As the season finished at the end of April I was jogging and felt a sudden pain in the calf again. Once again the next morning it was very sore, and I have been struggling since then to recover. The pain is not so bad to walf short distances, but is triggered when I flex my knee under pressure (bending down). The pain is now very specific to the middle of my calf and feels "deep". My achilles also is a little sore at the top when walking. Someone told me I may have a soleus muscle tear and that is due to overuse? I do train hard and most days (when not injured!), and am finding this very frustrating. I have not even jogged since end of April to allow it to recover. I have been walking alot though, due to a travelling holiday, which was uncomfortable (but had to be done).
I was just looking for advice really. Should I be stretching? strengthening? resting?. At the mo I have just started swimming to keep fit and this doesn't cause too much discomfort.
Any help would be appreciated.
Thanks,
Guy

[guy909uk]

Hi guys,
Still struggling a bit with this one. Was hoping somebody might have some helpful advice to help me shake this off as I seems to have been going on alot longer than I expected for a calf strain.
Any advice would be appreciated!
Thanks,
Guy

[physio7]

Hi, I understand your frustration. I have a few questions to ask in order to give you appropriate advice on exercises.

Any pain walking?

Any pain pushin up on toes 2 leg? and just on bad leg?
What about on 10 repititions?

any pain pushing up on toes with knees bent 2 leg and 1 leg?

Any pain on calf stretch with knee stariaght and then with knee bent keeping your heel on the floor?

Any difference in size of your calf muscles? either ask someone to look or maybe measure with tape measure at different points in your calf

If you do these for me it would give a better chance of me giving you more appropriate exercises

[guy909uk]

Hi,
Thanks for your reply, very much appreciated.

I have some pain on walking which feels "deep" and right in the centre of my calf (a sharpish pain). It definately gets worse when I walk up an incline (even moderate). Walking downhill is easier.

Standing up straight and doing calf raises causes little discomfort. The calf feels a bit weak on my bad leg, but suppose thats to be expected!

There seems to be no discernable difference in calf size between good and bad.

Suprisingly (perhaps!) bent leg calf raises arn't as painful as I expected. I have some discomfort, but am able to perform them, although the calf feels weak again. I dont get the same sharpish pain I do when walking or going up an incline.

When walking, the pain occurs just as I push off with my toes, and occasionally when I swing my leg out infront of me when walking in the centre of my calf (if that helps!?).

I also get pain as I bend down to, for example, sit down or stand up from kneeling at about the mid point of the movement.

I hope this helps. I've tried to describe it the best I can for you! If you need any more info, please let me know. Your help is greatly appreciated!
Many thanks,
Guy

[physio7]

It is difficult to assess you without seeing you but i would like you to do a few things.
Are you familiar with gastrocs and soleus stretches?
Is there any pain on stretching? Is there a difference on how far you get your knee from the wall on soleus stretching between good and bad leg?

and with the heel raises is the pain on single leg or double leg and is it as you push up or lower down? perform them slowly

[guy909uk]

Hi,
Thanks again for reply,

There is almost no pain when doing Gastroc stretch, just feels a bit tight right in the centre of the calf, but no pain. Flexibilty is as good if not better than good one. Think thats because i've recently been trying to stretch it a bit?

Soleus stretch is a bit painful, although not too much pain. Flexibility seems to be as good as other leg.

The 2 and 1 legged calf raises are not painful on up or down. I did them slowly and it was o.k.

The 2 legged knee bend raises were painful in the bad leg when pushing up, not so bad on down. I tried the 1 legged but that was painful and felt like it was "going to go", although pain went lower (top of achilles) than just in centre of calf. I could go on and complete a few reps without a huge amount of pain, although now I have stopped it feels like I have aggravated it a bit and I have that deep sharp pain feeling again. Lowering down with bent knee wasn't very painful.

Thanks,
Guy

[physio7]

Thanks for that,

I would continue with gastrocs and soleus strtches not pushing into pain just a stretch. 3x 30 sec each.

I would also do eccentric gastrocs and soleus strengthening as long as it it comfortable.
This involves standing on a step with heel of the edge then push up just on good leg. Then with put toes of bad leg on step and lower down just on the bad leg slowly till your heel is below your toes and you have a bit of a stretch in your calf.
Repeat with knees bent as long as you don't get sharp pain.
build up to 3 sets of 15 with knee straight and 3 x 15 with knee bent.
Perform only if comfortable. Up with good lower with bad.

try it out and let me know how it feels.

[guy909uk]

Thanks!
Just a couple of questions.

Should I expect some pain after doing the excercises? Everyone seems to say rest is the key, which makes sense although I seem to have plateau'd over the last week or 2 (i.e not improving), which I find frustrating, and wonder whether starting to try and build back up to training gently is a good idea? I have been swimming this week and tried a cycle, but seem to have made it marginally worse (or just maybe no better!). I appreciate that rest is probably the answer but I seem to have been resting a very long time now, and wonder whether I need to push things along a little? Perhaps that is what the exercises will be intended to do!?
Many thanks for your help,
Guy

[physio7]

Rest from aggravating activities is good.
The exercises shoul not increase pain if they do perform on 2 leg rather that 1.
Seems you have done a lot of resting an then gone back to heavy exercise and back to pain.
You need to condition your calf muscles with stretching and strengthening like i talked about but they should not increase your pain. You should just feel the muscle working and some fatigue.
Swimming should be ok at the moment but nothing that increases pain. we need to settle the pain and strengthen in a non painful manor.

[guy909uk]

O.k, that sounds great advice. Thanks again

[Graham32UK]

Hi Guy,

Just read about your problem. I have a similar problem myself which I have actually seen a physio about. The advice I got was very similar to what you've had. It is important to do the exercises and stretches really regularly. My problem has gone on and on, I think because I haven't done enough strengthening work.

I see is was a few days since your last post. How are you getting on?

[guy909uk]

Hi Graham,
Thanks for your post. Reassuring that I'm not struggling alone!!

Things were going well actually. I managed to complete 3 sets of 10 for both straight and bend calf raises. Unfortunately I went swimming yesturday and pushed a little harder than previously and seem to have gone backwards (very frustrating). The calf is more sore today and the sharp pain in more prominent than before yesturday. I find it frustrating because I feel like I need to push on in order to get back to running and eventually rugby, although when I do, I seem to slip backwards! Perhaps I just need to keep pushing on? Or give the strengthening longer?

Sorry for my ramblings, nice to voice them now and again!! I am trying to stay positive with this. Presumably you've had a similar thing? How are you going?

Cheers,
Guy

[guy909uk]

Just wondering how often you have been told to do the excersises and stretching? Have you been advised to steer away from anything? I realise that I should go "upto the pain, but not throught it". Presumerably this is what I should continue doing?

[Graham32UK]

Sorry to hear you've taken a step backwards. I did that on sunday - after steering clear of running for a few weeks and doing most of the exercises I'd been told to do. It was pretty depressing. Having said that I still think that taking it easy is the best policy because I was feeling pretty good. I just think that I did a bit too much too it first time I tested my calves out. I probably could've been more disciplined with the stretching and strengthening over the last few weeks as well.

I was told to strectch very gently, 3 times a day - holding each stretch for about 30 secs, repeated 3 times. Stretch to the point of slight resistance rather than a little bit of pain. As far as strengthening is concerned I think it was just once a day but to do straight leg calf raises off a 2 inch step so that the heels go below horizontal. I've been able to do 20 - 25 raises but I think thats because they work the gastrocs more than the soleus (where my problem is). Having read up a bit more on this I think I'm going to try bent leg raises once my soreness has settled down as thats supposed to work the soleus more.

I was told to avoid running for a few weeks which would prevent another 'flare-up' and allow the strengthening to work.

It's frustrating to be restricted isn't it? Running is what I like most but I've only done that on a couple of occasions since my problem started in early April! I've made do with cycling and the gym so long as I'm careful. It's kept me in decent condition but dreams of running long distances feel a long way off right now.

Have you been to see a physio? I found it helpful in understanding the problem and how to put it right. I had 3 sessions and didn't get any change out of 100 quid but the way I look at it is that running is a cheap hobby, if it costs me £100 to get me back to it then so be it. Sadly there doesn't seem to be a quick fix though. My plan is to resist testing them out for a couple of weeks and to be really disciplined with the stretching and strengthening. Oh and I might even pray a few times too! We'll have to share progress reports now and then.

[guy909uk]

Cheers for your post Graham. Good to see someone is in the same boat. I have seen a physio informally who suggested that stretching and strengthening was the order of the day.
Am I right in assuming that this is an overuse injury?
Hope the "rest" period is bearable. I'm off to watch the Tour de France tomorrow and will be very jealous of all the cyclists belting along through central London. Nevermind, hopefully not too long to go now!
Cheers,
Guy

[guy909uk]

How are you getting on Graham?