Lateral calf pain

[Te Quiero Mucho MI Vida]

Hey all -- I need some suggestions for stretches, techniques, etc. for a client of mine with lateral calf pain. She's in her 60's and an avid walker. Recently, she's been trying to up her speed walking, but has been unable to due to a "shin-splint feeling" in her lateral calf. She's definately got some adhesions that I've been working on, but was looking for some stretches, or unique techniques that you may have had success with. She's very good at doing all her other stretches at home, but the lateral calf pain isn't getting better yet. I'm open to any ideas!! Thanks!

 

[ladydi]

gosh...my husband was just complaining of this same thing... he has this deep aching pain on the side of his calf since he was a kid...pain is not constant...it comes and goes...no injuries that he can recall, its worse when he climbs stairs or bike rides...he is an avid runner.
its in one leg only.

i checked my trigger points book....side of leg pain is caused from trigger points in gastroc, peroneus longus, v. lateralis and glut minimus..

"walking, running and climbing stairs done in excess, preditcably cause trigger points in the per. longus muscles. Walking is even worse for these muscles if you have a short leg, flat feet, or Morton's toe structure. Per. longus trigger points found just below the head of the fiblula".

however, the longus referred pain is in the ankle area..

i am going to check my husband for a short leg....and work his gastroc. muscles, as the referred pain from trigger points in the gastroc. muscles can be on the side of the leg..

i'm working the calf muscles and his glutes....alternating days working on his quads..

here is a gatroc. stretch (there are others on this site as well):

http://www.exrx.net/Stretches/Gastrocnemius/Wall.html

good luck.

 

[Krish K]

Is she warming up before she is walking?
Is she cooling down and stretching afterwards?
How quickly is she trying to increase her speed of walking?

 

[Bruno R]

Are her feet inverted/everted?
One foot or both?
What’s going on @ knees/hips?
History of injury, etc???

It’s hard to say what is going on with your client from your description, but I’ll share what my daughter went thru – maybe it will help…

My teenage daughter runs track and strained her left lateral calf & tested positive for lateral leg strain (peroneus longus). She also felt pain in her ankle & pain in the attachment at the base of her pinky toe bone (5th metatarsal). She had a difficult time training and missed most of the season.

In trying to figure out what was causing the problem, (in addition to going to our Dr to check for a stress fracture, yadda, yadda, yadda) we went to the local running shop & had them assess her gait while walking and running we found out that she inverts her ankles. They fitted her with appropriate running shoes & it has made a world of difference. About 3 months later she was just beginning to have the same pain, so back to the shoe store & discovered she needed a new pair of shoes. We’ve been able to stay on top of it since.

The moral of the story for me was, the proper shoes make a world of difference and replace them regularly - every couple of months if need be.

When I have a client who inverts their ankles, their lateral calf muscles are strained, stretched out & weakened – hence the trigger points. These are the muscles that will need to be strengthened.

The tight muscles causing the inverted ankle are Extensor Hallicus Longus, Flexor Digitorum Longus, Flexor Hallicus Longus & Tibialis Anterior & especially Tibialis Posterior. These are the muscles to get in and stretch/open up/loosen up. To get into the posterior tib, try reaching in behind the tibia, approach from medial and work to warm up/loosen up behind the shin bone (hope you can get the visual). Go easy in here – not uncommon to hear my client say “ohh, I didn’t know it was so tight there”. Of course you want to work the whole lower leg – gastrocs, soleus and lateral leg as well as the foot, upper leg & hips – there’s usually stuff going on there too. But see what you can find when you go digging behind the medial aspect of the tibia.

For great info on specific stretches & strengthening exercises check out James Waslaski’s Ortho Massage seminars.

Hope this helps

 

[airdogspace2]

Hey all -- thanks for the info -- it's always nice to be able to "pick other therapists' brains"! The client is very good about warming-up & cooling down as well as stretching. From everyone's suggestions it sounds like I'm hitting the right areas; it may just take some work. She's had some Plantar Fascitis that we've been working with and high arches. It feels like a big puzzle some days -- you just gotta keep putting pieces together! Thanks so much for all your help!!

 

[Shaun R]

I am leaning towards that she needs to strengthen these muscles, since they may not be able to take the overload of the increased workout. I would also have her show you "How" she stretches before and after her workout. Some people think they know what they are doing and actually can be hurting themselves.

I would also go with the shoe theory, in the extent that the surface and shoe that you are using has a lot to do with shin splints as well. If she has new shoes they might not be fitted properly for high arches. If there isn't a proper arch support, walking can be unbearable after a while. Find out if she wears orthotics... they may also be the culprit...

Also find out if she has changed her course of where she is walking, if she is used to walking on pavement, then switched to a track or grass, indoor vs. outdoor.

I used to suffer from horrible shin splints when I was younger, mainly because I would be outside running on grass and dirt for Softball and Soccer then from March/April till Mid November I would be inside running on the hard basketball court... 2 weeks into the season and I would have a horrible foot drop because of the different surface and sneakers that I wore. I lived in the trainers room for quite a while... If I only knew then what I know now.

I would have her call a local runners store and find out if they also carry walking shoes and have them assess her for the proper footwear.

 

[Pompal 09.]

i agree with both berkana and pandora.

(although, one of my personal mantras is, "when all else fails, buy shoes.")

 

[Farrah]

Sidelying:Warm up.
Have client invert/evert while doing myofascial release.
After warming up....T bar on Tib Ant.
Robyn

 

[Wooster Rooster]

lateral lower leg pain

something that is working for me.... I had an accident and my whole foot was detached and then surgically reattached...

Pilates "froggy feet" and Cadillac sequence. amazingly fast restoration.
These exercises are easily recreated on the floor with an exercise ball.

This was fifteen years ago, after learning how to walk again, the feeling is almost totally back. The first several years my right foot had the awareness of a frozen snowshoe.

Exercise and beathing, yoga, T'ai chi and Pilates.
And massage,of course.

Just thought I'd give some hope.

 

[Pompal 09.]

Wow szuzso! That gave me the chill bumps! Your whole entire foot was detached???? Yai Yai Yai Yai...where is the emoticon for "I've got the willy's!"

I give you a standing ovation for getting through that and the amazing patience to regain movement and normal function abilities!!! t038 t038

A client I once had told me that she had a daily exercise from PT to pick up marbles with her toes and put them in a bucket.