- Posted by Ryan - NiRunning
- On May 12, 2017
- 0 Comments
Question: I have been struggling with a sore calf for the last week. A dull pain came on during a long run. I finished the run and it was sore and tender to touch. After 3 days, I was able to run again without pain, but it is still sore to touch. Any help would be appreciated.
Answer: As there is no swelling and there wasn’t one sudden injury or sudden pain, it is less likely that you have a local calf tear. From the information you’ve given us, it sounds as though your symptoms may be due to a lack of nerve movement (called altered neurodynamics) of the nerve (tibial nerve) that passes through the calf muscles.
Unfortunately, there are generally limited self management strategies to clear this problem and you most probably need physiotherapy treatment, from a physiotherapist who’s experienced in treating running injuries and nerve pain.
The treatment will involve freeing up the movement of the nerve which runs through your calf muscles and in the vast majority of cases, the pain can be cleared completely and fairly quickly. This problem often causes tenderness and soreness to touch, as the poor nerve movement can trigger a local inflammatory response in the calf region. At the moment, keep to the flat ground when running, keep your stride length short and your running speed low as well as doing low mileages. You should also add in very gentle calf stretches, just 2 calf stretches of each of the stretches for the 2 calf muscles, twice daily. If you do this advised regime that we’ve just mentioned, there is a small likelihood that the pain may clear completely. Otherwise, you’ll need physiotherapy treatment to get it cleared.
Question: The outside of my left knee (beside my knee cap) has been giving me problems for the last 4-6 weeks. It’s sore during running and very stiff afterwards. Thank you in advance for any help.
Answer: This is hard to diagnose accurately without assessing your knee fully, however it sounds like your pain could be due to either a cartilage tear (of the lateral meniscus) or patellofemoral pain. Patellofemoral pain is caused by tightness of the structures on the outside of the knee along with weakness of the muscle on the inside of the knee, and this combination doesn’t allow the knee cap to glide or move up and down smoothly.
However, from the information that you’ve given us, it is more likely that your pain is coming from a cartilage tear of the cartilage on the outside of the knee joint. The role of the cartilage in the knee is to help absorb shock passing through the joint and reduce friction on the joint surfaces. Researchers estimate that running increases the load through the knees by up to 5.5 times compared to walking. When the cartilage has been injured this can cause pain and stiffness around the joint line which will usually increase during and after running.
Generally, we advise that any injury which has not resolved within 3-4 weeks warrants a professional opinion. Since your condition has been present now for 4-6 weeks it is unlikely to fully clear by itself unfortunately. It is important that your knee is assessed by an experienced physiotherapist in order to confirm the exact diagnosis of your pain and therefore the correct, best treatment plan will be formulated. If you have a cartilage tear from clinical examination, the physiotherapist may want to refer you for an MRI scan of your knee, to establish the extent of the tear. A cartilage tear is usually treated successfully with conservative physiotherapy treatment alone, along with an exercise program. Patellofemoral pain usually clears completely with the correct physiotherapy regime including specific exercises. The two conditions mentioned previously are treated and managed very differently, so it’s very important to get the correct diagnosis.
In the meantime, whether you have a cartilage tear or patellofemoral pain, we recommend that you significantly reduce your running frequency and distance, as without an assessment of your knee you may potentially worsen your condition, especially if you have a cartilage tear, and this will result in a longer recovery period. Hope this helps.