Q & A from Injury Clinic on Thursday 5th December 2013:

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Question:  I was wondering if you had any advice on how to deal with persistent calf injuries and tightness of the calves in general.  I have always had this problem with my calves which sometimes leads  to achillies issues but the persistent issue appears to be tightness in both calves, despite pre and post run stretches.  Would foam rolling help or heat etc?

Apex Physio Belfast Clinic:  The best place to start is to look at your footwear and see if your trainers need to be replaced as being flat footed can very commonly predispose to this problem. Ensure you are gently stretching the calf muscles by doing this set of exercises twice DAILY:-

 

1.  Stand with one leg in front of the other with both feet pointed forward.  Place hands on a wall or similar for support.  Keep the back knee bent, with the heel pressed to the floor.  Push your hips forward, whilst pressing your back heel to the ground. Hold the stretch for 20 seconds and repeat on the other leg. Do this 3 times.

2.  Stand with one leg in front of the other, with both feet pointed forward.  Place hands on a wall or similar for support.  This time keep the back knee straight, with the heel pressed to the floor.  Push your hips forward, whilst pressing your back heel to the ground.  Hold the stretch for 20 seconds and repeat on the other leg.  Do this 3 times.

In terms of foam rolling, the literature is very controversial as to whether they help or not. In our opinion and experience they can be mildly useful for some sports people (but not all) to reduce feelings of muscle tightness. Heat increases the blood flow to the soft tissues which may feel beneficial but may not necessarily solve your longstanding problem.

Your pain may also have a neurogenic origin, especially as the pain is a longstanding issue. Nerve pain can present in many ways and not just pain eg feelings of cramping and tightness etc. This can be quickly diagnosed with a thorough specialised physiotherapy assessment. I hope this is of some help.  Please do not hesitate to contact us if you would like any more information.

Question:  I have a problem with a click in my hip.  Every time I lift my legs when in a standing position or lying on my back I get this clicking noise coming from my back along with pain in my buttocks. Also, when I run at a higher tempo or a race I take cramp in my right side under my rib cage (which makes me slow down). Any help welcome.

Apex Physio Belfast Clinic:  The rule of thumb with clicking joints is if they are not painful then we leave them alone and focus our attention on any area that is causing pain or discomfort. The pain in your buttock may be stemming from one of two sources.

1.  A muscle imbalance between your three glute muscles, and…

2.  A referred pain from your spine which may fit in with the symptoms you have described in your back.

We recommend a specific assessment by a physiotherapist to assess your gait, biomechanics and spinal mobility to get to the root of your symptoms. Hope this helps.

Remember: Apex Physio Belfast Clinic contributes lots of useful running advice and tips on staying pain and injury free on the ‘Physio’ page on NiRunning’s website where you can also find our contact details.  We will be back on 9th January 2014 with another live ‘injury clinic’ and we look forward to seeing your questions then.  Merry Christmas and have a pain free running New Year!