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I have a running injury I can't quite figure out--can you help?
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As some may remember from the barryp success thread (https://forum.slowtwitch.com/...y_P6625908/#p6625908)

my running has been going very well. I had a great race in St.G, then spent four days hiking in Zion. Returned home and did a nice easy run. No problems. The next day I did my four mile run (I'm at 4-8-12 in BarryP terms) that I've done dozens of times this year. At about mile 3.5, I suddenly had a vice gripping my right calf. Totally out of the blue. I didn't jump over anything, I didn't stumble, nothing remotely untoward. I got home and it was so tight I feared I'd pulled something.

I did a ride that afternoon and it felt fine. Compression socks, rolling, the whole shebang after that. The next day I did another four miler and was definitely hobbling. The day after that ( sorry, I know you don't need my full training schedule) I was feeling a lot better, walking around with my calf wrapped. I decided to do the 12 miler I had planned. Not my best decision. First four were pretty good, last eight not so much (yes, I finished and no, I shouldn't have).

I took two days off and tried to do a shake out run today. I made it through without too much pain, but I was totally off, I felt choppy, not the nice smooth feeling I had been enjoying up until now. And my left quad is now hurting due to compensating for my right calf.

It's tender to the touch just below the calf and above the Achilles. Rolling it hurts. Stretching it feels good, but I have to really bend my ankle to get the stretch in the right place. I'm not sure if it's just really tight, or a minor tear, or what. Swimming and biking do not seem to aggravate it.

So, my question: Does this sound familiar to anyone? What did you do? Did you just wait it out? It's really preplexing to me, since it seemed to happen out of the blue.

Thanks very much for any help or advice you might give.

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Any run that doesn't include pooping in someone's front yard is a win.
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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Could it be Mad Calf Disease?

I have something similar and it comes and goes and I can't seem to figure out when and why...

if you can read this
YOU'RE DRAFTING!
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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Take 5 days completely off, no swimming or biking either.

You said foam rolling hurts, don't roll ON the injury.
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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It could be a calf strain but it could also be a partial tear at the junction between the Achilles' tendon and the muscle. Typically, you can get over the calf strain fairly quickly by taking a week off from running and then ease back into it. The musculotendon junction tear, is a completely different beast and requires A LOT longer to heal.

The easiest way to find out is:

1). Take off five days, from running, and then see if it hurts when you try to start back. If it does, you've most likely got something more serious than a calf strain and need to see a sports med doc

2). Go ahead and see the sports med doc now so an in office ultrasound can be performed to rule out a partial tear of the tendon. This is the safest route and the one I'd recommend. Plus, other potential (but far less likely) issues can be ruled out to give you peace of mind
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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Had the same. Basic idea there is a stress reaction under the layer that shields your nerves and it puts pressure on these nerves.
My chiropractor completely fixed it with ART and what is that other thing they do. Hurts like hell but works like a charm.

strava
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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Google "Calf Heart Attack".

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Some are born to move the world to live their fantasies...

http://www.mjolnircycles.com/
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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CCF wrote:
As some may remember from the barryp success thread (https://forum.slowtwitch.com/...y_P6625908/#p6625908)

my running has been going very well. I had a great race in St.G, then spent four days hiking in Zion. Returned home and did a nice easy run. No problems. The next day I did my four mile run (I'm at 4-8-12 in BarryP terms) that I've done dozens of times this year. At about mile 3.5, I suddenly had a vice gripping my right calf. Totally out of the blue. I didn't jump over anything, I didn't stumble, nothing remotely untoward. I got home and it was so tight I feared I'd pulled something.

At this point....should have taken a week off. Time for a small swim-bike focus.

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I did a ride that afternoon and it felt fine. Compression socks, rolling, the whole shebang after that. The next day I did another four miler and was definitely hobbling. The day after that ( sorry, I know you don't need my full training schedule) I was feeling a lot better, walking around with my calf wrapped. I decided to do the 12 miler I had planned. Not my best decision. First four were pretty good, last eight not so much (yes, I finished and no, I shouldn't have).


Dude.

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I took two days off and tried to do a shake out run today. I made it through without too much pain, but I was totally off, I felt choppy, not the nice smooth feeling I had been enjoying up until now. And my left quad is now hurting due to compensating for my right calf.

Definitely follow the advice of all3MD. Although, in my experience with SportsMedDocs you will end up doing both because it will take 5 days or longer to get in to see the SportsMedDoc---no running until cleared by doc.

But, on the decision making side of things...wow. just. wow.

Okay. I've made decisions like the above, many, many times. Never worked out in my favor. They always end like the above.

My version of reality is:
  1. It takes a minimum of a week off to recover from THE FIRST OCCURANCE of a minor running related injury (twinge in the Achilles, a little plantar fasciitis flare up, patellar tendonitis, patellar femoral syndrome, ITB syndrome, etc).
  2. For every time you time you try to "push" through it, add another week.
  3. When you come back, take it EASY for gods sake!!! That is not defined as a long run. Cut your short run in half, and work back up to your short run over 3-4 more runs. You shouldn't feel any effects from the injury during or after. Maybe a little fatigue the first day, but after that it should feel totally normal. If not, don't keep increasing. Maybe give it another day off, and try again. NO PAIN.
  4. Since you are 4/8/12...I'd try something like 2-2-3-off-4-5-6. If that goes well....the next week, do your normal week but, do a med run for your long. After that, build your long back up to over a couple/few weeks.

So, following along above, I would be looking at 3 (maybe 4) weeks off based on your progression (assuming I didn't go see a doc). The longer you have to take off, the longer you need to drag out steps 3-4 above.

Injuries happen---its what you do after that determines how bad its gonna get. I just had my first bout with plantar fasciitis on Monday in 16 months. I ran in the wrong shoes (I grabbed a year old pair off the shelf). I feel fine today...so, next Monday I hope to do a 2 miler (since I'm also a 4/8/12 guy). IN GOOD SHOES.
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Re: I have a running injury I can't quite figure out--can you help? [Tom_hampton] [ In reply to ]
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Thanks all for the advice and for reminding me not to be a dumbass. I'm feeling much better today so I did a 15 mile tempo run. No, wait, I really didn't do that. Saw the doc, taking some time off, will hope to rebuild slowly before too long. I'd like to race Victoria half in two weeks. We'll see how that goes.

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Any run that doesn't include pooping in someone's front yard is a win.
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Re: I have a running injury I can't quite figure out--can you help? [eye3md] [ In reply to ]
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eye3md wrote:
It could be a calf strain but it could also be a partial tear at the junction between the Achilles' tendon and the muscle. Typically, you can get over the calf strain fairly quickly by taking a week off from running and then ease back into it. The musculotendon junction tear, is a completely different beast and requires A LOT longer to heal.

The easiest way to find out is:

1). Take off five days, from running, and then see if it hurts when you try to start back. If it does, you've most likely got something more serious than a calf strain and need to see a sports med doc

2). Go ahead and see the sports med doc now so an in office ultrasound can be performed to rule out a partial tear of the tendon. This is the safest route and the one I'd recommend. Plus, other potential (but far less likely) issues can be ruled out to give you peace of mind

THIS ^^^^

Been there.
If you don't take proper care of some tearing at the muscle-tendon interface, it will come back and haunt you (scar tissue and all).
.
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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The advice in the posts above DOES work.

I re-did my "Calf Heart Attack" for about the 3rd time in ~5yrs - April 9.

Followed the advice for recovery below

https://www.runnersworld.com/...-attacks?page=single

I was able to finish WF long course less than a month later. I'll admit I was concerned that I'd re-injure it again but, I had an okay time, and didn't re-injure it. As of yesterday, I'm back to track workouts that are almost as good as before the injury. My lesson is that I actually had a warning sign that I ignored during the run that caused the injury, and, I'd been neglecting maintenance rolling.

Isn't aging fun?


I could break the course record - theoretically, Bishop Pickering - from the movie "Caddyshack"
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Re: I have a running injury I can't quite figure out--can you help? [manofthewoods] [ In reply to ]
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manofthewoods wrote:
The advice in the posts above DOES work.

I re-did my "Calf Heart Attack" for about the 3rd time in ~5yrs - April 9.

Followed the advice for recovery below

https://www.runnersworld.com/...-attacks?page=single

I was able to finish WF long course less than a month later. I'll admit I was concerned that I'd re-injure it again but, I had an okay time, and didn't re-injure it. As of yesterday, I'm back to track workouts that are almost as good as before the injury. My lesson is that I actually had a warning sign that I ignored during the run that caused the injury, and, I'd been neglecting maintenance rolling.

Isn't aging fun?

It's a good article. The one thing I don't understand is when they say to roll the hell out of it. If it's a tear or partial tear, wouldn't rolling aggravate it?

------------------------------------------------------------
Any run that doesn't include pooping in someone's front yard is a win.
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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CCF wrote:
It's a good article. The one thing I don't understand is when they say to roll the hell out of it. If it's a tear or partial tear, wouldn't rolling aggravate it?

Your question is a good reason to see the doc. But, you said you did that. Did (s)he think it was torn?

The article is referring to "micro-tears". Not the same as a large tear. The article says "stretch" not roll. So, its a bit of a stretch to call "rolling" "stretching". <pun intented> :-)

I've been living with a bunch of micro-tears in my groin and abdomen since last November---diagnosed with Athletic Pubalgia (aka Sports Hernia). Not much fun, but I've done lots and lots of stretching, and various PT exercises to strengthen the muscles around these tears. But, all of those exercises and stretches were specifically directed to "cause no pain". Ie, tension until you "feel it", but it doesn't "hurt". These are ALMOST gone---7 months later.

Quote:
Isn't aging fun?

No aging is NOT fun...but, its the best of the two alternatives. :-)
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Re: I have a running injury I can't quite figure out--can you help? [Tom_hampton] [ In reply to ]
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article wrote:

Step 2. Get as much massage – including self-massage – as you can, TheStick massage tool has been invaluable to me in this regard (because this injury is in deep, icing has not been as helpful as it has for most injuries). Definitely don't stretch your calf yet. Let it heal first.


When I said roll, I mostly meant stick.

Doc just figured it was a minor tear for me, told me to take it easy, wouldn't entertain the thought of a sport med referral nor an ultrasound. Annoying, but that's health care!!

Just another anecdote, I've been basically living in my compression socks/calf sleeve for the past couple of days (sleeping included). Feeling much better. Annoyingly, the quad that I tweaked when compensating for my calf is now hurting more than the calf!

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Any run that doesn't include pooping in someone's front yard is a win.
Last edited by: CCF: May 18, 18 13:30
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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Quote:

When I said roll, I mostly meant stick.


Ah, gotcha. I was keying off the "hell out of it" phrase. Which the author used in reference to "stretching".

Quote:

Doc just figured it was a minor tear for me, told me to take it easy, wouldn't entertain the thought of a sport med referral nor an ultrasound. Annoying, but that's health care!!


This is why I have a PPO plan in the USA. So, I don't need anyone's "permission" to go see the doctor I want to.

Quote:

Annoyingly, the quad that I tweaked when compensating for my calf is now hurting more than the calf!


HA! Yeah, I've been down that "overcompensation" road, too many times to count. My general reaction is, "Oh come on...FFS! Just heal already." Nothing like your injury injuring you...again. Adding insult to injury.
Last edited by: Tom_hampton: May 18, 18 14:33
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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CCF wrote:
manofthewoods wrote:
The advice in the posts above DOES work.

I re-did my "Calf Heart Attack" for about the 3rd time in ~5yrs - April 9.

Followed the advice for recovery below

https://www.runnersworld.com/...-attacks?page=single

I was able to finish WF long course less than a month later. I'll admit I was concerned that I'd re-injure it again but, I had an okay time, and didn't re-injure it. As of yesterday, I'm back to track workouts that are almost as good as before the injury. My lesson is that I actually had a warning sign that I ignored during the run that caused the injury, and, I'd been neglecting maintenance rolling.

Isn't aging fun?


It's a good article. The one thing I don't understand is when they say to roll the hell out of it. If it's a tear or partial tear, wouldn't rolling aggravate it?

Well, because it's 'Runner's World' article, not medical literature.

Yes, rolling and stretching can worsen or at least aggravate tears and partial tears of any muscle. The general rule is: ice for the acute injury to minimize edema and then heat and gentle massage to improve blood flow. Gentle stretching has worked well for me but not rolling. YMMV

Remember, we are talking about muscle micro-tears and strains/sprains.

And the MOST important thing is rest. The key is to realize injury early on and not worsen it (um..as you seem to have done...um...)

At this point, be cautious in your return. I have had so many injuries now that I pretty much know the drill for recovery for me.

Walking
Walking on TM
Walking with intervals of slow jogging-increasing the interval-usually outside
Slow jogging

and finally-Back to running--with NO SPEEDWORK for an additional 2-4 weeks

Good luck.
Dale
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Re: I have a running injury I can't quite figure out--can you help? [CCF] [ In reply to ]
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CCF wrote:
As some may remember from the barryp success thread (https://forum.slowtwitch.com/...y_P6625908/#p6625908)

my running has been going very well. I had a great race in St.G, then spent four days hiking in Zion. Returned home and did a nice easy run. No problems. The next day I did my four mile run (I'm at 4-8-12 in BarryP terms) that I've done dozens of times this year. At about mile 3.5, I suddenly had a vice gripping my right calf. Totally out of the blue. I didn't jump over anything, I didn't stumble, nothing remotely untoward. I got home and it was so tight I feared I'd pulled something.

I did a ride that afternoon and it felt fine. Compression socks, rolling, the whole shebang after that. The next day I did another four miler and was definitely hobbling. The day after that ( sorry, I know you don't need my full training schedule) I was feeling a lot better, walking around with my calf wrapped. I decided to do the 12 miler I had planned. Not my best decision. First four were pretty good, last eight not so much (yes, I finished and no, I shouldn't have).

I took two days off and tried to do a shake out run today. I made it through without too much pain, but I was totally off, I felt choppy, not the nice smooth feeling I had been enjoying up until now. And my left quad is now hurting due to compensating for my right calf.

It's tender to the touch just below the calf and above the Achilles. Rolling it hurts. Stretching it feels good, but I have to really bend my ankle to get the stretch in the right place. I'm not sure if it's just really tight, or a minor tear, or what. Swimming and biking do not seem to aggravate it.

So, my question: Does this sound familiar to anyone? What did you do? Did you just wait it out? It's really preplexing to me, since it seemed to happen out of the blue.

Thanks very much for any help or advice you might give.

I believe the whole mad calf disease and calf heart attack are frustrating diagnoses. First, they do not diagnose the pain generator nor do they help to direct the appropriate course of action.

Our team has found that the calf will become up regulated during the course of triathlon training, especially if the athlete is increasing swimming volume (using fins as well) and running. This leads to a lack of golgi tendon organ muscle inhibition and drives over activation of the calf. This leads to the feeling of extreme tightness or muscle strain in the calf.

The soleus and gastroc will hit above 80% of its maximal voluntary isometric contraction during running and close to that with walking. When you start to lose golgi tendon organ inhibition signals then you get an increase in calf activation and go beyond 80% to something like 85% or 90%. The feeling can come on rapidly and will be reported as a strain, a tearing sensation, or a deep sore spot in the calf.

I would recommend the following if this is the issue:
  1. Focus on the anterior tib, extensor hallucis, and extensor digitorum muscles with heel walks keeping the toes flexed toward the shins.
  2. Second, stop swimming with fins as this is most likely the primary driver of the problem.
  3. Use a heel strike on your upcoming runs. This will decrease the calf load and increase pretibial activation.

It is also important to realize that the calf muscles are still loaded significantly with walking. Walking is not a way to recover nor does this problem tend to resolve with just time off because it is a neuromuscular problem. It has a high rate of recurrence if the root cause is not fixed. Finally, the micro tear hypothesis is hard for me to get behind. Most people report a rapid onset, no bruising, and no traumatic event.
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