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Prioritize the Specialists I See After Re-Inflaming Chronic Calf Injury
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I'm finally going to see a specialist for a chronic calf strain that has prevented run training over a continuous 3 months. I have healthcare that would cover doctor/chiropractor/medical therapist, but would prefer not to burn through my $1,500 deductible just to find the right specialist. After exhausting Slowtwitch search function, I'm still not sure where to start. I'd really appreciate the advice from those with this unfortunate experience on how to triage this. In otherwords, with benefit of hindsight, who would you have seen first to address chronic calf strain?

Background: I'm 35 in Dallas-Fort Worth, ran cross country and track in high school. Did light running (~10 mi/week) for a few years after. Flexibility has never been a strength, but until 25 I had no injury history, not even shin splints, despite same range of motion. Got into 5ks, 10ks, Oly tris, et. al. but for the last 10 years I've struggled with what Dr. Slowtwitch Forum has diagnosed as anything from a Calf Heart Attack to Chronic Exertional Compartment Syndrome of the Posterior Calf (posterior being very rare, affecting only 5-10% of those diagnosed with the syndrome). I've managed to do 5ks, an Olympic distance tri, but always on limited training due to injury. I don't think it's overtraining. After feeling that familiar catch/pop of the calf spasming/seizing up after 1 to 2 easy zone-2 miles and feeling fresh, I've employed the approach of: no running for 1-3 months, starting at 0.5 miles 3-4 days a week and increasing weekly mileage by no more than 5%. This seems to work well but for a limited time. After 1-3 months of really conservative building I inevitably reinjure my calf within 1 to 2 miles of zone 2 (haven't been confident enough in my calf to do speed work). It seems to alternate almost 50-50 bt left and right calf.

After each reinjury I've tried to focus on a new remedy, from really, really conservative builds, stretching, not stretching, foam rolling, etc. but to no avail. I definitely have a less than average range of motion but I'm still stymied bc my injuries always seem to occur within 1 to 2 miles while i'm feeling good and not trying to run through tightness (see: Compartment Syndrome). I'm finally ready to pay someone to address this. Who should I see first?
  1. Chiropractor with ART Cert? (Active Release Techniques)
  2. Physical Therapist
  3. Orthopedic Surgeon/Sports Medicine Dr. (thinking to get the pressure test to rule out Compartment Syndrome)
  4. Other?

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Re: Prioritize the Specialists I See After Re-Inflaming Chronic Calf Injury [mbiemer] [ In reply to ]
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100% go see a sports med specialist first. Not sure what you have going on but you need a proper diagnosis first. The sports med doc may be able to do ultrasound on your "calf tendons" to look for issues that contribute. I would be extremely frustrated if I was in your shoes so I hope you get some answers. Good luck!!!
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Re: Prioritize the Specialists I See After Re-Inflaming Chronic Calf Injury [mbiemer] [ In reply to ]
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I had never ending foot/achilles/calf issues until I tried Hokas. Zero issues ever since, and we're going on almost six years.

Your post never addressed shoes.

2018 Races:
INJURED

Favorite Gear: Dimond Bikes | Desoto Sport | Hoka One One
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Re: Prioritize the Specialists I See After Re-Inflaming Chronic Calf Injury [The GMAN] [ In reply to ]
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^^

I had recurring Achilles issues for over 3 years until switching to Hokas, since then the issues have gone away. I'd tried everything I could find that related to my problem. The two things that have remained constant since then are the Hokas and eccentric calf/achilles drops.

Going on 4 years with no repeat problems.
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Re: Prioritize the Specialists I See After Re-Inflaming Chronic Calf Injury [mbiemer] [ In reply to ]
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Thanks, I'll check them out. I'm a midfoot runner so I didn't put much stock in shoes but you're right, I really hadn't considered shoes as that big of a factor. I did however notice I could extend my injury free running by running on the treadmill, so impact seems to be a factor. It was always during an outdoor run that my calf blew up.
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Re: Prioritize the Specialists I See After Re-Inflaming Chronic Calf Injury [mbiemer] [ In reply to ]
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Do you ride a trainer in the Erg mode? I had serious calf issues each winter, call them what you want, 1-2 miles into a run, bam! Ever since I stopped riding the Computrainer in the Erg mode my problems have gone away. Just a thought. good luck.
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Re: Prioritize the Specialists I See After Re-Inflaming Chronic Calf Injury [mbiemer] [ In reply to ]
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mbiemer wrote:
Thanks, I'll check them out. I'm a midfoot runner so I didn't put much stock in shoes but you're right, I really hadn't considered shoes as that big of a factor. I did however notice I could extend my injury free running by running on the treadmill, so impact seems to be a factor. It was always during an outdoor run that my calf blew up.

Shoes could arguably be almost the entire factor.

2018 Races:
INJURED

Favorite Gear: Dimond Bikes | Desoto Sport | Hoka One One
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