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lower leg/foot pain
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Okay...I have had Plantar F for quite a while. Nothing seemed to help.

About two-three weeks ago I got the trigger point package for the lower leg and foot. I've been using it at least every other day...if not every day.

At first it was GREAT. I felt the difference after using it twice. As we speak, my PF is doing really well. In fact I could handle it all through Ironman training with no more improvement if needed. I doesn't even really hurt much any more.

However about a week and a half ago I went for a 1.5 hour run. Had I been running straight through I would not have made it...but I was doing a run 4 minutes walk 1 minute program to get my mileage up. Helps reduce the beating this early in the season and helps prevent injuries. Well since I am an idiot...the 1.5 hours was still too aggressive...by about 10 minutes.

It first started as mild pain/burning to the outside of my left foot behind the ball of the foot, but really on the side of the foot, not the bottom. (same foot as the PF). I kept using the trigger point and it seems like the entire outside of my leg was really tight. I rested a few days after that and was pain free so I did a short 30 minute jog with no real side effects...a little soreness was it...so I skipped my long run and did another short 30 minute jog instead...a little sore again, but not real bad. I figured by taking it a bit easy like this everything would work itself out.
Well, during this 9-10 days my calf, ankle, and foot have been burning and just feel very tight. Using the trigger point on the outside of the calf and ankle can be quite painful. I can't tell if it's helping or hurting but I figure it's loosening things up...and that can't be all bad considering all the problems being really tight has caused.

I went for another 30 minute jog on Tuesday AM and all hell broke loose. The run itself felt ok, it was on a treadmill and at an easy pace. But now the foot, ankle, and calf are all burning and REALLY tight. I really hit the trigger point hard last night to try to work things out. It wasn't so much the pressure I used, but I was massaging everything for a good 30-40 minutes and then I iced it. It didn't hurt too bad at the time and actually felt better immediately afterward...but today my leg is really burning good. It really almost feels like a lactic acid burn...I'm not sure how else to describe how it feels. Even sitting at my desk, it burns and kinda hurts. It isn't really painful (I have a a very high pain threshold)...so I don't know how else to describe it. It is annoying and breaks concentration.

Is it possible that the trigger point loosened up some REALLY tight muscles and "stuff" on the interior side of the leg since I concentrated on that early on...while I missed the outside of my calf which stayed tight...and so the outside really the brunt of that long run to cause this?

If feels kinda like a strain, and I'm sure it is an overuse strain of some kind. How long does that type of injury take to heal? I have no problem resting it...but I have no idea for how long. Any thoughts?
In fact, I need a small procedure on the other foot and was thinking about getting it done right now...it will force a good two weeks off of running, would that be enough time? At that point I would have to start back pretty slow and easy...which is fine by me too. IM isn't until September...so I have some time.

Thx

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Re: lower leg/foot pain [JReed] [ In reply to ]
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#1: if you need a "small procedure on the other foot", discuss this with your physician who I assume can rule out some things you *may* be describing (like compartment syndrome, peroneal muscle strain/tendonitis, etc.)

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Fatigue is biochemical, not biomechanical.
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Re: lower leg/foot pain [JReed] [ In reply to ]
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JReed-

Any previous injuries to this foot/ankle? Previous sprains/strains? Any history of low back pain? I am gathering that the pain is on the outside of the calf; what relation does it have to the knee? Close to? Half way down? Recent shoe change? Bike fit changes? Are these painful runs after bike rides? Or does it matter? Pain at rest? Or only with running? Pain with walking?

Sorry for all of the questions...I ask about low back pain because depending on the distribution of pain, it could stem from the low back EVEN without feeling low back pain. This is why any history of low back issues could help.

My other thought is that maybe there's a nerve entrapment possibly coming from the fibular head (outside of calf). You can feel the fibular head just below the knee on the outside. The common peroneal nerve runs around the head; if there's tightness around this nerve, it could cause the muscle to freak out.

A history of sprains may indicate instability of the ankle causing faulty foot mechanics. Any recent additions of orthotics? If the inserts are inappropriate, this could cause your foot to not function properly possibly straining the peroneus longus tendon that runs on the outside of your foot and attaching to the base of the first metatarsal. Regardless, the tendon of the peroneus longus may be irritated.

You may want to see if a local physical therapist or athletic trainer can perform an injury screen for you. They are typically complimentary.

This could take a while to heal especially if you keep training. If the symptoms get better with rest, then maybe that's what you needed. Ease up on the trigger point for now.


Mark Payares, PT, DPT, CSCS
Physical Therapist
USA Cycling Coach Level 3
http://www.start2finishstudio.com
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Re: lower leg/foot pain [Roadie9] [ In reply to ]
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Lets see,
Years back I chip fractured the ankle. I was running in a zone and didn't see the drain...ouch.
I am a fast healer and was actually back and running pain free after 2-3 weeks with a brace.

I did some pretty heavy rehab to get strength back...but have sprained it once or twice since then. Although the ankle has not bothered me in years...and I've run quite a bit since then.

I have new orthotics...they are 3 months old or so...but they were new versions of my old ones with slight changes. I ran on those for years and years.

I don't really have pain on the outside of the calf...but when I roll on the trigger point roller I know it is really tight. Right now the ankle is tender, mostly on the outside of the ankle. The top/side of the foot is tender, and the calf feels a little tight. But it will feel better with rest pretty fast. In fact I'll be surprised if there is any pain tomorrow from just normal activity. Biking does not seem to have any impact...only running.

I don't tend to have any back issues that I know of. Although I would not be surprised if my hips were the problem. Everything starts there. Umm...my knees are fine, although I had knee reconstruction 10 years ago or so. Never had a problem with that. My IT band is not what I call loose, but I don't think it's too tight either.

ANd this all started after rolling on the trigger point. I'd say the pain starts toward the middle/lower portion of the calf, above the ankle a little bit. I know my calf was obnoxiously tight before the trigger point...based on a recent massage it's much improved.

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Re: lower leg/foot pain [JReed] [ In reply to ]
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OK...doesn't sound all bad. Keep with the massage but lay low with rolling on the trigger point. Stretch those hip flexors if needed and strengthen the glut's, especially the glut. medius. Lateral walks and side planks will help to stengthen.

With the shoe inserts, hopefully they are not forcing you to run more on the outside of the foot which could cause irritation to the outside of the foot.


Mark Payares, PT, DPT, CSCS
Physical Therapist
USA Cycling Coach Level 3
http://www.start2finishstudio.com
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