Thursday, February 01, 2007

Calf Strain

You are not going to believe this. I don't believe this. I'm sort of under the weather today, so I'm working from home so as not to expose anyone in my office to my head cold. What could be safer than working at home? Around noonish, my stomach started growling, so I headed downstairs in search of nourishment.

I step off the landing onto the top step leading with my left foot. Immediately after my toes touched the stair and I started applying pressure, I felt a searing pain deep in my left calf. First thought: "This can't be good”. I hobbled down to the landing and sat there for a while massaging my aching calf. 4 hours later, it’s still hurting. I’ve been through two icing cycles and I’m keeping it elevated, but I can’t rise up on my left toes nor can I walk without dragging my left foot behind me.

This is definitely muscle related. It’s way too high to be my Achilles tendon (I think) and the pain is isolated to a thick calf muscle running up the inside of the lower leg. In the picture below, the specific muscle involved is between my two fingers.

OK … what did I do and what do I do next, beyond rest, ice, compress and elevate? I could use some sagacious advice.

22 comments:

Runningdoctor said...

Phil, you seriously need to go in and have that looked at. From what you have written, it sounds like a total or near-total achilles tear. You will need an ultrasound or even an MRI to diagnose this.

I'm crossing my fingers I'm wrong.

Let us know.

tb1 said...

You most probably tore something although if it were a partial achilles tear even at the proximal end I would think that it would be somewhat visual and palpable since the achilles is a superficial tendon. Hopefully it is merely a gastrocnemeus or other muscle tear which would be less severe then a tendon. The way you described dragging your foot and the inability to lift yourself up on your toes may suggest otherwise.

Phil said...

Running Doctor .. I don't think it's an achilles tear. I can still flex my foot without pain and the pain is much higher up on the medial side of the calf. And perhaps my tendency to over dramatize everything mislead you (I've got a very low pain threshold and I'm known as a very poor patient) Also, the picture is probably misleading. I realize (now) that my right thumb is right over the spot where the achilles tendon joins the gastrocnemius (how do you ever memorize all this stuff?) What I was trying to show is the gastrocnemius hurts from the medial head down to the achilles; however; if I roll this muscle between my fingers, most of the pain is up towards the medial head.

I can't do toe raises with my left foot only. It hurts way too much. But I can do two foot toe raises without only minor pain. There's no swelling or internal bleeding evident. What my calf does not want me to do is walk heel to toe. Nor is it willing to walk up or down stairs on my toes.

I'll be in town next week and should be able to get this checked out.

All that said, I think this is a huge wake up call to get more limber. I've built up lots of strength over the past year and have noticeably lost flexibility.

I welcome all your comments and observations.

Angie said...

it reminds me of what my ex dealt with last year; he tried to run a 50 miler on it, and then ended up not running at all for a few months. He's just now getting back into things. He never got it checked out, so I'm really no help. I just hope you get it figured out and can continue running.

Dusty said...

Phil, I think you need to get this checked out. If I recall, the toe trouble was the big toe - is this the same leg? Toes can have issues for many reasons - these two together could mean either Acute or Exercise-Induced Compartment Syndrome - from where you are pointing - the posterior compartment. Here are the symptoms:

1) weakness in plantar flexion
2) weakness of great toe and little toe flexion
3) paresthesia of the sole and foot.

If it is Acute, it is classified as a major emergency in the athletic training world. Go to the doctor. If exercise induced and you don't treat it, it could become accute.

If this is what it isn you need to keep your leg elevated and a cold pack on it. Do NOT wrap it. Do not constrict the lower leg in any way.

I don't mean to freak you out and can't identify without seeing you and I haven't been an athletic trainer in a decade. There are other things this could be - calf strain, etc., but go get this checked out to make sure. You need to get a doctor to diagnose, regardless of what it is - you could compound a small injury into something big if you don't treat it. Be sure to tell the Dr. about your toe and anything else that you may think of as insignificant.

I really hope my guess is wrong.

Phil said...

Hi Dusty ... thanks for the input. My left big-toe is classic osteoarthritis. I don't have any cartilage in the joint.

I do have one more remembrance that is probably relevant. The first night I was in South Bend, the same calf spontaneously cramped while I was lying in bed. I didn’t think much about it at the time, but the memory came flooding back this evening when I laid down.

Regardless, I'll try to get in to see my ortho guy tomorrow.

Ewen said...

Where you're pointing, looks like the Soleus. Hopefully it's not a tear. I had this injury from August-October last year.

It responded mainly by rest. I was able to cross-train (cycling). If it's a tear and not just a strain, my best advice is to wait until there is no pain - walking, up, down stairs etc. Then wait another 3 days or so before commencing very easy jogging. Fingers crossed it's not that bad.

Jim said...

Phil . . . I am not a Dr or trainer but I must agree with most of the comments-get it checked out regardless. It would be a shame to take something minor that needs a few days rest and turn it into something that would keep you off your feet for months. Of course, I am one to talk . . . as you know, I had very similar pain. I just started one day out of the blue. I am guilty of not going to the Doc. I took off for a week. Ran low mileage for a couple of days and it still hurt. Took off another week. The whole time I was icing, gentle stretching, using DMSO (http://www.dmso.org/subLevels/what.htm) and whining. It took another couple of weeks of low mileage but I am getting back up to speed and things seem normal. Hopefully, yours is just overuse injury and minor.

Bummer on the head cold. Like you told me . . . I think there is something going around!

Have a great weekend.

Adama Anderson said...

I wouldn't have any advice on the your injury but hopefully you'll get better! I would definitely not move around on it that much, and do what you were doing ice it for a day, if worse i'd see the doctor unfortunately. Hopefully it's nothing.

It's the weekend hope you end up enjoying it!

Irene said...

I have no advice, but I'm glad you posted this because I've learned so much reading the "sage advice." I hope you recover quickly!

Dusty said...

Hi Phil - glad to hear about the toe - you had me a bit worried, but I would still get it checked out (as you said you will try). If it is something minor and you don't get it taken care of, can get a lot worse - I had a weird twinge in my hip or leg - did the basics, but shook it off as sleeping on it wrong repeatedly and continued to run - ended up throwing out my SI and it took longer to fix.

I'm not digging this ageing thing, we don't always bounce back after a good night's sleep anymore. haha

Dusty said...

Random thing -- you might try eating more bananas for the leg cramp part. You may be a little low on potassium. Bananas usually do the trick. My asthma Rx seems to impact my potassium (has my dr & I perplexed) and I get insane leg cramps. I try to remember to eat a banana a day and wala!

olga said...

Although I used to be a doctor, I was a baby doctor. But - I am a Queen in injuries. So what it seems to me is a muscle strain. Knowing myself, I wouldn't go to get it checked (not that I recommend not to, but I don't push to). Regular RICE and Ibupro, after a couple of days if pain gets down to negligible - gentle stretch. I think you built up the strain and just triggered it now. Along with stretcheing you may self-massage it (nicely, not deep). Before coming back to running, do another type of cardio first, may be biking, but stationary, so you don't have to point toes down and can control the load. Don't do squats or ham curls for a bit (if you do it at all).
Look who is talking. But I always hope others are way smarter and have more common sense than I do. Feel better.
Olga Tolstoy:)

carmen said...

oh phil, it's really unfortunate that this had to happen to you. i certainly hope that your ortho guy can clear up some of the confusion for you.

i'm sorry that i don't have much to offer in terms of advice but i hope that whatever it is that is afflicting you isn't too serious.

DawnB said...

Phil sorry ot hear about this I really hope its not as bad as it sounds

J~Mom said...

Phil I hope it is feeling better already. Please update us when you can.

Lana said...

Phil - Oh no. So sorry. I'm not the one you want giving medical advice, so I'll that to those who are qualified...but I do hope this goes away soon and proves to be something minor. Get some rest and keep the ice on it!

Abadabajev said...

It's your soleus muscle. If you can't go up on your toes. Sounds like a micro tear. Watch for spasms in your calves for the next couple days.

Nicole said...

Call the ortho doc.
I think you tore some muscle fibers in your calf muscles. Not as serious as an achilles rupture but they still might give you a walking cast to allow the muscle to rest so it can heal.

Adama Anderson said...

Hey Phil, thanks for the comment back. Yeah I hope to get under 1 hour on this 10K, I'm sure I will, well I hope I will, this would be my PR by 2 minutes at least. I'm looking forward to a day off from work. I've been thinking about doing the Whiskey Row, though i'm not sure if I want to drive up there the day of or spend the night the day before. I seriously would love to knock that out before I do the SF half-marathon. Thanks for wishing me luck with my traning, hopefully everything gets better for you.

Gabrielle said...

Hi there, Phil:
I came across your post when I was doing a google search...I, too, have a similar problem and I was wondering if you did seek help and what they said. I have been training for a 5k recently and have been having really bad pain in my legs to the point of when I get off the treadmill I can not walk right. The pain is near the top of my calves too and it hurts when I walk down stairs A LOT. I probably should see someone and stop running, but I am only 20 years old and a girl my age should not have to stop exercising, which is what they will tell me. Anyway, I was wondering what the docotr did end up telling you...
Also, try some IcyHot from the drug store...it will really relax your muscles and use a heating pad...it will all help with the pain.

Phil said...

Hi Gabrielle ... thanks for stopping by ... it looks like you don't have a public blog, so I'll respond over here and hope you return.

In the end, I didn't get professional help beyond the 20 or so blogging friends that guided me through the process. I tore my soleus. This is the muscle under the large meaty calf muscle you feel when you massage your calves.

The pain I had was extremely intense and I couldn't walk for straight for several days .. and forget about walking up and down stairs. I used the standard RICE routine (Rest, Ice, Compression, Elevation) and over the course of 2 long weeks the calf healed. I didn't start running on it again until I was not feeling any pain.

It sounds like you have something different. It sounds like you have an over-use type of injury or tendonitis at the point the medial head of the gastrocnemius (the large muscle). You can get this from increasing your mileage too fast, running up hills hard, or just simply increasing your training regiment too fast. I’d suggest backing off a little and icing it after every run. I wouldn’t advise using heat. It may feel good, but it doesn’t help with the inflammation.

Set up a blog for yourself and I guarantee you that you’ll get more advice than you know what to do with. The running community is about the nicest group of folks you’ll run into anywhere.