I'm hoping someone can help....I was training for my first half marathon, running my last long run before my taper. I had no pain during the run, but was very fatigued because I had been sick earlier in the week. Later that night, I had significant lateral calf pain, followed by posterior-lateral knee pain on the left. I would experience pain in the calf when trying to straighten my knee. Going up stairs was impossible, as well as coming down stairs. Sitting with my left ankle crossed over my right knee also caused pain. My knee felt generally weak-I didn't trust it to hold my weight. This lasted for four days. X-rays, ultrasounds were negative. Special tests for ligamentous and meniscal damage during exam by sports med doc are negative. Also, I discovered that I would get posterior knee pain when trying to push my foot into a shoe or use my opposite toe to slide the heel of my left shoe off. I have iced, rested and taken ibuprofen to address. I had pain with walking for about a week. I have been doing stretches, strengthening exercises and walking without flaring it up, so I tried to run today (light easy jog, on a flat dirt trail) for the first time in three weeks. I had minimal pain during the run, but then the pain started coming back like before this afternoon. I have already missed my half because of this pain and am supposed to start training for my first marathon in a couple of weeks. Does anyone have any ideas or suggestions? I'm getting frustrated because I feel like I'm doing all the right things, but still can't run.
Oddly enough I have the exact same symptoms right now and am having the hardest time figuring this out. It doesn't hurt when I run, it only hurts at the end of the my run when I am walking. It hurts to bend the kness post run. Stretching helps get rid of the pain with time but I can't figure out what is going on!
When you say posterolateral knee pain are you referring to one of the cords
(tendons) in the side of the posterior aspect of the knee?
What kind of pain? Sharp? Dull? Burning?
Can you press on the lateral side of lower leg and produce any pain?
"The answer is a duck. Maybe a mallard." -Lyle McDonald
The pain is occasionally sharp, but mostly the pain just feels deep in the posterior knee and sometimes calf. The only time I have pain to the touch is if I push on my anterior tib muscle, then I get pain behind the knee, by the fibular head.
Two things come to mind... nerve issue or stress fracture/reaction. I'm leaning
towards a nerve issue though. Common peroneal maybe? As I'm sure you've
heard before, best to see a professional.
"The answer is a duck. Maybe a mallard." -Lyle McDonald
Sorry this comes to you so late. You are doing many things right, but there is something missing from your list. Your symptoms point to lateral Gastrocnemius muscle strain, which should have been the first thing explored by medical personnel. I am always baffled when every test is done except for myofascial causes, since they are the most common source of this type of pain. Then I realize that, based on what I've seen, there is not much money to be made paying attention to the elephant in the room.. and quite an elephant it is!
This upper rear calf muscle spans both the knee and ankle joints (via Achilles tendon), which is why the muscle strain becomes evident when both joints are extended, as in standing while leaning forward. The muscle is located between the joints, menisci, tendons, and ligaments that everyone has been looking at, and weighs more than all those other things put together. Muscle strains do not respond to the usual rest, ice, compression, elevation, strengthening, or stretching protocols designed for trauma control. Anti-inflammatories do nothing to treat an ongoing muscle strain, even though symptoms are suppressed. In this case, the muscle is affected not only by your exercise, but by how you stand and sit.
As you suspect, weakness after extended training was no doubt compounded by your illness, but pressure on the hamstrings from chairs, or on the calves by an ottoman in an attempt to elevate it, both combine to restrict circulation in the muscle, and increase the likelihood of painful spasms. Extended stretches, as when propping your foot up onto a wall, will aggravate the strain and set up spasms and dysfunction in this and other calf muscles.
A good example of how easy it is to provoke these responses from your muscles happened to me last night. I fell asleep with my feet propped on an opposite chair. When I got up, I could hardly walk. my knees buckled and would not support my weight. There was sharp pain in the back of my knees. This only went on for 5 minutes or so, but your training has lasted a lot longer, with longer lasting results. Muscular strain symptoms can be frighteningly dramatic. In my case, a small muscle called the Popliteus, which is in the back of the knee and used to unlock it, was aching from being stretched out so long.
So what to do when the strain seems so permanent? While doctors once used a "spray and stretch" technique to treat these kinds of strains (temporarily chilling the cutaneous nerves over the strained, but still warm muscle allows it to be stretched with better results), the timing of this technique is generally considered to be too sensitive for self treatment. It's also messy and involved the use of CFCs as a refrigerant, and has since been replaced by manual therapy.
Simply get your thumbs into the muscle and compress focused portions of the muscle until the spasms subside and the muscle relaxes, circulation restored. A relaxed muscle can heal; one that is left unattended will heal more slowly. OK, I make it sound too easy, but it is. You get better at it with practice. I've been doing it professionally for years, and often drive over a hundred miles a day to unlock people's muscles. Fortunately for my car, I have a day job where people come to me (just put a guy to sleep, woke him on some rough spots, and put him back to sleep again). If I didn't see this work every day, I would not be so bold. If I can do this for doctors, you can do this yourself, or find someone else to do it. It's the missing element in your list.
Thank you JamesJohnson and others for your input. I have had a sports massage and it did make a difference in my symptoms. I also recently found out through MRI that there is a stress reaction going on in my posterior lateral tibia. I have been shut down for 4 more weeks (on top of the 7 I've already had-ugh!). I'm going to keep getting massages for the soft tissue discomfort, cross training, then hopefully back on the road for my marathon this fall. Thanks again everyone!
I am just an amateur and a patient at that, I have learned alot about soft tissue damage after my bicycle crash..................reading about your symptoms, I agree with James and would like to add that when I get prolotherapy injections into stretched tendons or ligaments I have bent the needles suddenly when something lets go, my doctor says he found a trigger point and man it feel great to release those, if you can do it with your thumb, all the simpler...I have heard of ACT...Active Release Therapy I think James is describing........
Prolotherapy does not recommend icing an injury and they dislike anti-inflammatories by the way.......
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