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1628 Views 3 Replies Latest reply: Mar 14, 2013 12:49 PM by JamesJohnsonLMT
Spookas Rookie 2 posts since
Mar 13, 2013
Currently Being Moderated

Mar 13, 2013 6:23 PM

Ankle Pain (injured in the past) / Tight Calf

Hey everyone!


I'll try to be bas breif as possible, but I also want to be thorough.


I've recently started the couch-to-5k running program, and have run across some problems. My left calf started bothering me the first time through, and by the end of week 3, my right ankle had been bothering me too. I decided to take a week off, as well as buy new shoes (my parents are runners, so I did go to a store and got fitted properly).


I started up again (from the beginning), and everything was going fine. My left calf started bothering me again, but I figured it was just not conditioned to it yet. My right ankle started getting a bit sore right after running around week 3, but would go away shortly after. I've just finished my second workout of week 4, and by the end of it, my right ankle was REALLY bothering me.



The discomfort in my left calf isn't really pain, it's more of a tightness. It occurs in the middle of the calf, and arises normally at a walk phase of the routine or towards the start of a hill (though I have switched to indoor track running because hills are unavoidable where I live). I suspect I was favoring my other side, leading the the right ankle problems. I tried stretching before runs (have always strecthed after), both "static" and "dynamic" stretching, and nothing seemed to help. I also tried a compression sleeve, but again, no luck.


Then, today, then concerning thing happened. On Monday, I noticed a bit of soreness come back in my ankle at the end of my run, so I took some Ibuprofen, iced it, elevated it, and put a compression brace on until the next morning. Today, midway through the run, I noticed the same pain come back sooner. In hindsight, I should've gone home and posted this, but I continued to the end of the workout, and it was really hurting when I finished; the walk home from the gym wasn't pleasant at all. I did the same things as Monday when I got home. The pain was on the right side (again, left ankle) towards the front, and on the walk home, it reminded me of the pain I felt after spraining it 3-4 years ago. I also have pain from the bottom to mid calf on the back/left of my lower leg, which is new, and not comforting.


To get an idea of what my poor ankle has to deal with; I'm 6'2'', 230 lb 22-year-old guy who has been weightlifting for the past 5-6 years. I'm not a model of male physique, but I'm also pretty far from "fat". I lift 3 days a week, run 3 other days, and rest 1. I've been tracking my nutrition extremely closely for a while now to try and battle slightly high blood pressure (it's working, by the way), which is why I also started running. I follow a spilt workout plan, putting legs only on Thursday (running is MWF); I've recently starting doing calves on Saturday with my standard workout in an attempt to help.



My question is: what actions do I need to take to get back to running? Am I overworking myself?


I have decided to skip Friday's run, but I would love to get back on it Monday. I starting writing this after removing the ice (on for 20mins), have no pain in the actual ankle anymore, and the muscle in the back of my lower leg feels similar to muscles the day after lifting.



Thank you so much for your time! I appreciate any advice you can provide me with!

  • justamaniac Legend 240 posts since
    May 30, 2007
    Currently Being Moderated
    1. Mar 14, 2013 7:09 AM (in response to Spookas)
    Ankle Pain (injured in the past) / Tight Calf

    Great call on skipping Friday's run - if your ankle was hurting that much you definitely need to not agravate it further.  Being very easy on it for a few days may help it, but you may want to go see somebody, possibly even just a podiatrist, to get a better read on on the status of the injury.  You may have stressed a ligament or a tendon and the only thing that usually fixes that is time. 


    Ibuprofin will make you feel better, but it's not going to fix it (it may help reduce swelling, but that's it) - as a rule, I tend to avoid NSAIDS (like Ibuprofen) during the day because they mask where the pain is, causing me to potentially cause more damage by not favoring the injured area (like allowing me to walk on a hurt ankle as if it were 100%).  But I'll dose up on them it at night to help me rest!


    The calf tightness may have been, as you noted, from lack of conditioning and perhaps as a result of the new shoes (is the heal on the new shoes a little lower than your normal shoes? That can cause tightness in one or both calf's until you get used to them.)   You might be able to help relieve the tightness in your calf with a foam roller - it worked for me.

    The root cause may have been your shoes -  you might even benefit from some kind of orthodics.  But the bottom line is that if it is hurting you while or after running, that is NOT a good thing, and continuing to run is not going to help it heal. Rule #1 for runners is "take care of your feet" !  Be very ginger with your ankle - you've got a large frame and you need good strong ankles.


    Good luck


  • JamesJohnsonLMT Legend 1,283 posts since
    Aug 23, 2009
    Currently Being Moderated
    3. Mar 14, 2013 12:49 PM (in response to Spookas)
    Ankle Pain (injured in the past) / Tight Calf

    Ditto on the foam roller, if you don't overdo it, and the pressure hits the right spots. I often tell people to take a seat and bring the bad calf over onto the opposite knee, starting low on the calf and letting it slide slowly down the knee to check for sensitive spots in the calf. Most runners will find some, and it gives you a good idea where to focus your pressure. Rollers usually don't get between the bones well enough unless modified to do so, but you may have more to think about than just getting better.


    It helps to approach one-sided repetitive-motion injuries by looking for one-sided causes. It usually boils down to running surface or anatomy, barring any history of accidental injuries, etc (your sprain could count). Most people who run on roads will find that the road surface they run on is slanted to the right or left for drainage. This can be tough on the downhill calf as it raises to compensate and keep your body level. Switching to the other side can help temporarily, but you also run the risk of ruining the other leg. Track oval workouts can pose problems, too.


    Most people have one leg that is a bit shorter than the other. It doesn't take much of a difference to add up over the miles, and this can be felt anywhere from the head down to the feet. Back or hip problems are common, as well as headaches, knee pain, and of course the ankles. One reason, besides stress on the joints, is chronic muscular tension, again due to compensation. This can occur from the ankles all the way up to the jaw.


    I have found, as many others have, relief when the short side gets some stable padding in the shoe to compensate for the difference. This can be in the form of a tough gel insole (what I use), or a prescription orthotic. If, the latter, it should be sports-med specific, since athletes require much greater precision, more flexibility, and less weight than desk jockeys do. My apologies if you happen to be both, but getting out of that chair onto the road can highlight those anatomical discrepancies very quickly.


    Remember that muscles do not always represent pain locally. It is often felt in the joints they operate, even further away. When troubleshooting pain, always think in terms of the prime movers - and other conditions - that affect the area. Don't focus too closely on the symptom(s) alone. In medicine, common sense is not always common. Look for the big picture.


    On stretching, it is a very general term used to describe many techniques, under diverse circumstances. It can help or hurt, depending on your condition and method. What I have found in general, is an inverse relationship between the fitness of the athlete and the success of the stretch. The healthier you are, the more you can get away with. This ironically leads many to believe that they will become more fit if they stretch like the pros, but it doesn't work that way. Damaged tissue can sustain more damage after a fit-person stretch, no matter what type it is. A better term for what can help is "range of motion exercise," which keeps things from getting stiff during the healing process, and can actually help them heal better. This kind of movement is more natural, benefits when the opposite muscle from the one being "stretched" is contracted to stretch it, and helps the collagen fibers to align properly as scar tissue forms in the healing process.


    Whether you resort to ice, massage, or medicine to address the pain, don't do it with increased activity in mind. As Justamaniac, says, controlling pain can help you rest, which is one of the most important parts of healing. A body at rest devotes more resources to healing than it can in the active waking state.


    The object of training is to build and strengthen, not to repair. The object of rest is to repair. In order to rest, it helps to reduce pain and relax. Then, moderate activity can help to enhance circulation, and to properly model the repair. Any attempt to resume training as usual can defeat both of those goals. In this way endurance athletes differ from body-builders, who break tissue down in order to increase size and strength. I know pro and elite athletes often ignore this, but that's because the temporary glory, paycheck, pride and reputation are more important to them than a life of joyful running. Which is more important to you?


    I recommend after looking for obvious problems with your running surface, you find any anatomical asymmetry that can affect the motion of your ankle, whether directly or indirectly. Excess pronation, tight hip muscles, leg length discrepancies are some good examples of what to look for, and you may require the help of a professional to do this. Weight is important, because running multiplies the g-forces on the joints. There can also be problems with the configuration and ligaments in the tarpal bones of your ankle. You are probably right about the stress fracture, which appears to dog endurance runners more than weight lifters. You would be feeling it more.


    Meanwhile, optimize your rest, seeking pain control only when necessary, and keep moving only for the circulation. Training as usual can only be of benefit later, if you do this first part right. You can heal weaker or heal stronger. The choice of what kind of scar tissue you're going to get, is yours to make.

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