Well, I have become somewhat of a runner in the past 2 years. I have run two half marathons and have been training for a third. That is until my right lower leg has gotten in the way. In May, I ran 1:40:08 at The Flying Pig Half in Cinci (tons of hills). Not bad for a 184 pound former football player, right? My goal was to crush that time in Columbus on 10/18.
About 5 weeks ago I felt intense pain near the medial head of my right calf during the end of a 4.5 mile run. I iced immediately afterward, but I knew something was wrong. I had to take about 10 days off from running. I had recently made it back to 4-5 days per week running and thought all was fine. I even completed an 8 mile run in 60 minutes without incident two weeks ago.
But alas, the pain returned last week on a 10 mile run. Only 2 miles into it I felt horrific sharp pain just below the calf. I had to hobble back to my car. This is a frustrating and defeating experience to be sure. While I suspected a small medial head gastroc (calf) tear, I wanted to get my friend and orthopedic surgeon’s medical opinion. So, I went and saw the man I send all my hurt athletes to yesterday. I wanted him to confirm that my achilles tendon was indeed OK. That he did. Whew!! What a relief. X-Rays revealed no stress fractures either.
We talked and decided I would wear a heel lift to off load the calf for a short while and try to run in the half on 10/18. As I continued to marvel at my scenario today, I began testing my leg and thinking, “Why can I do a single leg calf raise and single leg hop without pain if my calf is injured?”
Then the light bulb went on. It dawned on me the pain was deeper and perhaps just below the calf. The thing that hurts the most is descending stairs. Of course! The injury (or strain if you will) is of the soleus, a smaller muscle deep to the calf and responsible for assisting the calf with push-off and preventing excessive dorsiflexion (foot moving toward to head) of the foot with gait.
You see the pain is almost non-existent when my knee is straight. But, once the knee bends and I transfer weight forward over the foot I feel significant pain/weakness. Yes, the soleus is not quite right. The calf is less responsible for controlling the body weight as the knee bends which makes sense to me based on the symptoms. I can honestly say I am not sure I have treated anyone with a soleus strain.
See the soleus in red below:
So, what is the course of rehab? Cross training on the elliptical this week and then gradual integration of running again. The real challenge for the soleus occurs at heel strike to foot flat as it works to slow the dorsiflexion down and take all the weight of the body during single leg support. Ouch!!
The good news is my tendon is fine. The bad news is that the half marathon involves so many steps it may become an endurance based issue. I will be adding knee bent stretching, single leg calf raises (straight and bent knee), anterior reaches, step downs and lunges into the program as pain allows this week.
So, for all the runners out there keep in mind pain around the calf may actually be related to a soleus strain. Identifying whther the pain occurs mostly with a straight or bent knee will be key in finding the tissue at fault. The two may be linked as I had a bad medial calf tear many years ago.
The take home message is listen to the body and develop the right strategies to maximize recovery and rehab. Hopefully, I will still hit that goal on 10/18. Then, perhaps I will take a short hiatus from distance running until 2010 to allow it to heal 100%.
Have questions and want answers to your sports training issues or injuries? Let me know and I will attempt to answer them as part of my blog posts.