Posts in category: Sport Therapy

The majority of calf pain can be attributed to two relatively minor issues, but there are also some more serious potential underlying causes. So if you are experiencing calf pain be sure to read this post in full.

The term “calf muscle” actually refers to two muscles; the gastrocnemius and the soleus muscle. The gastrocnemius is the larger muscle, with the soleus muscle sitting beneath the gastrocnemius. These two muscles run down the back of the lower leg and join to form the Achilles tendon, which connects to the heel.

The most common problems that can result in calf pain are cramps and muscle strain. A cramp is the involuntary contraction of muscles, often a symptom of overuse of the muscle or dehydration. A strain occurs when a muscle or tendon is forced outside of its normal range of motion, resulting in the stretching or tearing of the muscle or tendon.

A tear in the muscle may present with slow development of pain or can occur with sudden sharp pain that feels like you have been kicked in the leg or have sudden feeling of a “POP” in the leg. A torn muscle can also be associated with bruising and swelling in the area. Fortunately, conditions such as these can be easily treated at home, with massages and stretches working to alleviate cramps, and the R.I.C.E. technique (Rest, Ice, Compression, Elevation) for strains.

While those may be the most common causes of calf pain and will be to blame in the majority of cases, it is important to be able to recognise the signs that your calf pain may be coming from something more serious.

Calf pain can be a symptom of sciatica, which is when an injury or pressure on the sciatic nerve refers pain, numbness, and tingling down the lower leg to the calf. If sharp pangs can be felt when sitting, sneezing or coughing, that is an indication of sciatica, and you should visit a doctor or physiotherapist as soon as possible.

Another possible cause of calf pain is compartment syndrome, a very serious condition that can be either acute (sudden) or chronic (long-term). Compartment syndrome is when intra-compartmental pressure builds up in a muscle. This prevents the flow of blood and lymph, meaning less oxygen and nutrients reach past that point to the muscle and more toxic waste builds up in the muscle. The process leads to ischemia of the muscle tissue which is where cells die due to lack of oxygen. Symptoms include intense pain, a burning sensation, and tightness. This condition requires immediate medical review.

Deep vein thrombosis (DVT) is another condition which occurs when a blood clot forms in one of the deep veins. The symptoms include calf pain, warm feeling, and red skin discoloration around the affected area. DVT can be caused from reduced circulation or altered blood clotting from injury to vein, post-surgery, medications and reduced movement. DVT can be fatal, so it is crucial to get it checked out immediately if you suspect it.

The last major condition that could be a cause of calf pain is diabetic peripheral neuropathy, which, as the name implies, is a condition affecting diabetics. Peripheral neuropathy refers to damage to the nerves from high blood sugar. Depending on the nerves affected symptoms can range from pain, weakness, tingling, and aches If you have been diagnosed with any form of diabetes and present with these symptoms you should get checked out as soon as possible. If you have not been diagnosed with diabetes, you should consider the possibility that it may be the cause of your pain.

We are always being told that exercise is good for us, but how important is it really?

The positive effects of physical activity on physical and mental health as well as quality of life have been well documented. Insufficient activity is a major public health problem. 

What are the benefits of exercise?

Exercise has significant health benefits and some you may not even realise. These include reducing risk of cancer, diabetes, cardiovascular disease, lower back pain, depression, anxiety and COPD (Chronic Obstructive Pulmonary Disease — an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, and non-reversible asthma. This disease is characterized by increasing breathlessness)

The table below shows how much physical activity can help reduce the risk of long-term conditions and mortality. For example, doing physical activity can reduce your risk of getting breast cancer by 20%!

On top of these long-term conditions, physical activity can help with:

• Sleep – exercise helps you drift off more quickly and into a deeper sleep, allowing a better night’s rest. A good night’s sleep is essential for overall health.
• Boost energy levels – the surge of blood around the body transports oxygen to the brain to make you feel mentally alert. It also increases blood flow to the tissue as well as your lungs and heart. Better conditioned muscles and cardiovascular system require less effort to perform physical tasks and over time as the body becomes stronger so too does the immune system reducing the risk of illness.
• Memory — regular exercise has also been shown to improve memory and learning functions, both of which are impaired by chronic stress. Scientists have also discovered that exercise helps in preventing dementia and cognitive impairment in older adults. 
• Depression — Exercise helps chronic depression by increasing serotonin, which helps your brain regulate mood, sleep and appetite. Immune system chemicals that can worsen depression are also reduced.
• Mood – exercising also releases a chemical called endorphins in the brain, which help to improve your mood.
• Reduces inflammation and visceral (abdominal) fat – increasing physical activity increases muscle activity, which then increases a substance called anti-inflammatory myokines. This in turn reduces systemic inflammation and also reduces the fat around your organs knows as visceral fat. Visceral fat itself can be dangerous and causes an increased risk of dementia, heart disease, diabetes, stroke, breast and colon cancer. 

So how much exercise should we be doing?

1. 150 minutes of moderate intensity activity per week OR

75 minutes of vigorous intensity activity per week OR

A combination of both

2. Muscle-strengthening activity at least 2 day per week 

3. Limit time spent sitting for extended periods (recommend getting up for 2 mins every 20 mins)

4. For older adults (65+) — Balance and co-ordination activities at least 2 days per week

This doesn’t mean that you have to go to the gym every day and lift heavy weights, the most important factor is to pick something that you enjoy doing, make it achievable and build it into part of your daily routine. For example, getting off one tube stop earlier and walking. Take the stairs instead of the lift or escalator. Run or cycle into work as part of your normal daily commute. Head out for a walk in your lunch break. Try a new hobby with some friends. 

Remember.… More is better. Some is better than none.

It’s Marathon Time!

With only three months until the WEB Marathon, most competitors should have started their strength & conditioning programme and starting to build up the miles.

How many competitors are optimising their recovery time?

Muscle soreness appears many hours after participation of the damage-inducing exercise and peaks 24–48 hr post exercise – known as – delayed onset muscle soreness (DOMS). The fact that soreness peaks 24–48 hr post exercise and any swelling becomes pronounced several days after exercise suggests that damage may be exacerbated after exercise. Muscle damage is initially caused by mechanical strain on the muscle and this damage is exacerbated by the inflammatory response in the days after the exercise. The inflammation occurring after the initial trauma incurred by long runs is likely responsible for the continued damage (1). DOMS accompanies muscle damage and may be caused by a combination of factors including swelling, increases in noxious chemicals and by-products of inflammation.  

Whether you have just started your training programme or you are well on your way, Soft Tissue Therapy (STT) and sports massage can be used to assist in recovery from the effects of strenuous exercise.  STT is also important in rehabilitation to increase range of movement, decrease pain, anxiety and reduce stiffness.

Soft tissue therapy has the potential to reduce the inflammatory process associated with the micro tears sustained during strenuous exercise. STT also helps facilitate early recovery, and provide pain relief from muscular injuries.  By altering signalling pathways involved with the inflammatory process STT is reported to also decrease secondary injury, reduce nerve sensitisation resulting in the reduction or prevention of pain and increased recovery from tissue damage (2). Changes in parasympathetic nervous system activity as measured by heart rate, blood pressure, and hormonal levels such as cortisol (known as the stress hormone) following STT result in a relaxation response (3).

In general athletes and exercise practitioners have assumed that increased training was the ultimate prescription for improvement. It is well accepted that overload is necessary for improvement, however, overtraining results in a breakdown of tissue at some level, thus impairment or regression of performance rather than improvement become normal. Overtraining is usually thought of strictly in terms of training, yet overtraining might also be expressed as under-recovering. If the recovery rate can be improved greater training volumes would be possible without incurring the negative consequences of overtraining (4).

Studies have shown that STT initiated immediately after exercise and 48 hours post exercise were both effective in reducing muscle oedema and decreasing the number of damaged muscle fibres compared to exercise only and non-massaged controls. Soft tissue therapy can mitigate secondary injury associated with intense exercise, thereby reducing tissue damage and accelerating recovery (5). Rest, diet considerations and water are an important part of the recovery process and should not be overlooked.

The hamstrings are a group of large muscles that include the Semimembranosus, Semitendinosus and Biceps Femoris, which are located at the back of the thigh. These muscles play a major role in gait (walking), running and many other activities that require flexion of the knee and extension of the hip.

A tendon is a band of connective tissue which attaches the muscle to the bone. In hamstring tendinopathy the tendon becomes sensitised to load and movement. It is commonly an overuse injury related to;  an increased training load, training errors, an increase in physical activity or as an indirect result of another injury or deficiency.

Signs Of Hamstring Tendinopathy

• A gradual, developing pain in the knee joint or buttock region which can be pulsating, sharp, aching and persistent.
• Lingering pain or pain upon activity around the thigh area or gluteal region including the hip and pelvis.
• Activity related pain which often eases with warm up initially but as the condition deteriorates the pain stays during activity and may last long after the activity has ceased.
• Pain sitting, especially around the sit bones.

How Can Physiotherapy Alleviate These Symptoms?

Hamstring tendinopathy is associated with loading of the tendon so it is essential that you modify your activities correctly and follow an appropriate exercise prescription to get better. Your physiotherapist will evaluate your current exercise regime to keep you as active as possible within the limits of the condition. You will then need to follow a tendon loading program to work the affected tendon to stimulate change, whilst not overloading it. Working with an expert is essential to achieve the correct exercise balance.

In addition to exercises to specifically address the hamstring tendon, any other predisposing factors need to be taken into consideration. This will include pelvic stability, gluteal power and function, foot posture and lower limb movement patterns. Any deficits in these areas should be addressed as part of your rehabilitation program.

It is important that once you suspect that you have a hamstring tedinopathy you start the process of recovery promptly as the longer you wait, the further it progresses.

To book an assessment with one of our expert physiotherapists you can book online or contact us on:

Email: talofosa@gmail.com

Phone: 58442970