unknown leg injury...help !!

[TangLangCh'uan]

hey everyone,
okay, this is the second time that this has happened to me. the last time i was experiencing pain like this, i ended up not being able to walk for a week, and it took me almost a month before i was back to full training condition. basically, i have a sharp pain in the back of my right calf. it is centralized, and doesn't shoot up or down my leg. it is most painful when i'm in a ma bu stance, doing side blade stretches, or if i receive any kind of impact to the immediate area, or the outer part of my leg at all. the same thing triggered it this time as it did last time (suicide kicks), although i'm not sure what it is about the manuever that is causing this, and it doesn't happen everytime i do suicide kicks.
if anyone can help me decipher what this is, and can suggest any ways to prevent this from getting worse, i'd really appreciate it. just in case you're wondering, the last time it happened, i did go to the hospital, and after having a doctor do a half-a$$ examination, followed by an ultrasound to determine the nonexstence of a blood clot, i was told i had "severely strained a muscle and/or ligament in my calf", and nothing more specific than that.....and people wonder why i don't trust most western medicine.

thanks in advance,
christopher

[TenTigers]

what exactly is a suicide kick?

[IronFist]

Sounds like a charlie horse? If you pull your foot up does it go away? I've had bad ones that hurt for 3 days after they went away, but never a month.

Is the muscle contracting when it happens? Like, does the muscle contract and become very hard?

[AndrewS]

the last time it happened, i did go to the hospital, and after having a doctor do a half-a$$ examination, followed by an ultrasound to determine the nonexstence of a blood clot, i was told i had "severely strained a muscle and/or ligament in my calf", and nothing more specific than that.....and people wonder why i don't trust most western medicine.

Umm, because your doctor made sure that your complaint wasn't one of the few things that could present that way that could kill you?

Sounds like a good reason not to trust western medicine. Go play in traffic for a while, then insist on going to a TCM clinic for your hemopnemonthorax and splenic laceration.

Andrew Somlyo MD

[viper]

When it comes to medicine both work well it different situations. Maybe you should consolt another opion and prehaps look at the specifics and put some faith in your doc east or west their there to help you maybe noit go as hard sounds like you really work yourself I understand that but for the future maybe lots of rest massage and another doc opion.

[monkeyfoot]

wisest oil.....I have never had something it doesn't seem to help

touch wood

craig

[Merryprankster]

You know, there is always the possibility that you had a severely strained muscle or ligament, and that's why that diagnosis was made.

Seriously, we often do things to ourselves that are overuse injuries and we don't even know it till later. On that note, if don't trust your doctor's diagnosis, instead of asking for help here, GO GET A SECOND OPINION.

[TangLangCh'uan]

thanks for the responses. while i don't believe it's a charley horse, i will seek a secondary opinion regarding this,from both my TCM practicioner, and another doctor.

while i try to be respectful of other people who post, and avoid trying to start any kind of conflicts, i felt the need to respond to this.....



Go play in traffic for a while, then insist on going to a TCM clinic for your hemopnemonthorax and splenic laceration.

Andrew Somlyo MD

jesus...i was simply stating my opinion...i thought i was allowed to have that....i guess my PCP isn't the only one who thinks that because they have an extra pair of letters after their name, they also have a license to be a *****. sorry if i'm jaded by the fact that whenever i've gone to my PCP, or the emergency room i've paid a whole lot of money for very little care or interest in my injuries.

i appreciated the ultrasound to check for a blood clot....

i don't appreciate being belittled by someone who talks to other adults like they are children, and uses large words to make themselves seem smarter...i hope you're more respectful of your patients than you are of the other people who post on this message board.....

...i'm off to play in traffic

[Ford Prefect]

If you didn't go to a specialist...

[AndrewS]

jesus...i was simply stating my opinion...i thought i was allowed to have that....i guess my PCP isn't the only one who thinks that because they have an extra pair of letters after their name, they also have a license to be a *****. sorry if i'm jaded by the fact that whenever i've gone to my PCP, or the emergency room i've paid a whole lot of money for very little care or interest in my injuries.

My habit of not suffering fools well predates my degree. You are, from your profile, 23 years old, and practicing a fairly rigorous martial art. Odds are your 'injuries' have been fairly minor soft tissue events, with perhaps a fracture or two. If you've had a pediatric malignancy, congenital heart defect, cystic fibrosis, or any other malady, my apologies, otherwise the reason your doctors aren't interested in your complaints is because they are, essentially, trivial, and have been made to the wrong people.

Yes, every person's problem can be huge to them- wonderful statements about empowerment and empathy can be inserted here, but the brutal truth is that your PCP sees 15 people a day who he or she can do little to do to fix or even diagnose more than clinically, 10 who have some ongoing problem which requires careful fine-tuning, and lives in fear of that easily-missed disaster they see every few hundred patients or so. The ED doc- multiply the number of patients by 5, and the number of serious problems by 20, if not more.

You're b*tching because you went to see people involved in triage and general medicine who did their jobs, seem to have come up with a reasonable diagnosis, and *didn't fix you immediately* or stroke you appropriately. That's like being p*ssed at your handyman because they don't know how to lay italian marble or wire in 220.

It's called 'sports medicine' and it's a 1-2 year fellowship after residency, in case you were wondering. . .


i don't appreciate being belittled by someone who talks to other adults like they are children, and uses large words to make themselves seem smarter...i hope you're more respectful of your patients than you are of the other people who post on this message board...

Sorry about the big words making your head hurt. Medical terminology has no place in the discussion of medicine, after all.

As to my patients- one of the reasons I take care of extremely sick people is so that when they start throwing entitled delusional temper tantrums (like the woman screaming at one of my surgeons yesterday because he didn't break scrub and extend his pump time to call out of the operating room to update her), it's much easier for me to bite my tongue, put on my game face, and do my best to make a bad situation better for someone with a real problem.

23 and you think your ouchy calf is the end of the world, ready to condemn all of a discipline which has been extending life near miraculously for the last 100 years? You're going to a joy with your first myocardial infarction, or your ostomy for colon ca.

Andrew

[Ben Gash]

I must say, a cursory examination does not usually involve an ultrasound. You received a thorough investigation and appear to have been treated appropriately. It tends to upset health care professionals when you make inane comments about the adequate treatment you've received. You give a very good story for a soft tissue injury, which requires regular painkillers (of the over the counter variety) and gentle exercise. These injuries can take up to 12 weeks to get better, especially if you keep doing things that aggrevate them (such as horse stance). If you want a more detailed diagnosis than you've pulled a muscle and/or ligament (what more do you really want to know?), and something to help it, then see a remedial massage therapist, who specialises in pulled muscles. You could also try something like red flower oil.

[KPM]

Hey Christopher!

---Me thinks Andrew may have been a little cranky post-call. :D I'm not post-call, in fact I just had a day off, so I'll try and point some things out for you.

I have a sharp pain in the back of my right calf. it is centralized, and doesn't shoot up or down my leg.

---Sounds like a muscle strain alright. Most likely where the gastrocnemius muscle meets the soleus muscle. If this is the second injury to the same spot then you likely have a chronic strain with some scar tissue formation.

i'm not sure what it is about the manuever that is causing this, and it doesn't happen everytime i do suicide kicks.

---Well, since I have no idea what a "suicide kick" is and you didn't answer the previous poster that asked about it, I'm afraid I can't help you there. But a small tear at the gastroc/soleus junction typically results from forceful planting of the foot...like doing "step-ups" with weight when training for gastroc strengthening...or perhaps a hook kick in which the sole of the foot meets solid resistance.

just in case you're wondering, the last time it happened, i did go to the hospital, and after having a doctor do a half-a$$ examination, followed by an ultrasound to determine the nonexstence of a blood clot, i was told i had "severely strained a muscle and/or ligament in my calf", and nothing more specific than that.....and people wonder why i don't trust most western medicine.

---You see, that's a pretty lame comment. First of all, the doc ruled out the one common thing that causes calf pain....and that can also KILL YOU. The examination for a muscle strain is not that complicated.....does it hurt when I poke here?.......does it hurt when you try to stand on your tip toes?....that's about it. How specific did you want him to be? Let me guess....he also told you to go home, take some anti-inflammatory meds, rest, put some ice on the area, and that it would heal with time if you didn't stress it. But you decided he didn't know what he was talking about and continued to train and stress the area. Now you have a chronic problem. But you don't trust most western medicine...... If you wanted more detailed instruction than you will get from an ER doc or a family practitioner, then you should have went to a doc that does sports medicine, as Andrew suggested.

---Now, despite the fact that you have maligned my profession (just joking :D )....here is what limited advice I can give from a distance. STRETCH! If the acuteness has resolved and you have given it a good rest since reinjuring it, poke around and find the most tender spot. Now use your thumb to do a deep, localized massage to that area, moving your thumb back and forth in a line parallel to the floor. This can help break up scar tissue. Then do a good calf stretch. To rehab it and help prevent future injury you can do eccentric conditioning. Stand with front part of your feet on a step or platform with your heels hanging off. Lower yourself with your injured side (an eccentric contraction of the calf) and then raise yourself back up with the good side (a concentric contraction). It should be a bit painful. If it isn't, and is relatively easy, then put some weights in a backpack and continue on.

---I don't typically come to this forum, and so probably won't see any follow up replies. Just don't be so quick to pass judgement on people that are only trying to help you.

Keith P. Myers, MD, DC

[Wong Fei Hong]

I just saw the help !! off the main page of the forums so i thought i would wonder over from another page !!!!
Well my 2 cents is this,
calf muslces arent like other muscles they are highly predominantly made up of fast twich muscle fibres, fast twitch means they can all be employed really fast to do a task ie if you want to jump all the calf fibres are employed really fast.
However they also tire out the fastest. Slow twitch fibres are employed slowly but go the distance.

So if you contract a calf muscle for a long time even for 10 seconds you could damage it , whereas you could tense a slow twitch muscle for a longer time with no problem. So you gotta be careful

The other thing is that calf muscles for some reason are linked directly to your groin through some neuro muscular pathways, all the way to your heels.
You may have noticed when someone is struck in the groin , instructors will either tell them to squat and whilst squattign to go on tip toes, or they will be told to jump up and land on the heels this causes a slight disconnection between the nerves that are linked to the groin and it stops you from feeling the pain.

Now if you shoot your man juice, before a workout as they say it weakens your knees but it will also make your calf super susseptible to being damaged if you tense, also disorders of the groin or lack of energy down there, can also be factors, so conserve your super swimmers before training and now that its damaged to heal.

[ZIM]

Christopher-
This is the second time and it's touched off by stance work, yes? I had something like this going on and you'll know if it's alike by the next Q: Does it still hurt when you're not doing stance work, as if it's stuck somehow?

What was going on in my case was: The interior, small/fine muscles of the lower leg [inside the tibia/fibula area*] were being compressed by the lowered stancework I was doing, while the exterior muscles were doing the usual increased blood flow.

*here:
http://www.patient.co.uk/showdoc/21692493/..%5Cimages%5CI77_L.JPG

That combination choked off the oxygen to the interior muscles and they could not adequately recover without aid, since they'd reached exhaustion and the exterior muscles then took up the slack, thus increasing the problem. As muscles, they're not overly important, but they're enough to give you pain when they give out. Ignore them and they can start to go necrotic.

What solved it was:
-Ace bandage, for about a week. Firming up the exteriors allowed them to relax and to work the interiors, restoring the bloodflow.
-I also had to slowly, carefully go over my stancework again. You need to watch for pronation, shifting off-line in the knees, ankles, how much time you spend in stance, and especially how far forwards your knees go past your feet - the lower parts of tib/fib are what are choking them off.

Hope that helps.

[IronFist]

So if you contract a calf muscle for a long time even for 10 seconds you could damage it

"Damage?" :confused:

[KPM]

calf muslces arent like other muscles they are highly predominantly made up of fast twich muscle fibres, fast twitch means they can all be employed really fast to do a task ie if you want to jump all the calf fibres are employed really fast.
However they also tire out the fastest. Slow twitch fibres are employed slowly but go the distance.

So if you contract a calf muscle for a long time even for 10 seconds you could damage it , whereas you could tense a slow twitch muscle for a longer time with no problem. So you gotta be careful



Uhhh....no. You have it completely backwards. The calf muscles are part of your "postural muscles." They are predominately endurance muscles. When you are standing in a good perfectly upright posture, the ONLY muscles firing to maintain your upright position are your calf muscles. If you are upright on your feet, your calves are firing! If a 10 second contraction could produce damage, we would all be in big trouble!!! :eek:

Keith

[Wong Fei Hong]

I donno dude, I learnt the calf is made of two muscles the soleus which is predominantly slow twitch or endurance muscles and the gastrocnemius which is the larger of the two. It is located at the top back of the lower leg and it extends from the knee joint to the ankle joint. This is made of either 50/50 slow twitch fast twitch or has a higher majority of fast twitch fibres.