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Differential Diagnosis of Calf pain – Part 2

We will begin this week, discussing some of the less common sources.

Firstly, let’s talk about chronic exertional compartment syndrome (CECS). Our muscles, with the adjacent blood vessels and nerves are surrounded by fascial tissue. When the pressure within this ‘compartment’ increases, this results in restricted blood flow to the area and pain in the area, thus the onset of CECS.

It usually occurs during and after consistent exercise such as running or cycling – at roughly the same time and distance. It can be described as a crampy, achy pain that eases within minutes of ceasing the activity. Sometimes it can be as a result of overuse of a certain muscle group in the leg. Therefore it is advisable to see a physiotherapist to assess, diagnose and then treat this problem so you can exercise pain free.

Medial tibial stress syndrome

is a more typical overuse injury, commonly known as ‘shin splints’. It normally affects 5-35% of the running population and if left untreated can result in stress fracture.

It is an achy pain that occurs along the inner edge of your shin bone, mainly occurs at beginning of running/exercise, can ease during warm up but then lasts for hours afterwards.

It can be as a result of many different factors such as footwear, training too fast/hard and muscle imbalances. All of which can be altered and improved with help from your therapist.

Stress fractures of the tibia.

This is the weight-bearing bone in your lower leg which connects your knee to your ankle. It is a hairline fracture that normally occurs with increased loading – through increased training. When the muscles of the lower legs fatigue or cannot keep up with the increased training/impact, the load/impact is then placed upon the bone. When the bone does not have sufficient time to recover from this increased load, it results in a cumulative effect and ultimately in a fracture of the bone.

75% of all fractures occur in the tibia and it is more common in women than men. It occurs normally with increased training load – duration or intensity. Symptoms include pain that occurs during activity and eases with rest, only to begin again with activity. Initially it can present as point tenderness along the tibial bone and only later manifests as swelling and bruising.

If you are having any issues like these and they are affecting your activity/exercise, please contact us for advice and assessment on 0208 5427788.

 

References:

https://bjsm.bmj.com/content/52/19/1267.abstract  

https://www.nhs.uk/conditions/compartment-syndrome/ 

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