Pain in Calf While Jogging

Muscle strain to the calves can occur while engaging in heavy leg use, such as jogging, hiking (especially uphill), cycling, and basketball or other sport that requires frequent running.  This is due to damage to the muscle fibers, tendon, fascia (muscle covering) and/or blood vessels.

But before you assume that your calf pain is a muscle strain, know that calf pain can also be caused by a thrombus, or blood clot.  This is a medical emergency that demands a visit to your physician and special tests.   For more information on blood clotting in the legs (deep vein thrombosis or DVT), read this article.

Strains occur in different grades.   The most simple strains and sprains (Grade I) occur when there is mild tearing of some muscle fibers.  Grade III sprains and strains involve complete tears to the muscle and/or ligament (the ligaments are on the ends of the muscle and connect it to bone) and joint damage.  Grade III sprains and strains are emergency in nature and will most likely require surgery.

If you get leg (lower) cramps when jogging, you’ll probably need to stop or risk getting a “pulled” calf muscle.  This can be painful enough to force you to get off your feet and sit on the ground.  A pulled calf muscle starts with a twitchy sensation in the calf, followed by an involuntary, painful contraction that forces you to bend your knee for relief.  It signifies a strained gastrocnemeus muscle, tendon or fascia and is related to abnormal muscle physiology due to muscle exhaustion.

You see, muscle contraction involves very complex biochemical reactions.  Calcium, sodium and potassium ions modulate the actions of actin and myosin, the specialized protein structures that make up skeletal muscle and enable changes in muscle length.   Lactic acid builds up as the muscle contracts and relaxes continuously during running.  It is flushed out of the area by normal biological pathways but eventually builds up as the activity continues.

If you get calf pain after engaging in heavy leg use, use the PRICE protocol:

  • Protect the muscle from further injury
  • Rest the muscle
  • Ice the muscle for 20 minutes using a frozen gel pack*
  • Compress the ice around the muscle (use two long socks or ace wrap)
  • Elevate your leg for gravity-assisted swelling reduction

If you keep getting calf pain during heavy physical activity, it could be that your legs need more exercise/ conditioning before attempting to engage in such activities.    This is usually the case for those who spend a lot of their time sitting.   You can do the following leg exercises at home to strengthen your calves:

1.  Lunges.  Find a place where you can walk 10 yards doing lunges; switch legs.

2.  Squat/knee bend exercises.  Even better if you can hold a 10-16 pound medicine ball while doing.

3.  While standing (bare feet) go up on the balls of your feet, hold one second and go back down; repeat 20 times and hold the last three (on the balls of your feet) for 20 seconds each.

4.  Calf stretch.  Stand two feet in front of a wall, put one leg back, bend the other.  Keep the bottoms of both feet touching the ground (don’t let your heel come off the floor).  Bend your front leg; keep your rear leg straight and keep bending until you can tolerate the maximum stretch to your rear leg.  Hold for 10 seconds; release.  Repeat five times.

Reduce Headaches with Peppermint Oil

Peppermint (Mentha piperita L.) is one of the most widely consumed single ingredient herbal teas.    Medical research shows that peppermint oil can reduce spasm of smooth muscle (the type of muscle that comprises the esophagus, stomach, lungs, intestines) and can therefore provide some relief for conditions like IBS (irritable bowel syndrome), esophageal spasm, and spastic colon.  In lab tests, peppermint  has significant antimicrobial and antiviral activities, strong antioxidant and antitumor actions, and some antiallergenic potential.

Animal model studies demonstrate a relaxation effect on gastrointestinal (GI) tissue, analgesic (pain reducing) and anesthetic (nerve desensitizing) effects in the central and peripheral nervous system, immunomodulating actions and chemopreventive potential.

Mentha piperita 0.1 R
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The effects of peppermint oil and eucalyptus oil preparations on headaches and cognitive function were investigated in 32 healthy subjects in a double-blind, placebo-controlled, randomized cross-over design.* Four different test preparations were applied to large areas of the forehead and temples using a small sponge and their effect was evaluated by comparing baseline and treatment measure. The combination of peppermint oil, eucalyptus oil and ethanol increased cognitive performance and had a muscle-relaxing and mentally relaxing effect, but had little influence on pain sensitivity. A significant analgesic effect with a reduction in sensitivity to headache was produced by a combination of peppermint oil and ethanol (rubbing alcohol). The essential plant oil preparations often used in empiric medicine can thus be shown by laboratory tests to exert significant effects on mechanisms associated with the pathophysiology of headache.

The evidence suggests that peppermint can somehow relax smooth muscle.  Since blood vessels are also comprised of smooth muscle, and some types of headaches are caused by spasms in the blood vessels that lead to the head, taking peppermint either as a tea or concentrated oil may provide relief.

*Göbel H, Schmidt G, Soyka D, Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters.  Cephalalgia. 1994 Jun;14(3):228-34; discussion 182.

Foot Pain Can Be Caused By This

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If you have pain in your feet, it could be that your feet’s intrinsic muscles are weak and are not supporting and moving your foot bones properly during gait (walking).   As a result, certain bones can bear more weight pressure than others and develop pain; for example the first metatarsal-phalangeal joint (big toe joint).

Muscles can become weak when they are underused, or immobilized in some way over a long period of time.  For example, if you fracture your lower leg and had to wear a cast for three months, that leg would be smaller than the non-injured leg after taking off the cast.  This is because the calf muscle in the injured leg would experience some atrophy due to three months of decreased muscle activity.  You would most likely feel the difference in leg strength as well, after removing the cast.

But what would cause the foot muscles to weaken?  It’s a very simple action just about everyone does in the morning  before going to work, and that is putting on shoes.  Shoes, especially snug fitting ones like lace-up formal leather shoes with hard heels constrict the feet and don’t allow proper engagement of the foot joints when walking.  Basically, shoes act like a cast or splint on your feet.  Imagine wearing a shoe-equivalent on your hands, lacing them up tightly for nine hours a day.  Your hands would weaken eventually, and probably experience pain.

So what’s the solution?  Realize that the feet are designed to grip the ground with the toes/ forefoot, and elongate slightly at the arch to build up energy for toe-off during gait.  The toes splay out when bearing weight to increase stability to the body above.  Wearing shoes inhibits all these actions and can have an adverse effect on foot biomechanics.

Therefore, it is a good idea to exercise your feet by walking barefoot; preferably on a non-flat surface.  Find a grassy park and try running barefoot.  These activities will offer badly needed exercise (strengthening and stretching) for your feet.  If you’re like most people who have been wearing shoes most of their lives, your feet will be highly sensitive to the pebbles and small objects on the  ground; this is normal.  Keep walking and running barefoot as much as you can, breaking them in but obviously avoiding sharp objects on the ground.  This will strengthen your feet and make it more resistant to developing foot problems.

If you arent’ into going barefoot, the next best thing is to wear the Vibram Five Fingers KSO – Men’s walking “shoe.”  It offers the protection of a shoe, while offering the most freedom of movement of your feet.

Stenosing Tenosynovitis

original Finkelstein's Test, as described by H...

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Stenosing tenosynovitis translates to “tendon inflammation due to narrowing passageways.”  It is entrapment and inflammation of the extensor pollicus longus tendon, the muscle that moves the thumb up in a “hitchhiker sign.”   It is also known as DeQuervain’s Syndrome.

The passageway in question is a tunnel formed by ligaments that hold the extensor pollicus longus tendon to the distal radius (lateral wrist), one of the two bones of the forearm.

The onset is gradual over a few days.  There is a very sharp, unrelenting pain at the radial styloid, the bony prominence at the lateral wrist right below the wrist crease.  There is no loss of muscle strength in the thumb.  Bending the affected thumb inward towards the palm while bending the wrist sideways towards the ulna (in direction away from the pain) makes the pain much worse.

Causation is believed to be related to overusing the thumbs, such as BlackBerry use, or frequent bending of the wrist while carrying weight, such as in cradling a baby several times a day.  However, there are documented cases of stenosing tenosynovitis occurring with no apparent trigger (idiopathic causation).

What is known is that the synovial sheath that covers the portion of the tendon in the tunnel gets inflamed and undergoes degenerative changes.  It triggers a chronic, localized inflammatory response.  Pain comes from tiny nerve endings in the synovial sheath that are irritated by rubbing against the ligament holding it to the distal radius, and perhaps also by exposure to the products of inflammation.

The condition is known to be self limiting, running its course for a few months and then resolving as the body regenerates the synovial sheath.  However, during its acute stage it is quite unpleasant, despite the fact that only about an inch of tendon is involved.

TREATMENT:

Wrist immobilization (wrist brace with thumb splint) to limit movement of the adductor pollicus longus is recommended for 1-3 weeks.  Wear most of the day and night; remove every hour or so to do ice therapy.

Ice massage is helpful in temporarily reducing the pain by numbing the area and constricting blood vessels, which tends to suppress production of inflammatory chemicals.  A wrist ice wrap can also be effective.   Apply ice for 10-20 minutes directly onto the painful area.

Topical ointments may be helpful in reducing the severity of the pain.  Narayan oil and products containing capsaicin (don’t use together) are worth trying.  Rub into inflamed tendon gently.

Chinese herbal patches may be helpful in temporarily relieving the pain as well.

Cortisone injection into the tunnel can be effective in neutralizing the pain; however it still may take a few weeks to months for the pain to go entirely away.

Whey Protein – Great Supplement for Healthy Tissue Healing

Skeletal muscle Bone Perimysium Blood vessel M...

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Whenever you suffer an injury to the musculoskeletal system, there is some degree of tissue damage.  In minor sprains and strains, it is microscopic tears to the fascia, muscle fibers, tendons and ligaments; in major sprains and strains it is complete rupture or tearing of large groups of muscle, ligament and/or tendon fibers.

The first thing the body does at the onset of the injury is initiate the inflammatory response.  Various biochemicals constitute inflammation; each having an important role.  Inflammation confines the injury to the injury site and is actually the first step in tissue repair.  It is only when it is overproduced that it becomes a problem in itself (which is why you should use ice therapy to mediate swelling  the first few days after an injury).

At some point, the body sends special cells called fibroblasts to the injury site.  These cells synthesize connective tissue comprised of collagen to close the tears of the injury.

Collagen is the main protein of connective tissue in animals, making up 25%-35% of the total protein content .   It forms as elongated fibrils (long chain of amino acids in a strand formation) and is mostly found in fibrous tissues such as tendon, ligament and skin, as well as other places in the body.

Therefore, after sustaining an injury, the body needs a ready supply of protein in order to properly heal itself.  If you recently sustained a soft tissue injury such as a sports injury to a joint, whiplash car accident, or sprained your lower back from heavy lifting, make sure you are eating enough protein.   I recommend whey protein due to its ability to be digested very rapidly, making it available for use shortly after consumption.  Whey is a protein-rich byproduct that is formed during cheese formation, usually from cow’s milk.

Body builders and athletes drink whey protein shakes after workouts to help increase amino acid levels in the blood, which are taken up by the muscles to ultimately increase mass. During exercise, whey helps improve blood flow by inhibiting an enzyme that constricts blood vessels; this allows better flow of nutrients to needed areas to help repair and rebuild muscle tissues.

Leucine is an amino acid found in whey protein shakes.  When leucine is ingested in high amounts it stimulates protein synthesis, which may speed recovery and adaptation to the stress that occurs from heavy exercise and injuries.

Another good source of protein is eggs.  Eggs are a complete source of protein, especially the yolk.  Cook them at low heat; and if you have the stomach for it, eat them raw.

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