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Emily asked...

Tags: running

I am training for london marathon and last night experienced a burning pain in my right calf which got progressively worse. I iced, elevated etc when home. Today it feels fine to walk around on but I am worried as had a similar problem last year when I trained for marathon (posterior tibialis tendon).

Do you think it could be same tendon or perhaps achilles tenoditis? I have been advised to strengthen my right glutes and hips which I will do, is there anything else you think could help / hinder it? When should I test it out by running again?

My current training schedule is very cautious as I wanted to avoid another injury(!) so I strength train 2x per week and run 3x per week with only very slight increases each week. Long run = 7 miles this weekend.

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The Answer

A burning pain in the calf may be caused by a sprain of the fibres of the calf muscle, soleus or tibialis posterior muscles. Another possibility is a tear of the fibrous tissue which joins the calf and upper portion of the Achilles tendon.  

If the pain came on gradually while running it is more likely to be a sprain of the muscle fibres within the calf, soleus or tibialis posterior muscles. If the pain was more sudden and severe then a micro-tear of the upper portion of the Achilles tendon or the fibrous tissue of the lower portion of the calf muscle is possible. The tibialis posterior muscle tendon serves to support the arch of the foot and is commonly injured if there is overpronation (flattening) of the arch of the foot.

It is important to analyse the position of the foot when walking and running to determine whether a corrective insole might be needed to prevent further injury. Sometimes spinal problems will also cause burning pain into the buttock, thigh or calf. I would recommend seeing a physiotherapist first for analysis, then, if necessary, a podiatrist to obtain custom made insoles.

It is likely you will need a few weeks concentrating on stretching, strengthening and core stability work. Keep the running down to short distances for the next few weeks and consider cycling as a temporary alternative so as to maintain cardiovascular fitness while this injury heals.

Answered by Dr. A. R. Wright.

 

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