Lower leg and foot pain... HELP!

[euan1984]

Hello,

I have been suffering from front lower leg pain for nearly 3 years and cannot get it to go away. I have tried everything possible to sort this out so am looking for some further advice. I am a very keen sportsman and am in good health. I play rugby and squash competitively and try to run or cycle a bit to keep my fitness up. Generally I find it hard to push myself and improve my fitness any more because I can feel injury coming on in the first 30 mins or so and generally realise that I should stop.

The problem started when I used to walk a lot. I used to get pain down the front of my shins on both sides of the bone… I obviously tried to rest it, applied RICE and the problem did slowly get better. However I still sometimes get slight pain down the front of my shins on both sides. I have also been to a podiatrist and tried some custom made insoles, which have had a slightly better effect but not removed the problem completely yet. The evaluation of the podiatrist was that I had a flat arch at standing but a high arch when running and tt it was probably an impact injury that was causing pain down my shin bone…

I have quite heavy feet and my heel does take a lot of impact, but I am not sure if that is the problem. I have used both gel and custom made insoles and I still seem to have some trouble, although it takes longer to arise. Currently the pain / feeling of strain is around my Anterior Talofibular and Anterior Tibiofibular ligaments and there is a slight pain down the outside of my shin. If I pull my foot towards my shin I get pain on the front of the ankle / shin joint and can feel the muscles tensing and straining. One of the problems that has never really gone away is that I can easily cramp the sole of my foot by bending my toes down. The majority of the cramping seems to be towards the heel but I also have some pain and bruising around my arch and up the inside of my foot.

So generally as you can see there could be a few problems here, but I am struggling to get it resolved. My feet, ankles and shins are always very tight and find it very hard to relax at all. It is always lower leg / foot problems and I have never had a problem anywhere else. I always stretch before sport and am a pretty flexible person. My next attempt of fixing this will be to again rest and then try to strengthen my front shin muscles as I have quite strong calves and have never had a problem with them.

If you have any advice that could help it would be much appreciated.

[Heidi]

Hi,

I think you've done most of the right things, however there may be more you can do and treatment should be using everything in conjunction, not trying one thing at a time to see if it helps. Sorry if I have read this at all wrong.

My first advice is to make sure that your calf muscles are flexible. There are two muscles you need to consider. The gastrocnemius and the soleus. A lot of people forget the soleus as it is under the larger gastroc.

Stretch both muscles on a 3-5 times daily basis. To stretch the soleus, bend the knee. You can find these stretches here: http://www.sportsinjuryclinic.net/cybertherapist/stretching/allstretches.php

Sports massage to the muscles of the calf andf shin may be very beneficial too. I have good results with my clients using massage and stretching alone.

If you have biomechanical problems related to the feet I would seek a second opinion to make sure firstly that your feet do as the last podiatrist said and secondly that the orthotics made for you are suitable. If they help a little bit, then continue to wear them whilst stretching regularly and getting some massage.

Strengthening can be commenced once you can see that range of motion is increasing.

In the mean time you should rest from activities which aggravate it. So running or walking any distance is out! Stick to cycling to keep the fitness up! When you do return to running, make sure it is a very gradual increase in time, starting at 5 minutes max.