Lockdown Running Pain – Problem Area – Calf/Shin Region
Introduction
Like a lot of people right now, I have been using running as one component within my training schedule. I’ve been lucky enough to have access to a great 5k running program from Aristos Fitness Head Coach, Robbie Price. Prior to the program I could probably count on one hand the number of times I’ve actually been out for a “run” in the last 6 months, and knowing what I know, I knew that along the way I would pick up some problem areas. In fact, it was during a Sunday volume run session that I got some inspiration for this blog post. During the course of the session I had been aware of some sensations around my left knee, right ankle/shin, and my right hip. Nothing that would stop me from continuing but just an awareness. I’ve also spoken to a few people who are doing their own running and a question that keeps popping up is what is going on their shins/calf region when they are running, with some able to continue and others forced to stop. With the increase in running during lockdown I thought it would be useful to dig deeper into some potential problem areas and contributing factors. The first part of this blog will make you aware of some of the anatomy and commons locations of pain. This may allow you to pinpoint a particular problem area for you. The second part will look into the different contributing factors and some potential management strategies.
Anatomy
First let’s take a very brief look at the anatomy to identify some common “hot spots” in the lower leg when it comes to running.
Back Portion
Within the back of the lower leg, commonly referred to the “calf”, we have the two big force producing muscles known as the Soleus and Gastrocnemius, which then come together to form the Achilles tendon (the thick tendon at the back of your heel). We also have some smaller muscles deep to these muscles, with one that may be of importance to the runner - the Flexor Hallucis Longus – the muscle used to bend our big toe, as well as our Tibialis Posterior. The Gastrosoleus complex plays a vital role in absorbing, distributing and producing force whilst running, whilst the Achilles Tendon acts like a spring to store and release elastic energy.
Common Complaints:
Overload of muscle group – fatigue, perception of tightness, pain
Achilles Tendon Pain
Front Portion
The main muscle at the front, outside part of our lower leg is the Tibialis Anterior. This muscles role during walking is to pull out toes towards us so that our toes don’t drag along the ground, as well as controlling the drop of our foot during ground contact, and it continues this function during walking. The smaller, deeper muscles within the front of the leg are used to dorsiflex/evert our foot (pull our foot up) and extend our toes – Peroneus Tertius being one of these.
Common Complaints:
Overload of muscle group – fatigue, perception of tightness, pain
Extensor Hallucis / Digitorum Tendon Pain (pain originating from our toe tendons)
Middle Portion
Within the inside portion of the lower leg we have various muscles groups and tendons that originate from the back / inside portion of the calf region. Some key tissues important for runners here will likely be: the soleus attachment to the tibia; the tendon of Flexor Digitorum / Hallucis Longus Tendons (the tendons or our big and small toes); the Tibialis Posterior Tendon; and the Tibial Nerve and its divisions. The tissues in this area are responsible for absorbing forces where the foot would be rolling in (eversion), and producing inversion force to support the arch of the foot and aid propulsion during running.
Common Complaints:
Overload of muscle group – fatigue, perception of tightness, pain within the muscle bellies
Tibialis Posterior Tendon Pain
Flexor Hallucis / Digitorum Tendon Pain
Medial Tibial Stress Syndrome aka “shin splints”
Outside Portion
On the outside of the calf region we have the Peroneal muscle group which is made up by the Peroneus Longus, Peroneus Brevis muscle groups and their tendons that run via the lower outside leg/foot. This muscle groups helps absorb inversion forces and plays a crucial role is proprioception of the ankle joint – with it assisting in preventing us from rolling our ankle.
Common Complaints:
Overload of muscle group – fatigue, perception of tightness, pain
Peroneal Tendon Pain
Now that you understand the anatomy a bit better, the next part in this blog will look into some contributing factors for each portion of the lower leg. This should hopefully give you an insight as to why you may be developing pain in a particular area. We will also cover some common contributing factors to pain that you may be able to address yourself to get you back to running free from the constraints of pain.