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Referred pain question (Read 471 times)

jasc


    About 8 months ago I started experiencing stiffness in my Achilles. Saw a podiatrist in July after taking some time off of running (didn't help) and he diagnosed me with Insertional AT. I've had 4 months of PT and the only thing that made a slight difference was to quit running. So I quit about 11 weeks ago. Still experiencing pain, I had an MRI. MRI showed a slight irritation at the insertion but nothing major. Achilles, fat pad, and other surrounding areas were normal. Podiatrist now thinks it's referred pain from a tight hamstring since I mentioned to him when I stretch my hamstring I can feel a "pulling" sensation on the outside of my foot near the heel.

     

    I'm having a hard time believing after 8 months of active rest that a tight hamstring is what the problem is. Does anyone have any ideas or advice?


    A Saucy Wench

      Well, I feel my hamstring pull because of an L4 compression.  It feels like a torn hamstring when it is really bad.  Referred pain is a bitch to diagnose and to treat.  Good luck!

      I have become Death, the destroyer of electronic gadgets

       

      "When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7

        About 8 months ago I started experiencing stiffness in my Achilles. Saw a podiatrist in July after taking some time off of running (didn't help) and he diagnosed me with Insertional AT. I've had 4 months of PT and the only thing that made a slight difference was to quit running. So I quit about 11 weeks ago. Still experiencing pain, I had an MRI. MRI showed a slight irritation at the insertion but nothing major. Achilles, fat pad, and other surrounding areas were normal. Podiatrist now thinks it's referred pain from a tight hamstring since I mentioned to him when I stretch my hamstring I can feel a "pulling" sensation on the outside of my foot near the heel.

         

        I'm having a hard time believing after 8 months of active rest that a tight hamstring is what the problem is. Does anyone have any ideas or advice?

         To find the source of referred pain go to this site: http://www.triggerpoints.net/leg-ankle-foot.htm. It may help you.

         

        I have the book "The Trigger Point Therapy workbook: Your Self-Treatment Guide for Pain Relief, Second Edition," it works wonders.

         

        Bottom line, it takes time to learn your body. Once you do, you can prevent most injuries with some ice and massage. The book pin point a lot of issues related to referred pain and how to resolve them. 

         


        rebuilding r2th v2.0

           To find the source of referred pain go to this site: http://www.triggerpoints.net/leg-ankle-foot.htm. It may help you.

           

          I have the book "The Trigger Point Therapy workbook: Your Self-Treatment Guide for Pain Relief, Second Edition," it works wonders.

           

          Bottom line, it takes time to learn your body. Once you do, you can prevent most injuries with some ice and massage. The book pin point a lot of issues related to referred pain and how to resolve them. 


          rebuilding r2th v2.0

            Somehow I am having problem with the quote function....

             

            I agree - this is a very useful source of information. At a fraction of the cost of a visit to your Dr/PT it's a great value. Oftentimes the areas that hurt are located far from where the actual problem/trigger point is located.

             

            The book does a great job at identifying where the problem really is. Not saying that it's your problem, but AT issues are oftentimes linked to very tight calves.

              I agree - this is a very useful source of information. At a fraction of the cost of a visit to your Dr/PT it's a great value. Oftentimes the areas that hurt are located far from where the actual problem/trigger point is located.

               

              The book does a great job at identifying where the problem really is. Not saying that it's your problem, but AT issues are oftentimes linked to very tight calves.

              I have this book too - a fantastic resource!!!   I was going to say the same thing, that AT issues can be linked to knots in the calf.   The reason being that the knots render the calf tight and inflexible and that pulls on the AT (which is a nonstretchy tendon). You need to work on loosening the calf so it can release it's pull on the AT.

               

              I have this particular muscle "knot" issue - the plague of my existence. I work on it  with a tennis ball and it will get better, but always comes back and the pain can get quite severe (I have the 4x's pain distribution, sometimes down to the foot). I wish I could figure out what causes that muscle to be overworked. Could it be as simple as the rest of the muscles around it being weak?

               

              Use your momentum...keep going.  You know you can make it.

              jasc


                Thanks for the info. I'll take a look at the book and website. My PT originally thought it was due to tight calves and I have knots in both but after over a month of treatment, the pain still hasn't gotten any better. I'm beginning to wonder if those knots will ever get worked out...Anyway, I'll have her assess my hamstrings and get her opinion. My insurance covers another 10 or so PT sessions so I'm going to take advantage while I can.

                 

                Thanks again for the advice.

                jasc


                  I have this book too - a fantastic resource!!!   I was going to say the same thing, that AT issues can be linked to knots in the calf.   The reason being that the knots render the calf tight and inflexible and that pulls on the AT (which is a nonstretchy tendon). You need to work on loosening the calf so it can release it's pull on the AT.

                   

                  I have this particular muscle "knot" issue - the plague of my existence. I work on it  with a tennis ball and it will get better, but always comes back and the pain can get quite severe (I have the 4x's pain distribution, sometimes down to the foot). I wish I could figure out what causes that muscle to be overworked. Could it be as simple as the rest of the muscles around it being weak?

                   

                   

                   My calf knots are where the red is on the third picture - slightly right of middle. . I've used tennis balls, foam roller and even a rolling pin and I can't seem to get those knots to release. My PT has worked pretty consistently on them too but hasn't had a lot of luck. I may be in the same boat as you, HappyFeet: I'll always have to work on my calves and hamstrings in order to keep running. Out of curiosity, do you every focus on your achilles or do you just concentrate on loosening your calves? Since my Achilles is normal based on the MRI, I wonder if the Graston I've been getting may cause more problems.

                    I sometimes use a rolling pin on my achilles just to get them warmed up, but no deep pressure. For me, deep massage seems to make my AT worse.

                     

                    Also, I've read that there can be a constellation of knots (trigger points) and that if you don't undo every one, the problem won't go away. So the trick is to find them all. It's quite the puzzle.  I loaned my TP book out to a friend or I'd look in it to see where else you might check for another source of the problem. Maybe next week.

                    Use your momentum...keep going.  You know you can make it.

                       My calf knots are where the red is on the third picture - slightly right of middle. . I've used tennis balls, foam roller and even a rolling pin and I can't seem to get those knots to release. My PT has worked pretty consistently on them too but hasn't had a lot of luck. I may be in the same boat as you, HappyFeet: I'll always have to work on my calves and hamstrings in order to keep running. Out of curiosity, do you every focus on your achilles or do you just concentrate on loosening your calves? Since my Achilles is normal based on the MRI, I wonder if the Graston I've been getting may cause more problems.

                       Cross your legs so the knot in your calve is on the opposite knee cap and dig deep by pulling on your lower leg. Hold for 30 second on the knot.  Sometimes the knot slips. When the pain feels like it's letting up dig deeper. You might feel pain shoot up your back and your muscle might freak out and twitch. When the twitching stops your muscle may release. The results can be immediate relief. Some knots are stubborn and will need several attempts. Keep in mind, you muscle will be very sore after it releases. Drink plenty of water after.

                       

                      Good luck.

                       

                      jasc


                        I ordered the book you guys recommended. Looking forward to receiving it soon although I might have more questions once I've read through it.

                         

                        I tried your suggestion of the opposite calf to knee and that was definitely painful. Not sure if it released but I'll keep trying it. I thought I might need something a little more intense as the foam roller isn't uncomfortable at all anymore.

                         

                        Thanks again for everyone's help/advice. I hope to find myself running pain free one day soon.