Katie is a 32 year-old runner who came in to see us at Dynamic Sports Physical Therapy in New York City because she was experiencing pain in her right calf that got worse every time she started running. She told us that this pain was intense enough that it forced her to stop running after 10 minutes, and she remained in pain for 2-3 days after each run. Katie also explained that she originally injured her calf while running in college about 10 years ago and was diagnosed at that time with calcification in her calf.
During Katie’s evaluation, her physical therapist noticed that her hip range of motion was significantly reduced, especially when she tried to rotate her hip while it was flexed or extended. This dysfunction created a position that caused Katie to rotate her leg outwards all the way from her hip down to her foot and ankle. Having her foot and ankle rotated outwards limited her ability to move her ankle upwards (dorsiflexion), which decreased the extensibility of her calf muscles, preventing them from stretching easily.
Katie’s treatment plan from Dynamic Sports Physical Therapy in New York City
Katie’s therapist originally treated her injury directly with Active Release Technique, which helped decrease her pain levels and increased her soft tissue extensibility. Additional joint mobilizations were used to increase her right ankle dorsiflexion, especially in a weight-bearing position. Katie got to a point where she was able to start running again, but continued to have slight discomfort as the intensity of her running increased.
During future visits, the focus of her treatments shifted to the hip and how the dysfunction in that area created stress down the chain. Active Release Technique was administered again, focusing on a number of muscles in the thigh, knee, and core, and joint mobilizations were applied to her hip joint to increase its range of motion. In addition to these hip-focused treatments, Katie also followed a home-exercise program that helped her maintain the improvements she made with her foot and ankle.
Upon returning to her running program this time, Katie was able to increase the duration and intensity of her running without any complaints of calf pain. She was discharged from physical therapy and has been able to continue her recreational running program without issue. Katie had this to say about her experience and success with physical therapy: “I came to Dynamic Sports PT with a long-term injury to my calf. It was preventing me from running on a regular basis for years. Jon took the time to identify the root cause of my issue and worked to address my problems holistically. As a result, I am back running again, and most importantly, I am pain-free. I would definitely recommend Dynamic Sports PT to anyone. Great and friendly staff and PTs!”
Katie’s success in physical therapy highlights the interdependence of the kinetic chain and how a dysfunctional piece of the puzzle can influence a joint or muscle downstream. It also shows why as physical therapists, we avoid chasing the pain, as the underlying issue can be one or even two joints away from the painful spot. Finally, her story highlights the importance of why we reevaluate each patient every time they come in for treatment. If a patient’s symptoms return after we’ve cleared a body part, we will not continue to treat the same body part and expect a different result. Instead, we look elsewhere and continue the process of reevaluating the patient to determine what else may be causing the problem.
We are thrilled to see that Katie has returned to her running routine without pain, and we hope that she continues to stick with her home-exercise program in order to maintain her improvements. If you’re dealing with any painful issues of your own, we invite you to come in for a visit to find out what we can do for you. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 to schedule an appointment, or click here to read our last blog or here for more information on calf pain.