There is a connection between pain in the inner calf and lack of flexibility of the foot.
A lot of the time, there is a description of pain travelling up the inside of the calf and can exist during the day, during activity and/or after activity. With my work, I am always dealing with the pain locally but need to figure out why the muscles are so tight. There is a lot of stress put on the calves as it is, but I find myself focusing on returning the surrounding joints to normal function. A lot of time, the joints that make up the inside of the foot are the culprits. I notice that the Calcaneus at the back, has been pulled in slightly and the inner arch of the foot (between the big toe and the heel has become rigid and unable to flatten to the degree that it needs to. What this does is turns the foot into a rigid platform, as opposed to a moving multi-joint foot. This has to make the calves work super hard during anything from walking to running to biking and anything in between. My treatment often includes release of the calf muscle, realigning the Calcaneus (heel bone) and remobilizing the middle inside joints of the foot. I teach the client a way to maintain mobility of the joints as well at home so they experience a long lasting effect. There is a simple method to maintaining flexibility of the midfoot joints and to keep the Plantar Fascia (of Plantar Fasciitis fame) at the bottom of the foot in a flexible position. Very often as well, is that underneath the calves are muscles that attach to the underside of the foot and involved in curling the toes. In most cases, they have lost their flexibility and are pulling too hard where they begin, which is on the back/inside of the lower leg bone, and is best described as shin splints. If the shin splints are relatively recent, are a manageable condition.
There is also consideration that the gluteus muscles may not be firing during push off, that can also make the calves work too hard as well. I confirm that the hip can extend properly (which is what the Gluteus muscles do) and teach them to fire the hip muscles properly from very focused exercises to including the firing during whatever function they are doing.
Identifying the issues, treatment and homecare for the patient will be the focus to get them back to function but as I always say, half of their success will be what I do and the other half will be their understanding and maintaining the progress that we make and their commitment to their exercises and homecare. In most cases the person will have to reduce any unnecessary repetitive activity for a short period of time, while the initial treatments and rehabilitation are in process but able to return slowly to original activity as symptoms reduce and normal biomechanics are in place.
Neck pain is something that I see a lot of coming into the clinic The one common denominator is that more than often, the pain occurs as a result of the neck pulling the head straight because the shoulders are out of position. This leads to my previous blog with relation to the shoulder and shoulder pain.
People will describe achiness going down from the neck to the top outer edge of the shoulder or sharp pain that occurs when rotating or side bending in one direction.
In each ear, deep inside, in the Utricle and Saccule are small gelatinous masses called Otoliths, which have tiny receptor hairs attached to them. If the head is leaned to the side, the Otoliths will move to that side and initiate a response to the receptor hairs going down into the brain to tell the muscles on the other side of the neck to tighten to pull the head back to a level position. This is completely subconscious function so you are unaware that you are doing it. This is where the shoulder comes into play.
Lets say that your right low back is tight and pulls your torso to the right. If you do this, you will notice that your left shoulder is now higher than your right, and your head is now leaned to the right. The Otolith will indicate that your head is in that position and will tell your left neck muscles to tighten to pull your head level. Now the muscles are contracting chronically to keep your head level, which can cause eventual weakness and pain with the muscles that are contracting all the time. What this also causes is a curve in the spine, with the concave on the left side and convex on the right. This will cause pinching of the neck on the left side (especially on turning and side bending your head, like with shoulder checking when driving). There are small lateral joints in the neck called Facet Joints, which are now irritated as they are closer to each other on the concave side. The misposition of the joints vastly affect your neck mobility. Now, there is a little work done to relieve the pain with the neck muscles and to help to take the neck out of that concave/convex curvature but the big long term goal is to level the shoulders so the neck doesn’t have to tighten to relevel the head.
Part of this work is to identify why the shoulders are out of position. Many people are hunched forward so the shoulders are rolled forward, which causes the back neck muscles to tighten on both sides to pull the head straight. Alternatively, it could be a pelvic or (as I described earlier) low back tightness imbalance that leans the upper torso and back to one side or another.
Many people don’t notice the imbalance in the shoulders or back as the Head Righting Reflex will level the head so it is really hard to notice.
I’ve had a lot of success with treating the body as a whole to reduce the need for the neck muscles to tighten to pull the head back to level. Part of it is what I do, but most of the time, what I do is only necessary to make it easier for the patient to do what they need to do, so it is 50% me and 50% them. I’ve seen torso twisted around, pulled to the left or right or leaned forward or backward. Imagine that the head is a house and the shoulders are the foundation. If you want the house level, you need to level the foundation.