Calf connected to shoulder problems

Hi Docs

History:
Have previously run 6 marathons with ordinary heellanding. Have changed to forefoot/midfoot landing and have now been running barefooted for about 5 months. Have walked appr. 100 miles barefooted before running and have slowly increased running mileage so haven´t expericed any problems concerning to much to soon. I though only run about 10 miles/week.

But I do have some minor problems on the outside of my right calf just below the knee. See picture. It´s not direct pain but more like a stretching sensation, wich i assume could be tight bands.
I massage and strecth the area and can still run. Ran 6 miles last week and couldn´t feel anything. It comes the day after running.
I have no probnlems at all in my left leg.

calf3.jpg

For about 1,5 months I have had some irritations in a bursa in my right shoulder (behind the delta) and got a adrenocortical injection (correct name?) yesterday. This irritation have extended to the neck, arm and back and I assume that this most likely is connected to the problems in my calf.
But is it possible to say something more precise what is going on in my body; could it be my core/torso thats twisted or my hip that in some way compensates or both?

Should I asssume that the problems automaticaly will go away now that the shoulder problems hopefully soon is gone or would it be best to perform some exercises to correct the wrong movement in my body?


Thanks in advance

Bjarke
 
Hello Bjarke - that's very insightful for you to associate pain in one joint with possible pain in another area of the body. When I typically see shoulder linked to foot pain it is on the opposite side. This doesn't mean that you pains may not be associated - but we could start by focusing on the pelvis and lower extremity.

For me to fully know your movement patterns, I need to see more pictures of your foot type, knees and pelvis alignment. But if I were to base it on the above picture.....

These are your peroneals. When you run and strike the ground this muscle is contracting eccentrically - or like a break - to slow down the impact forces. As you move through the rest of your gait cycle - depending on how flexbile your subtalar joint (or foot) is will dictate how much stress is placed on this muscle.

In a rigid, higher arched foot - it is dificult to move freely through the subtalare joint which means excess tension is placed on the peroneals. This will then travel up to the ITB through the lateral fascial highway and eventually irritate your right hip. When I see rigid feet I almost always see rigid hips - so mobilizing the hips and pelvis is an important first step.

Once you mobilize remember you always need to stabilize so building pelvic stability is important. I'd try to do myofascial release to the peroneals, soleus and bottom of the foot - then up to the vastus lateralis, TFL and glutes. After this I'd do pelvic stabilization exercises such as a posterior pelvic tilt, pilates roll downs and short foot.

This should be done before you run (shorter version) - and then after you run (longer version).

I hope this helps! :happy:
 
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Riffing on Dr. Splichal, there are a couple of other things you may wish to consider. If the IT band is tight (it sounds like the foot is quite stiff and you are feeling the entire side being tight, now being felt in the shoulder, you are likely very tight on the right. Barefoot tends to cause a shorter stride that is more mid foot centric but it is likely you are understriding one side and overstriding on the other.

Care to share a phone video of you on a treadmill so me and the other doc can be a bit more effective in our analysis. Data is appreciated. Use your cell phone and upload it on to this site. A side view can be quite telling
 
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Wow that was fast replies!. Thanks for that.

Some of my text didn´t appeared in the tread (copy/paste) but I actually have a supraspinatus tear at the point of attachment. The cause of the injury is unknown, but may be an old one (former javelin thrower) I have another appointment at the reumatologist next week to clarify the exact scope of the injury.
This fact is why I consider the shoulder problems to cause some instability in my body and not that my entire right side generally is tight. But it sounds like a very good idea to look into the stride patterns of right and left foot.

I don´t feel that my feet is stiff (at least not the right one – left foot has suffered from peroneus brevis tendon tear in ´99 due to military service and is a bit more stiffer than the right foot) but I do think I have a pretty high arched foot. What does the picture says?

So from both of your answers the cause could be that if my foot is high arched this could be part of the problem and that the shoulder problems could further induce the instability/tightness in my right side. Furthermore my stride patterns could also be a part of it.
Not easy with so many factors, but nice to have something to further investigate. Hopefully it is all due to the shoulder problems.

I will try to make a video on a treadmill to clarify both stride patterns and general posture.

Dr. Splichal which kind of picture do you need to evaluate knees and pelvis alignment, just front and sideways?

Thanks for your comprehensive answers.

Kind regards

Bjarke

right.jpgleft.jpg
 
I finally got the chance to make a video on a treadmill.

Concerning my stridelenght, I find it very difficuelt to see if there´s any difference between right and left side. I´m not skilled at a treadmill so its very hard to land at the same spot. Maybe you can see more than I can.

But there´s 2 things that i notice:

1) Though the angle may be misleading it seems like my left foot/calf is lifted more than the right in the forward movement of the leg. Easiest to be seen from the left side view. What can be the result of that?

2) What I also think i maybe can see, both from the right side view and from the slowmotion video, is that there could be a tendency towards that my right foot has a sharper impact angle than my left foot which is more flat. If this is correct, then my right side peroneals would be loaded with much more eccentrical force and may cause the tightness I feel. What do you think of this assumption?

Right side view: (My running speed in real life is approximately the same as first half of the video)


Left side view:


View from the back in slowmotion:


Kind regards
Bjarke
 
Without feeling this, my guess is that it is the lateral fascial tract or band that runs from the lower lateral leg to the shoulder region. This is described in Myers Anatomy Trains. Myofascial Release is a good way to address. this. I hope that helps