clengman

I've had a constant niggling pain in my calf ever since I started riding a bike frequently, 6 or 7 years ago. Specifically, (for anyone who knows their anatomy) it's in the medial head of the gastrocnemius of my right leg. I've never asked a doctor about it because it's really more of an annoyance than anything else. It doesn't impede my mobility or riding, it's just a little sore all the time. It even continued throughout a year-long hiatus from riding about 4 years ago.

I try to stretch it out a little as I'm riding. I'll stand up on the pedals with my right leg behind and drop my heel and push down and forward a little until I can feel the stretch. I have tried stretching and massaging it off the bike, but it persists. Has anyone here had anything similar? Any suggestions for anything to try to loosen it up? Thanks!

joelcool

I'm no doctor or fitter, but 6-7 years of pain? Wow. Do you clip in? I wonder if your right foot sits differently on the pedal than your left. Ever do strength training on your calves?

clengman

Hey, I've had frequent back pain for close to 30 years. And I've had lingering chest pain from an episode of pericarditis three years ago. A little soreness in my calf barely moves the needle compared to these. But I have thought about getting a referral to see a sports therapist. Just, every time i go to see my doctor, I've got bigger things to worry about.

I use clipless (spd) pedals around 70% of the time. One bike has flats, the other has two-sided commuter pedals. I have the cleats set the same on both shoes, just behind the ball of my foot. I have noticed that when my knees are in and in line with the pedals, I'm transmitting most of my pedaling force through the ball of my big toe. Or the force is even across the width of my foot, but my knee and ankle are rotated slightly outward. But it's the same for both legs and I've never had any pain in the left.

I don't do any strength training. My commute by bike is really the only significant exercise i get.

DimplePimple

In my experience a good physiotherapist is well worth the money. Really they're not that expensive and, despite what they will try to tell you, 2-3 visits is usually sufficient. At $60 a visit it can be well worth it. I had chronic elbow pain which was alleviated a month after 2 sessions.

TiHabanero

You have messaged it, however have you had a deep muscle massage by a professional over several (3 or more) weeks on the area?

Try firing the butt muscle more giving it and the upper leg the work load over the lower leg muscles. The pedal stroke will change as you transfer the work load to the upper leg and butt.

Set cleats all the way back and set seat forward so knee is more over the pedal spindle. Too far forward can cause injury to the knee over time.

Stretch for 10 minutes after every ride. Full leg and glutes stretching.

That said, I have suffered lower and upper back pain since the summer of 1986. Constantly there unless I have a deep muscle tissue massage every week. It works.

CliffordK

I'd start with @TiHabanero's suggestion, try a cleat position quite far back.

I think Specialized may have a "touring" shoe that has the cleats a bit further back than normal.

There are people who have advocated a mid-sole position. I'm not there yet, but it is worth considering.

KraneXL

You're going to have to be way more descriptive than just pain, e.g. type, location, duration, intensity. What activities increase/decrease it. Do you put anything on it? Do you take anything for it? And if you do, is there an effect?

I'm not just asking this for here, but if you ever go to see a doctor (or healthcare practitioner) he will need this information. The more precise and descriptive you are, the less likely he will be to prescribe the wrong solution and/or medication.

canklecat

By now that pain is practically hardwired into your nerves. Long after some injuries have healed the body keeps feeling phantom pain. Been there, know what it's like. I had six vertebrae cracked in my back and neck when I was hit by a car in 2001, with permanent C2 damage. There's hardly been a day without pain in 17 years.

Even physical therapy may not help, and might actually feel worse, if you don't address the chronic pain and probable inflammation. If PT hurts even worse, most folks will quit.

I finally took some constructive steps toward resolving it this year. No choice. I was hit by a car again this year, breaking and dislocating my shoulder. Then, coincidentally -- unrelated to the injury -- while doing a neck X-ray the docs discovered my old thyroid problem had worsened significantly. Then the thyroid quit working around July, with all the accompanying fun -- fatigue, every joint aching and the shoulder injury feeling like it was making zero progress months later.

After three or four ortho consults with mostly do-nothing doctors, I finally got one who did a local injection of an anti-inflammatory. That helped the shoulder and neck pain.

Then I switched general clinic docs after getting bad advice from an NP at the first clinic -- she told me to stop taking thyroid meds and to take 2400-3600 mg of ibuprofen a day. Terrible advice. Switched health care facilities pronto. The new doc switched me to twice daily oral diclofenac, much smaller pills and more effective NSAIDs with fewer risks compared with massive doses of ibuprofen.

I'd been doing my own physical therapy at home, but tended to overdo it. At one point in July-August I tried weights -- nothing too heavy, just 5-10 lb jugs of water and some exercises that were very modest compared with what I'd been doing before the injury. But the resulting pain was intense. The ortho doc told me to ease up and do nothing but very light range of motion without any hyper-extension for a couple of weeks. I followed that advice and felt much better by September.

By September I finally felt some relief from the chronic pain from the old injury, an acute pain from the more recent injury. I had a physical therapy consult and the therapist said I was doing very well considering the shoulder was still dislocated and probably won't fully heal for a year. There really was nothing more they could do for me than I could do at home, so I'll try the VA health center where I'm now registered. They have more extensive PT facilities.

But the first step was getting a proper diagnosis -- again, I saw three or four ortho docs before finally getting one who listened. And getting effective anti-inflammatories.

A couple of topical analgesics that helped me (Stopain roll-on and Ted's Pain Cream) may not help you -- depends on how deep your pain is. My pain areas are surface level, joints just below the skin without much muscle or fat layer. Those are accessible to some topical analgesics. But I'm doubtful that even the best topical analgesic can reach below muscles to deeper joint, like you've described.

Over the nearly 20 years since my neck and back injury I've tried every topical analgesic around and most are useless. Without a transdermal carrier to penetrate the skin, the ingredients just sit on the skin surface and do almost nothing. Menthol, salicylates, lidocaine, glucosamine, resveratrol, arnica -- makes no difference unless it can penetrate the skin. The only thing salicylates do is relieve some types of skin rashes, psoriasis and acne. They're great for that. Any pain relief we feel in the muscles and joints is from the massaging and improved circulation.

An old recipe favored by farmers and ranchers was DMSO, often sold as horse liniment at supply stores. Some folks who applied it with bare hands to their horses swore it also relieved arthritis in their hands and wrists. DMSO does penetrate the skin so it's possible they got some relief. And it can be combined with analgesics and anti-inflammatories like salicylates. But it can also be dangerous -- combined with nicotine, it can poison people. Some heavy smokers actually got sick from DMSO on nicotine stained hands. Ditto pesticides and other chemicals, alongside DMSO. Also DMSO can cause uncomfortable rashes with itching and burning.

A safer transdermal carrier is MSM, chemically related to DMSO but gentler and safer. It's a crucial ingredient in some effective topical analgesics: Stopain roll-on, Ted's Pain Cream, some versions of Blue Emu and Biofreeze. Check the labels carefully to be sure any topical analgesic you buy has MSM. Otherwise it's not effective.

Hope this helps. Get to a doctor to consult about an anti-inflammatory injection and/or something like diclofenac.

Regarding bike ergonomics, only one of my bikes has clipless -- I use the old school Look delta cleats with the orange or red cleats that have lots of float. I set the cleats as far back as possible, behind the ball of the foot and closer to the arch. So far, so good, no knee pain. Switching to rigid sole shoes also relieved some occasional problems with arch cramping. I still occasionally get cramps in the thighs but that's a different problem. I ride the road bike mostly in rural areas with very few or no stops, so I seldom need to unclip. Look cleats aren't great for commuters -- they're slippery.

Back in the 1970s I used toe clips and Detto Pietro shoes with fixed metal cleats, no float. Back then the conventional wisdom was to pedal over the ball of the foot. Terrible advice, at least for me. I had shin splints, calf cramps, knee pain, etc., and I was only in my late teens and early 20s. If I'd known better I'd have had the cleats moved but I just followed the advice I was given.

I use platform pedals on my hybrids so my feet are free to move around. No problems. I don't want any foot retention when riding in traffic.

rumrunn6

magnesium is a natural muscle relaxer. it's a good daily supplement. just use a small dose or you'll get loose stools. magnesium is also in Epsom salt. so after long rides you might benefit from a long hot soak w lot's of Epsom salt. just add any kind of bath soap. I prefer Dr Teal's, pick a flavor, I like Eucalyptus & Spearmint

livedarklions

Not to freak you out or anything, but I once got a blood clot just about exactly in that spot. It was not an agonizing pain by any means, and I almost didn't go to get it checked out. It was in a branch vein that supposedly never gets clots so we only found it because my doctor reluctantly ordered an ultrasound thinking he was humoring me.

I doubt it's that because of how long you've had it, but any chronic pain in a place like that should be checked out by a doctor. Have you never mentioned it during a check up?

fietsbob

Hire a Massage..

clengman

Thanks for the input. I'll probably mention it to my doctor next time I see her. I'm not sure where out stands now. It sure would be nice if i could get some coverage for a therapeutic massage.

A massageand a hot bath sure sounds nice.

clengman

So, over the past month my pain has been increasing and has been accompanied by pain and cramping all along the back of my right leg from my gluts to my heel and the arch of my foot. I'm also getting some numbness in my right foot if I ride for much more than half an hour.

Went to my doctor yesterday and she says it's most likely impingement on the sciatic nerve. Went to PT this morning. He says he doesn't see any signs that my spine is the issue. (whew!) More likely to be my profound lack of flexibility in my hips and legs. I'll continue with PT for a little while and see if loosening up my gluts and hamstrings has any positive effect. Hoping that will help. It's gotten pretty miserable.

rudy17

You already mentioned lack of flexibilty - do you have any sort of stretching routine? From my own experience (plantar fasciitis from running since ~2008) a lot of the aches and niggles seem to go away with regular stretching.

Second question: do you do any cross training?

Third: How many rest days do you take between rides?

I'm no professional but adjusting these factors have helped me personally through a number of injuries across various sports.

clengman

1) I don't have a regular stretching routine. I do calf, hamstring, and glut stretches when I have some time and I'm thinking about it. I will be doing more stretching now.

2) cross training is walking the dog every once in a while.

3) It's all been rest days lately for the most part. I ride a little at low exertion every weekday to get to and from work (along with public transit), but I haven't been doing my long commute or any other long rides much for the last couple weeks.

rudy17

Currently I stretch immediately after I exercise, about 10 - 15 minutes. I don't exercise every day, so I don't stretch every day, but I'd like to change that.

My main sport is running, and I do weights for cross training. Or maybe it's the other way around... doesn't matter lol. Time off, rest days and lowering intensity have helped me recover from a shoulder injury, but I believe stretching is the main reason I can still run without limping (due to tendonitis) after the first mile.

I can go into more detail on any of those if you like, it's just my personal routine for you to consider. I hope you are able to resolve this - those niggles can really turn a fun ride into a negative experience.

lkoyanagi

Buy a baseball and glide your calf on the ball on the floor. You could use an ankle weight or someone press your ankle down later. Do the 10 rep thing multiple times. This could be very painful, if so, you need it every day whenever it feels tight, for a preventive.

clengman

I think I'll be on a program of remedial stretching for a while. Daily light stretches to try to lengthen hamstrings, quads, and gluts. The PT seems to think it's soft tissues pulling too tightly across my pelvis that's pinching the nerve. If that isn't helping after a while I think I'll have to see an orthopedist for imaging. I'm not entirely convinced that it's not a spinal thing. We'll see.

livedarklions

Have you been checked for a blood clot in your leg? The chronic "cramping" would make me suspicious. Apparently, it's not that unusual for them to go undiagnosed.

clengman

It's something I was concerned about. My dad has the Factor V Leiden mutation (I think he's a heterozygote, not a homozygote) that makes him more prone to clotting and has had a DVT in the past. So I have a 50-50% chance of having that allele too, and I may have a slightly elevated risk of thrombosis. My PCP didn't seem to think a clot was likely given my history of symptoms, so we're going with treating for sciatica for now.

livedarklions

I realize everybody is different, but I can tell you that the only reason I was checked for a blood clot was because I insisted on it. The doctor said he was just humoring me because he didn't think it was likely given the location and the symptoms. It was not a small clot, just in an unusual place. The test I had was an ultrasound, and it saved a lot of time trying to deal with things that weren't causing the problem.

The tip off for me was that it felt like I was having repeated long cramps.

Clots can be dangerous--if it was me, I'd want it ruled out, especially with your family history.

indyfabz

I know that from eating giant bowls of mussels, which have a decent amount of magnesium in them.

clengman

Maybe you got a bad mussel?

indyfabz

No. It's happened several times. I didn't feel sick. I just had to go, and bad. Magnesium citrate is an OTC laxative you can buy in just about any pharmacy. Magnesium is the active ingredient. It relaxes your muscles and draws water into your bowels. It's relatively mild as laxatives go, as long as you don't drink too much.

rumrunn6

I think mussels, in general, have their own "side effect" like clams