This case study perfectly illustrates how a pain experienced in one area of the body often does not originate in that particular spot, and highlights the importance of seeking a professional physiotherapist's advice to get to the root cause of the problem.

This evening we focus on a running mum, whose problems began when she started running again after the birth of her second child.

Sensibly, she had gradually increased her distance, but was finding that tightness had limited her ability to increase her distance, frequency or speed.

Over time, her symptoms had become more permanent. She tried foam rollers, massage sticks and stretches, but they only offered short term relief.

Then she visited us here at Blizard Physiotherapy.

What did her initial assessment involve, and what was revealed?

When we first assessed her, we found she had a good range of ankle movement, with no significant tightness of the calf muscles.

However, on feeling the calf muscles, they were tense, and she reported they were ‘uncomfortable’.

What were our physiotherapist's initial thoughts on the patient’s source of her symptoms?

It was clear at this point that the calf muscles were not the source of her problems, so the attention was turned to the nerves and the spine.

What part do nerves play in our body, and why were they so important in this lady’s case?

All nerves glide and move as we move - they don’t stretch - and thus they can become injured if they are put on a stretch.

This is why they glide from side to side, forward and backwards, and up and down, to avoid being stretched.

When they are put on a stretch, they can cause symptoms of pain, and, as the nerves give information to the muscles, this can cause the muscles around the nerve to become tense and tighten up.

In the case of this lady’s tight calf muscles, a few simple nerve tests confirmed that the nerves were the likely source of her problems.

What happened next with this patient’s treatment at the clinic?

Upon further investigation of the lady’s movement, the thoracic spine (the middle spine between the shoulder blades) was found to be tight and painful to touch - when this area is stiff, it can limit the degree of glide of the nerves in this area.

This then means the nerves have less ability to glide, and are therefore put on a greater stretch, which they don’t like, and the symptoms will be felt in the body.

What was the end result with her treatment plan - was she able to return to exercise?

The lady had two sessions, where she received treatment to her thoracic spine.
She was also given exercises and stretches to do at home, clearly explained and demonstrated to her at the clinic.

After just one session of treatment, she was able to run three times within the following week, with no calf pain!

Her treatment and exercises were progressed upon a reassessment, and, given that her calf symptoms had resolved, she was advised to continue with her exercises and running - pushing the speed, distance and frequency to see if the symptoms returned.
They did not, and no further physiotherapy was required!

The lady was, however, advised to keep up with her exercises long term, to keep her symptoms at bay.