Should I move on to physio number 3?

Longstanding injury without real diagnosis

4 messages
03/06/2014 at 17:45

Another sorry runner's tale. Hopefully someone can help.

On 31st January I got an injury which initially presented as pain down outside of my lower left leg and worsened to cause me to limp due to pain under outside of knee at top of bone. I stopped running and went to physio for next 3 weeks. She prescribed a very tight knotted soleus and massaged the hell out of it for three sessions before teling me I was good to go running again.

I was a little surprised at this point as I had a bony lump about midway down outside of my calf/bone and my leg beneath my knee still felt a bit tender but as with any runner I started running again although much reduced mileage with rest days. I also went to doctors and they told me lump was nothing to worry about then I went to a new physio and they told me the lump didn't seem right so get a scan. So I went back to doctors and got referred for an Ultrasound scan.

Ultra sound technician told me I had a periosteal edema (2 - 3 cm) which can develop eventually into a stress fracture and not to run for 4 weeks it should settle down. So I stopped running completely and continued to see new physio for ways to improve core/running style/strength to avoid it happening again when I restarted running.

I was also referred for an MRI scan 6 weeks after ultra sound scan as lump had not gone away to check for any bone damage. When I saw the consultant after the MRI scan they told me no bone damage, that I had some residual damage from a grade one (ie very minor) soleus tear and that the lump was not connected and he virtually dismissed the lump as nothing. He said it was okay to start running gradually again.

Both the consultant and the second physio had noticed that my left leg was tender just above the ankle and the physio felt that it was my peronei that may be causing the problem. So I've been to her for 5 sessions now and had ultra sound treatment, done strengthening exercises, had acupuncture but last week I was up to about 18 miles and ran a parkrun at my old MP pace (so this is 16 weeks since I was first injured) and afterwards my peronei were very tender and so for the last week I have stopped running again.

But I still have no firm diagnosis. The lump is not what it was but is still there a little, above my ankle is a little tender which suggest a self diagnosis of peroneal tendonitis but that is supposed to go away with rest and the top of my bone below ouside of my knee is still slightly tender to touch too. So I'm a bit frustrated.

It's been suggested that I try and find a lower leg running specialist but that is easier said than done around here. So, if anyone is still reading , I have two questions I would appreciate some help with.

1) Has anyone experienced a similar morphing injury in lower leg?

2) Has anyone been to the physio just outside Carlisle in the attached link and if so were they any good? I've been before many years ago and wasn't that impressed but they have changed hands since then but I think it is still the same person.

http://www.thesportsphysio.com/contents1a/category/gait-biomechanics-analysis/?doing_wp_cron=1401272061.7148110866546630859375

05/06/2014 at 15:02

Is the "lump" at about the right place to maybe be an avulsion fracture caused by the peroneal problem?

05/06/2014 at 15:05

Hi Emily - from the photos I've just looked at then no - the lump is about two thirds up the outside of the lower leg. Also from the photos I've looked at it would have shown up on the MRI scan whereas the MRI scan results report states 'cortical structure and bone marrow of the visualised parts of the tibia and fibula appear normal'.

Thanks very much for replying though, I appreciate it.

I actually went to see my current physio today whose specialist sport is golf and we had a really good open discussion about whether I might just get lucky, or have more chance of getting lucky, with a specialist running physio or consultant and she is going to try and find me someone - she really is trying so hard to help mend me.

Edited: 05/06/2014 at 15:19
08/06/2014 at 08:42

I have been 8 months with a variety of foot/ankle/heel/calf issues and now with a second physio. I think it's easy to get frustrated - we want the answer and then fix - but getting through cause/symptom is not always easy, and a problem in one part of the body leads on to problems elsewhere as the body moves in a different way to accommodate. It could be well worth following the kinetic chain up into hips/glutes to see if the muscles are firing/tight - I had some glute issues but don't know if cause or symptom...

You say you got back to 18 miles - I question if you went back into training too quick? Did you train each week tas you had trained the week before i.e. 10% rule, or did you train as you thought you could?

I hope you recover quickly. 

RD


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