I had a friend recently with complaints of calf pain that has lasted approximately 6 months. I believe the original injury was after a long run and the "strain" had improved, but never disappeared. He currently only had a sensation of "tightness" when running. As many of you know, anytime an injury lasts more than approximately 3 months, we should start to shift our focus towards the nervous system. I did a very limited assessment in the parking lot after playing a round of golf with him.
Multisegmental Flexion and Extension both looked Functional and Non-painful.
Sideglides in Standing looked slightly limited loading the involved side.
I performed a Passive SLR with a bias of the sural nerve and it recreated his pain with hip flexion.
As with any neural complaint, I try to focus my treatment on the spine, but thought he would benefit from neural mobilization as well. Below I will list some of the exercises I would prescribe for a case like this.
In order to ensure end-range with lumbar loading, I recently started prescribing the below exercise as a repeated motion as well. This is another sample video from the Insider Access Page and what we like to teach in Optim Manual Therapy.
I instructed him to perform approximately 10-15 repetitions of each of these exercises before and after he went running or did any other kind of exercise; however, ideally, a patient would do about 10-15 repetitions every hour awake as it would likely speed the recovery, lessening the need to do the exercise at all.
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