Aa
Aa
A
A
A
Close
Avatar universal

FDL pain

Hi there - I'm popping in with a nagging area of pain that would be nice to get rid of!

I've recently been doing some trail running. I have been getting a pain in my lower left leg. I'm not an anatomy expert but it seems to be in the lower area of the Flexor Digitorum Longus, on the tibia side. The pain is rstricted to above the ankle, and there is no pain on the sole of my foot or my toes. It usually begins the day after a run and lasts up to a few days. In those days afterwards, even walking 30-40 minutes can flare it up.
. A run with a very steep hill seems to be a guarantee to bring the symptoms on.

I run in Vibram Five Finger shoes but have had this problem mutliple times over the years using various shoes. I do have a good amount of pronation on that foot as well. I read [url=http://trainoutpain.blogspot.ca/2011/07/claw-toes-and-flexor-digitorum-longus.html ]this article[/url] which seems to accurately diagnose my situation. When I do the single leg calf raise test outlined, I notice that the toe beside my big toe curls/claws during the movement. The article suggests doing calf raises while focusing on keeping all toes flat.

Anyways, if anyone can chime in I would greatly appreciate it. When the pain pops up, I have to take at least a few days off from running and it is messing with my training. I have my first race coming up on June 9th and am hoping to be able to run in it, while keeping in my mind that I will still have 3 more races to go over the next 3 months.
3 Responses
Sort by: Helpful Oldest Newest
1656421 tn?1303912454
MEDICAL PROFESSIONAL
Many times with trail running the inconsistent nature of the terrain can alter the mechanics of your natural running style.  It sounds as if you may have a tendinopathy of the ankle/foot flexors as a result of the constant gripping of the foot for stability on this uneven terrain.  A strengthening routine would benefit, however,  do not limit to one direction but all directions of the ankle and foot as well as calf stretching.  Also, regular icing of the irritated areas after exercise will help to decrease the inflammation caused by the activity itself.  For any further questions do not hesitate to comment again.

Best in Health,
JAG
Helpful - 1
1656421 tn?1303912454
MEDICAL PROFESSIONAL
Icing should be done 2-3 times per day for 15 min and immediately after any form of vigorous exercise.  Also there are many different ways to strengthen the ankle including resistance band exercises up/down and towards both sides.  A piece of elastic called a theraband is often used to perform these.  You can also perform balance exercises standing on one leg with progression onto unlevel surfaces and performing a ball toss in order to create more difficulty which targets the stabilizers of the ankle which can in turn create less tension on the tendons.  I would try to limit overuse of the ankle and foot by performing strengthening and balance on the days you are not running and on the days that you do run be sure to warm up and cool down with stretching.

Best in Health,
JAG
Helpful - 0
Avatar universal
Thanks John!  This answer really helped me.  It makes alot of sense and I feel that it confirms what I was thinking.

I just have some specific questions about your recommendations:

1 - Icing afterwards - What would you suggest as reasonable guidelines for this?  How long to ice for and how many sessions? Ie 20 minutes on, 20 minutes x 3?

2 - Besides calf raises, are there other specific exercises to target the other directions of the ankle and foot?  

3 - I need direction on frequency of the strengthening routine.  I run on Tuesdays, Fridays and Sundays.  Sundays are my longest day.  Also, where in the week should I slot the routine - pre workout, post workout or on another day?
Helpful - 0

You are reading content posted in the Physical Therapy Forum

Popular Resources
Find out if PRP therapy right for you.
Tips for preventing one of the most common types of knee injury.
Tips and moves to ease backaches
How to bounce back fast from an ankle sprain - and stay pain free.
Patellofemoral pain and what to do about it.
A list of national and international resources and hotlines to help connect you to needed health and medical services.