# Help re: Continuing pain in the outside of lower legs



## Wish I Were Riding (Jan 30, 2004)

I'm not sure if I have this or not: Chronic Compartment Syndrome

I have been dealing with this for many months now. I SS an average of about 10-15miles per ride and average about 2000 vertical feet or more. I weigh 190, and I'm overweight in the gut. I have large lower leg muscles. I usually use 170mm cranks and have a 30" inseam.

For the past many months my lower legs are been painful on the outside of my lower legs. Its a long looking muscle that starts below the knee on the side of the legs and goes all the way down to the ankles. By the time I reach the top of my first climb ~1100 feet my legs are either extremely tight (even to the touch) or they are getting downright painful.

It is very hard to SS gingerly, which is to say that I'm trying not to strain my lower legs, and still make it up my climbs. The tightness and/or pain makes it difficult to stand on my legs as I'm turning the cranks. Sometimes on the downhills the legs are sore as well since they are supporting my weight and absorbing the terrain. Sometimes the pain can work itself out, sometimes I fit the tightness or pain for most of the ride.

I need help. I need thoughts and suggestions. This is seriously bumming me out.


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## Bowhuntmaster (Aug 29, 2008)

How often do you ride? Have you tried giving it a break for a couple of weeks? Try getting a Potassium vatamin or eating a couple bananas every day for a while. My dad has bad leg cramps and the potassium helps him along with lots of water.


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## Wish I Were Riding (Jan 30, 2004)

Bowhuntmaster said:


> How often do you ride? Have you tried giving it a break for a couple of weeks? Try getting a Potassium vatamin or eating a couple bananas every day for a while. My dad has bad leg cramps and the potassium helps him along with lots of water.


Shoot, I meant to mention that. I thought I was being thorough...

I ride 3 times a week (4 if I'm lucky).

I'm going to have to work on the hydration part. I drink enough Diet Coke every day to fill my lower legs... I drink water at night. I need to see if better hydration helps. Bananas are a good suggestion. Where can I get potassium pills?


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## Bowhuntmaster (Aug 29, 2008)

Man I half figured you were already doing the potassium.... Are you in the USA? Go to GNC and get some good quality one's. (if you take blood pressure meds, check to make sure this doesnt interact) They sell them at wal-mart, but they are no good. If you like banana's and they fit into your diet, one in the morning and one in the evening would probably be the best. You know my dad drinks alot of diet coke also.... maybe there is a link between diet coke and leg cramps/problems? Artifical sweetner causing it maybe? Try switching to that vitaman water or powerade zero. Both tasty and cheep options to diet coke and I think they have different sweetner in them.


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## Wish I Were Riding (Jan 30, 2004)

Bowhuntmaster said:


> Man I half figured you were already doing the potassium.... Are you in the USA? Go to GNC and get some good quality one's. (if you take blood pressure meds, check to make sure this doesnt interact) They sell them at wal-mart, but they are no good. If you like banana's and they fit into your diet, one in the morning and one in the evening would probably be the best. You know my dad drinks alot of diet coke also.... maybe there is a link between diet coke and leg cramps/problems? Artifical sweetner causing it maybe? Try switching to that vitaman water or powerade zero. Both tasty and cheep options to diet coke and I think they have different sweetner in them.


I am in the USA. I will start on the Bananas and look for some good Potassium pills ASAP.


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## SPRAG (Nov 6, 2008)

Are you on a hard tail? do you use clips?....do you stretch your calves?....

need this info with some follow ups probly....

but if your on a hard tail your legs might be absorbing more impacts that they can handle....

If you use clips you might not have them adjusted properly you have to make sure the axel of the peddle is lined up with the ball of your foot( under big toe) and your knee cap is 90 degrees from the bal of your foot when your feet are horizontal...this may help reduce some of the strain on your knees, hips and ankles..

its is very important to stretch youe calves, hams and quads before and after a ride, if you pull a muscle its a bittch to get healed if you keep riding with out a brake.....

it also helps (and for some people nessesary) to lift weights to get a complete leg workout.
if you quads are more than aprox 70 percent stronger that you hams than you can start developing problems with your back hips and knees, for example.......so doing a complete leg exercise at the gym with weights my help reduce your probem......maybe

i know someone ( not my self of course  ) who always had wrist pain and then started doing forarm and wrist exercise in his ( not me ) lifting routen, and not has not had any problems sence.


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## Wish I Were Riding (Jan 30, 2004)

SPRAG said:


> Are you on a hard tail? do you use clips?....do you stretch your calves?....
> 
> need this info with some follow ups probly....
> 
> ...


I'm on a rigid bike. I do use clips. My cleats are all the way back currently, which I did to try and help this problem. I figured moving them back might take some stress off my ankles. Not sure it has helped though.

I don't stretch much. I'll start doing that. My hamstrings are always the tightest, although I can touch the floor and my friend can barely reach past his knees. I'm 39 years old.


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## One_Speed (Aug 3, 2007)

Stretch!! After warming up 15 minutes or so and again when you complete your ride.

Another excellent modality is the foam roller. Really helps. basically it is a foam roller you use to give self massage.






If you never recovering from the rides you could always be sore. Therefore become more prone to overuse injuries.

The process of getting stronger involves rest.

After the change in cleat position, then you became sore all the time?

Have you taken time off and your still sore?


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## Wish I Were Riding (Jan 30, 2004)

One_Speed said:


> Stretch!! After warming up 15 minutes or so and again when you complete your ride.
> 
> Another excellent modality is the foam roller. Really helps. basically it is a foam roller you use to give self massage.
> 
> ...


I don't take time off. I figure riding only 3 days a week is time off. Riding is my only form of excersize, and the only one I enjoy.

I moved my cleat position towards my heal after having had the pain for a while. It was done to see if it would help. I guess it hasn't. I might try moving it forward again now.

I will work on stretching, but I don't really know what stretch would help this problem (ie which one to use for that area).


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## SPRAG (Nov 6, 2008)

yeah, your right that is an odd muscle to have pain in....its more of a stabalizer muscle...i think the best this is too at least try to stretch you calfs like you were saying.... take i ani-inflamitories like ibprofren .... ice it like 3 times a day if your can or after you work out or ride...it usealy helps with that type of strain. i do the same thing with my knees from time to time. good luck with that. :thumbsup:


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## Oregonism (Jan 14, 2009)

What gear ratio are you running and are you running fixed? I know pushing a really tough gear ratio is pretty bad for your knees, and if it's fixed, breaking with your legs will destroy the ligaments in your knees. There is a lot of people with similar problems in the SS/FG forum at bikeforums, and I get some pretty harsh pain in my legs if I ride my fixed gear too much. It's in a similar place as your describing as well. I push a pretty hard ratio and 175mm cranks.

I'd consider looking into some gears and maybe some suspension and just do longer rides to get your exercise.


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## belowambient (May 17, 2008)

diet coke = pain... enormous amounts... it also dehydrates you


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## the.vault (Oct 11, 2006)

I experience similar things when running, and on extended descents. It's almost a combination of muscle fatigue and tendinitis.

I have a very rigid foot type, which seems to exacerbate problems in my lower legs. 

Stretching helps. Doing stabilizing exercises for the lower leg and ankle area has helped me too. Some are simple, heel raises, standing on foot with your eyes closed ( honestly). 

All those helped, but it wasn't overnight.

Moving your cleat position behind the ball of your foot will make a difference. If your leg is already fatigued you might not notice the improvement right away, but that is something good to do, if your cycling shoes have a rigid sole.


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## Wish I Were Riding (Jan 30, 2004)

Oregonism said:


> What gear ratio are you running and are you running fixed? I know pushing a really tough gear ratio is pretty bad for your knees, and if it's fixed, breaking with your legs will destroy the ligaments in your knees. There is a lot of people with similar problems in the SS/FG forum at bikeforums, and I get some pretty harsh pain in my legs if I ride my fixed gear too much. It's in a similar place as your describing as well. I push a pretty hard ratio and 175mm cranks.
> 
> I'd consider looking into some gears and maybe some suspension and just do longer rides to get your exercise.


I do not ride fixed, but would like to try it some day. I currently ride about 47.5 gear inches, which is hard enough for me. My knees seem fine. I enjoy riding rigid and SS too much now to really want gears and suspension, but maybe I'll need to mix that in more now. I do have a FS bike with a Speedhub...


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## Bowhuntmaster (Aug 29, 2008)

I still think it's the diet coke. I have been telling my dad that for years. Water, Milk, and Beer. The only 3 liquids a man should ever need.


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## Wish I Were Riding (Jan 30, 2004)

the.vault said:


> Moving your cleat position behind the ball of your foot will make a difference. If your leg is already fatigued you might not notice the improvement right away, but that is something good to do, if your cycling shoes have a rigid sole.


That what I tried, and where they currently are on my shoes. I was thinking about moving them forward again since I haven't noticed a difference (it been a couple months with my cleats back farther). You think that it would be worth leaving them there?


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## Wish I Were Riding (Jan 30, 2004)

belowambient said:


> diet coke = pain... enormous amounts... it also dehydrates you


I would love to hear more. Seriously. Can you elaborate please?


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## Wish I Were Riding (Jan 30, 2004)

Bowhuntmaster said:


> I still think it's the diet coke. I have been telling my dad that for years. Water, Milk, and Beer. The only 3 liquids a man should ever need.


Diet Coke is about my only vice. I have been drinking it for probably more than 25 years. I have a serious addiction with it. I know it, will admit it, and have no idea how to solve it. :madman:


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## 4slomo (Jul 4, 2006)

Start by not drinking DC while you are riding.


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## Wish I Were Riding (Jan 30, 2004)

4slomo said:


> Start by not drinking DC while you are riding.


Ha! Good one. I don't actually do that. But I can drink more than a 6 pack per day while sitting at work. :eekster: :madman:


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## noodletips (Dec 8, 2008)

*A doctor's thoughts*

First it's not likely to be compartment syndrome. That's commonly called "shin splints", and affects the muscle in the front of the calf, lateral to the tibia.
Second, it's not diet coke. There is some concern that chronic, heavy intake of diet colas may enhance osteoporosis, although this is questionable. Muscle pain? Not that I've heard.
Third, hypokalemia (low potassium) would be suspect if you were having muscle _cramping_, which doesn't sound like your issue. Numerous muscles would be affected.

When you have this pain, is the affected muscle actually tender to the touch? Are you having low back pain? Sciatic (referred) pain could cause these symptoms - and the affected muscle would not be tender to massage. This can be difficult to objectively determine, however.

You may wish to consult a sports medicine physician. Diagnosis via forum is iffy at best, but the specific site of your pain makes me suspect a more complex cause than a sore muscle.

Best of luck to you. It's awful when you can't ride..

jeff


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## Wish I Were Riding (Jan 30, 2004)

noodletips said:


> First it's not compartment syndrome. That's commonly called "shin splints", and affects the muscle in the front of the calf, medial to the tibia.
> Second, it's not diet coke. There is some concern that chronic, heavy intake of diet colas may enhance osteoporosis, although this is questionable. Muscle pain? Not that I've heard.
> Third, hypokalemia (low potassium) would be suspect if you were having muscle _cramping_, which doesn't sound like your issue. Numerous muscles would be affected.
> 
> ...


The pain is always isolated in my legs on the outside. Nothing else is affected. When I get to the top of my climb, I get off and hobble around a bit, trying to get them to loosen up. Sometimes they do. I can't figure out what I'm doing to cause the pain, or what I'm doing (even during the same ride) to make it go away.

The pain IS like shin splits which I get if I run. However, it is not in the same place as I said.

I'm still going to ride, and try to strech, hydrate, drink less Diet Coke. I may go to the Dr as well.


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## cjohnson (Jul 14, 2004)

*IT band*

get PT on leg, calf, ankles. learn stretches. It is all connected.

When it is sore, is it easy to walk up stairs, but difficult to walk down stairs?


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## i1dry (Jan 12, 2004)

Do you you feel like your cramping up, or is it more of a sharp pain?

The group of muscles in this area [tibialis anterior, the peroneus longus and brevis, and extensors (hallucis longus)] are involved in the raising of the toes and and arch. Collectively when contracted they control the alignment and stabilization of the midfoot/forefoot.

Optimally, these small thin muscles contract prior to weight-bearing (when walking or running) to align the bones of the foot into a dynamic yet strong and stable arch system, capable of managing considerable loads, with minimal muscle effort.

These muscles become aggravated (and/or overworked) when they are forced to manage loads greater than their mechanical capacity due to a collapsed or collapsing arch system during peak loads (full weight-bearing). These poor mechanics result in the degenerative stresses which contribute to the formation of fibrosis/scar tissue (beginning with micro tears) in the muscle body as well as where the muscle joins the bone. Repeated micro-tearing leads a thickening area of inelastic scar tissue which is even more susceptible to peripheral tearing (the major contributing factor in the formation of "shin splints", (as mentioned above).

In your instance, I'm guessing that these poor muscle mechanics are conditioned (or trained) by your non-biking footwear habits which become exacerbated when you increase your activity levels on the bike.

The common causes are restrictions created by the shoe that inhibit the natural dynamic raising of the arch and toes, (i.e., tight lacing over the arch area or shallow toe box). I'd suggest that you find a cycling shoe with as much toe spring as possible and when tightening the shoe, raise your toes and arch as high as possible and then only snug the laces or straps to that point, no further.

If you have already formed some fibrosis/scar tissue, I'd suggest that you find a medical professional to treat it (break it down) and avoid stretching the area until you do so.

If you'd like some additional info, please PM me.

Best of luck.

i1dry?


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## Wish I Were Riding (Jan 30, 2004)

cjohnson said:


> get PT on leg, calf, ankles. learn stretches. It is all connected.
> 
> When it is sore, is it easy to walk up stairs, but difficult to walk down stairs?


I'm never around stairs at the top of the mountain, but if it helps I will try to walk up and down during todays ride and report back.

Thanks to all for continued discussion.


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## The Ruckus (Feb 15, 2009)

Compartment syndrome is bad. You don't want that. See the recent thread on scars/accidents. My case was result of almost instant trauma, and not a chronic situation like you're describing. Regardless of how you end up with it, it can do some serious damage. No, I'm not a doctor; but I did stay at a Holiday Inn  Can't hurt to ask about it if you were going to go see a doc anyway.


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## sq225917 (Dec 28, 2008)

I was going to reply, then idry answered it all.

Find a decent podiatrist who does biomechanics, get some insoles made to help correct your foot shape and work on building up your feet.


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## nybike1971 (Oct 6, 2005)

I am going to guess that you have flat feet and are not using orthotics. The low arch puts the foot in a position that strains the peroneous longus. You can feel that either at the attachment point in the knee and/or stiffness in the heel/lower ankle. 

Find a good podiatrist and have them check you out. Conditioning, stretching, and cross-training are all excellent things as others have suggested but if you start with a incorrect bio-mechanics, it's a hard cycle to break. 

Good luck!


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## Wish I Were Riding (Jan 30, 2004)

nybike1971 said:


> I am going to guess that you have flat feet and are not using orthotics. The low arch puts the foot in a position that strains the peroneous longus. You can feel that either at the attachment point in the knee and/or stiffness in the heel/lower ankle.


I do not have flat feet. I actually have a high instep and arch, and my footprint is very normal.


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## Wish I Were Riding (Jan 30, 2004)

I spent time putting together my Speedhub bike today, and I got a short ride in. I was able to complete the whole ride without any strain on my lower legs. 
(my ass is killing me though  )

I rode the SS yesterday, and had bad pain again, making it hard to climb the steep stuff. Was really bumming me out. I took some pictures of my leg, but I don't know if they would be useful for anything. I might throw them on here later.

So SSing seems to be the main problem. My FS bike weighs 30.5 lbs, I like my 25 lbs S better...


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## Wish I Were Riding (Jan 30, 2004)

Here's some random picts to try and show my leg strain and cleat position.


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## Wish I Were Riding (Jan 30, 2004)

I'm going to bump my own thread since I got it moved from the "All Mountain" forum.
(I have no idea why I accidentaly put it there)  

Thanks to gregg and Rensho for the moving help! :thumbsup:


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## Doggity (Mar 27, 2007)

I think the guys who are talking about your non cycling footwear have hit it on the head. The peroneals (the muscles that are hurting you) are stabilizing muscles, and the pain pattern you describe suggests your feet are rotating laterally (outwards) too much with each stroke. Now, I ain't no PT, nor podiatrist. But I was having all kinds of little probs with my knees, and my feet (working on plantar fasciitis). Was really cramping my style, riding wise. I tried a pair of MBT shoes, which are actually designed by podiatrists, with some off the shelf orthotics (Lynco), they've made such a difference, I actually gave away all my other shoes. These are all I wear now, including for riding. These are the first shoes I've ever had that I'd rather leave on, then take off, at the end of the day. Sole is so thick, had to raise the saddle an inch. These things give your arch so much support, it feels a lot like you're walking with a tennis ball under your arches at first. Believe me, you'll love it. Takes all of 5 minutes to adjust. Not cheap. But try a pair, see if your peroneal pain isn't gone like stink. These things correct all kinds of lower body anomolies, which come from ill designed shoes, which most of us wear. Heh...you know you're getting old when a pair of orthotic shoes really make your day. And yes, I ride plats. Would rather ride with these shoes and plats, then clipped in with anything else.


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