Date: 22/02/2021

Hours: 1

Total hours: 39

This session was an online consultation which took place during lockdown due to the recent covid-19 restrictions.

The client was a 41-year-old male who had complaints of calf pain. The client is currently working 12 hour shifts as a rigger and is seated for long periods of time. They are also trying to get back into running after taking a long break. They used to enjoy running frequently and would complete 4–5-mile runs. Upon their return to running, they decided to take it easy by reducing the amount of distance that they would usually complete. However, on their first run after their break, they felt a “slight twinge” in their right calf muscle and rested the injury for 3 days before their second attempt which resulted in the onset of pain after approximately 1 mile. The client also enjoys using the gym and has some equipment at home however this is reduced due to the gyms currently being closed.

Due to the client having to work away from home for long periods of time, this may influence their current social life as they tend to work long shifts then goes home to sleep. The client says that they have a good sleep schedule where they get around 8 hours every night, however it may need to be considered that this could be due to exhaustion after working such long shifts.

Due to moving away from home for work and now trying to run again, the change of running environment will need to be considered due to the area having many steep hills. The client may not be used to this and therefore will not have adapted their running style to suit this.

The clients job role may also be a contributing factor due to the long periods of sitting and lack of physical activity throughout. This may contribute to an unhealthy lifestyle where it is easier to gain weight.

The clinical impression for this injury was a slight calf strain due to the long periods of sitting and the change of running environment.

The treatment plan for this injury is exercise prescription to help strengthen the calf muscles. These exercises include seated calf raises which can be progressed to weighted or on a step. Tissue scrunches, crab walks, isometric exercises by pushing the toes into the floor from a seated position to cause an isometric contraction of the calf were included in the exercise plan. Some progressions were also provided as the client often uses the gym and may find this easy. These progressions included weighted lunges and squats to help increase loading. All exercises were prescribed for 8-10 reps for 3 sets to help increase strength. Stretches were also prescribed to help increase ROM and flexibility; this involves the use of a towel around the foot to help stretch it into dorsiflexion. Some proprioception exercises were also included which consisted of 1 leg stances and writing the alphabet with the foot. An RPE scale was also sent to the client which will be used as a clinical measure to help identify improvements.