Is the dreaded foam roller my only hope?
August 13, 2015 7:04 AM   Subscribe

My trainer believes that if I diligently ice and use the foam roller, my chronic calf-ankle-foot problems will be resolved. I believe him, but god it hurts so much. I'm a 37 year old woman, breast cancer survivor...

Over the past five years I've run several 5ks, a 10k, and two mini-triathlons. Currently I weight train a couple times a week and swim or walk other days. But running is out of the question at the moment, considering that most mornings on my 20 minute walk to work, I have to stop once and stretch my calf/try to rotate my ankle so I don't limp the rest of the way. It's discouraging.
My trainer feels that the calf tightness is affecting the ankle mobility (it's so bad if I try to walk up a hill I'm pretty much on my toes), so he often tries to release some calf muscles, which hurts A LOT. And, yes, I am also trying to eat better so that I can lose weight, which I know will help - however all of the above (10k, etc) were achieved while overweight, so I don't want to focus solely on that. Okay, so here are my questions:

1. Anyone tried acupuncture for calf/ankle issues?

2. Is chronic ankle swelling normal? When I get home at night I have to put my feet up and ice my ankles - just from walking home.

3. Has anyone had great success with regular use of foam roller?

Thanks a bunch!
posted by operalass to Health & Fitness (31 answers total) 7 users marked this as a favorite
My answer would be dependent on what your actual injury is. Does your PT know?
posted by roomthreeseventeen at 7:19 AM on August 13, 2015

I asked a similar question to #3 not too long ago.
posted by joeyjoejoejr at 7:20 AM on August 13, 2015

3) Foam rollers are magic as far as I'm concerned. Use them. Your foam roller should be your best friend. It's definitely mine when I exercise regularly.

My physical therapist recommended that I foam roll regularly a couple of years ago when I was dealing with recurring post tibial tendon dysfunction issues, which caused calf tightness that led to swollen/rolled ankles and a collapsed arch in my foot. I was a bit skeptical at first, but it helped!

I'm really partial to the Rumble Roller because I'm a bit of a masochist.
posted by astapasta24 at 7:24 AM on August 13, 2015 [5 favorites]

Is your hamstring, hip, lower and upper back also tight anywhere? I have similar recurrent problems with calf tightness that I am fairly certain is being caused by muscle tension imbalances else up the "drive train". I have seen many friends that I also train with suffer from lower extremity mobility and discovered it was something wrong with their posture or a muscle group in the hips or core. Maybe try checking your range of motion and flexibility all over your body and see if anything else seems compromised; you may uncover something to work on through stretching/rehab interventions. I have never had luck with the foam roller modalities. Just squeezing muscles never seemed to put them on a path of recovery for me. I have much better luck with postural and systemic approaches.
posted by incolorinred at 7:27 AM on August 13, 2015 [3 favorites]

Did you have any lymph node involvement with your cancer or its treatment?
posted by cocoagirl at 7:31 AM on August 13, 2015 [2 favorites]

With foam rollers and therapy of this kind, you don't have to just jump into the deep end, so to speak. Start easy, spread it out over multiple sessions in a day, try different techniques, use a warming pad first, work up to it, etc. Like any therapy, you don't just start at the advanced level.
posted by Cool Papa Bell at 7:37 AM on August 13, 2015

Response by poster: roomthreeseventeen: Well - that's part of the frustration. There isn't an 'injury' per se. Lots of ankle sprains as a teen - I've just always had 'ankle problems'. PT believes there is scar tissue that is choking my ankles/calves.

incolorinred: Yes my IT band/hip is also pretty tight - foam-rolled on my side a bit last night, wow did that hurt.

cocoagirl: Yes, I had 10 lymph nodes removed. I was Stage IIIA. Six years cancer-free.
posted by operalass at 7:48 AM on August 13, 2015 [1 favorite]

I would go to a doctor and see if you can get an MRI or CT to find out what's going on in there. It's hard to say if your PT's recommended treatment will work given that you don't know what the precise problem is.
posted by something something at 7:50 AM on August 13, 2015 [7 favorites]

I would definitely talk to a doctor about the swelling.

I also would note that I have had chronic ankle pain that finally was correctly identified by a podiatrist as mild sprains that I was walking on all the time (!!!), and in that case, ankle braces for about two weeks plus strengthening exercises got rid of the pain.

But yeah, the swelling is definitely something to see a doc about.
posted by internet fraud detective squad, station number 9 at 7:50 AM on August 13, 2015 [3 favorites]

Best answer: My wife had her PT do some myofascial release work on her calves a few months ago. She said a) it was agonising but b) it really did help loosen things up.

If your calves / hamstrings are so tight that you can’t walk uphill then I think this is a problem that is really worth addressing, just for general quality of life, nevermind running anywhere!

To answer your questions:

1) No, and I can’t imagine that it would help in any way. Acupuncture is not (as far as I’m aware) known to help with increasing muscle range of motion.

2) No, this is not normal.

3) Yes, they do help, or at least they seem to help me!

If your ankles are swelling up & in pain simply after walking for twenty minutes then something is seriously wrong. Please talk to a competent phsio or your GP about this, because it sounds like you either have plantar fascitis or achilles tendonitis & left untreated either of those could result in the tendon in question rupturing altogether. Needless to say, this is a *bad* outcome.
posted by pharm at 7:51 AM on August 13, 2015 [2 favorites]

Yeah, I have had chronic ankle/foot pain of a couple of kinds (probably not yours). What helped: correct identification of the problem; not continuing to reinjure the foot and ankle by taking time off walking for a while (as ifds,sn9 said) - even once it's chronic, it needs a break; doing prescribed exercises (many of which do involve other areas up and down the chain).

- Chronic swelling is definitely not normal and needs to be evaluated.
- Not being able to bear weight is also not normal (you shouldn't keep walking on it). And limping like that for a long time is almost certainly going to create new problems for your knees and possibly hips longer term, because it creates imbalances and unhealthy biomechanics.
- Acupuncture (electroacupuncture) definitely did help me with chronic pain (once I stopped continuing to hurt myself).
- So did orthotics fwiw
- Targeted massage by my physiotherapist did help; foam rolling is in the same ballpark, in that for chronic things, it's meant to break up what people think is essentially scar tissue, adhesions. But I'm not sure it's appropriate as the only therapy when something is actually inflamed and you can't bear weight. Nth seeing a doctor (a sports medicine specialist).
posted by cotton dress sock at 8:08 AM on August 13, 2015 [1 favorite]

If you can't run, and walking 20 minutes results in swollen ankles, I think you need to see a physical therapist (or doctor first if insurance requires that).

Answering the question, foam rolling really helps with the tightness of my calfs. When I stopped for a bit (my shoes were also over 800km at this point) I developed some foot pain. Restarting the foam rolling and stretching lessened this, and combining that with new shoes fully eliminated pain.You're not foam rolling on the joints themselves, right?

But seriously, you need to get your ankle(s) examined from your description; part of your therapy may likely involve foam rolling, but that won't be it.
posted by nobeagle at 8:25 AM on August 13, 2015 [1 favorite]

Best answer: I'm not going to comment on the foam roller, but I will say that I had "ankle problems" for years and years, lots of sprains as a kid and adult, and one bad sprain in particular as an adult, but was told time and time again that I was fine. Meanwhile limped home from the gym a lot of the time, walking down stairs was always painful, and I had bad swelling in my ankle most nights that required nightly ice packs. Finally got it rechecked by an orthopedic surgeon and my "ankle problem" was because I had a torn ligament in my foot and had to have surgery to repair it. Of course walking on it for almost three years with it torn has caused its own pile of complications, but yeah... maybe you should get that checked out again.
posted by PuppetMcSockerson at 8:36 AM on August 13, 2015 [4 favorites]

You might also want to see a podiatrist to see if you need orthotics or another intervention. I had similar (but not exactly the same) calf problems that turned into knee pain when I was younger. My case was borderline for needing surgery, but wearing orthotics pretty religiously for about 10 years was enough to avoid it (and the pain went away almost immediately). Now I only need to wear them if I'm walking or running 5+ miles in one stretch.
posted by snaw at 8:44 AM on August 13, 2015

Foam rollers are magic, but what you describe concerns me. If you were my friend, I'd urge you talk to your doctor about the swelling and to see a PT about your calf tightness. More anecdata: my PT says that ankle problems often arise from toe problems. I think I would take a PT's advice over your trainer, as much as you may like them.

So go ahead and foam roll gently and work up to it, but see a doc and a PT in the meantime. Also, ime PTs sometimes require repeat trips--you try one recommendation, let them know how it goes and they adjust treatment/diagnosis from there. It's kind of a trial and error process but it works.

I recommend these tools and methods for calf rolling. I've used a yoga block/shoe box and a tennis ball rather than a big foam roller.

Make sure your shoes are new, supportive and have good arch support or orthotics.
posted by purple_bird at 8:45 AM on August 13, 2015

Response by poster: PuppetMcSockerson: this is me, this is exactly me. Walking downstairs is embarrassingly painful.
posted by operalass at 9:25 AM on August 13, 2015

Your tight calves may well be a result of ankle dysfunction.

If you have a tendon rolling/popping over your lateral malleolus (outer ankle bump), that's your peroneal tendon or its retinaculum (the tendon that should hold the peroneal in place behind your ankle bone). A tear in those means surgery -- very low response rate to "conservative" (ie boot and rest) treatment.

Mine was torn secondary to a larger trauma, and it made going down stairs hard and often painful. I had it surgically repaired last winter. My calf on that side was always tight, because it was trying to compensate for the instability in my ankle.

See an orthopedist!
posted by Dashy at 9:46 AM on August 13, 2015 [1 favorite]

I can't stand foam rolling so I have a deep tissue massager like this one. I find I have better control and it doesn't hurt as much. I find it really helps. Maybe its not as good as foam rolling, I don't know but better a less good thing that you'll actually do than something you wont because its too painful.
posted by missmagenta at 9:59 AM on August 13, 2015

Best answer: The only thing I feel like I can comment on here is the acupuncture ask - which is to say, I had severe tightening of my bicep/everything around my elbow post-breaking-my arm and my PT did dry needling, which to vastly oversimplify, is acupuncture without the woo.

I found it to be tremendously helpful. I almost always saw more success / better outcome with my at-home therapy and immediate relief of pain in my arm/back/everything from my elbow being held hostage by the rest of my arm. I do not know the first thing about how acupuncturists are trained, by my PT was specifically trained to do this therapy and I loved it.
posted by Medieval Maven at 10:02 AM on August 13, 2015

I do think a foam roller can help with this type of thing, but you might want to start with a massage stick if it's too painful -- you can control the pressure a little better. I also think seeing a physical therapist is a good idea.
posted by rainbowbrite at 10:26 AM on August 13, 2015

I agree with everyone else that you should probably seek further professional attention, but as someone who runs every day, a foam roller is a godsend, especially on my calves (a tennis ball is also good for the soles of your feet)
posted by raisindebt at 10:52 AM on August 13, 2015

Your PT will work with you to figure out where you should be foam rolling, what hardness of roller to use, etc. They can teach you how the different muscle systems work together and how rolling out in one area will help decrease pain and increase mobility in a different area. She might have you start out with a very soft roller and just roll 1-3 times to start out, and roll out all the related areas, but make sure you do it every day, and eventually you will loosen up and can move to a harder roller. The main thing that will help you, in addition to having professional help to learn how to do it right, will be doing it religiously every day (do as I say, not as I do). I would be a little skeptical of having your trainer teach you how to do this unless they have had extensive training in anatomy. A PT would be a better resource. Some PTs do dry needling, which could indeed be considered "acupuncture without the woo", as someone said above, but it is related to some science about finding points that will cause the muscle to release itself. My PT tried it on me once for a super-spasmed muscle and it had absolutely no effect, so YMMV (your muscles may vary).
posted by matildaben at 11:25 AM on August 13, 2015

3. Has anyone had great success with regular use of foam roller?

God, yes!
A foam-roller is basically a do-it-yourself massage.
I use a foam roller nearly every day, especially after difficult training and racing (I am a cyclist). It's amazing for recovery.
Sometimes my leg or back muscles sieze up. I foam roll them out.
It is not always pleasant. Sometimes it hurts, like a massage.
But it always works.
posted by entropone at 11:29 AM on August 13, 2015

I was seeing a physical therapist for plantar fasciitis earlier this year. Mine was attributed mostly to tight calves (but also weak hips! ). I bought this calf stretching board and it is AMAZING for stretching calves.
posted by orangek8 at 11:35 AM on August 13, 2015

I love my foam roller. And also my lacrosse ball and softball. If my lifting coach had his way, I'd be foam rolling for an hour a day. I don't do that much of it, but I do manage some, and it's made such a huge difference in my mobility.

A good book on mobility work with a super-cheesy title is Becoming A Supple Leopard.
posted by culfinglin at 3:35 PM on August 13, 2015 [1 favorite]

3. Has anyone had great success with regular use of foam roller?

Just to answer this one-- yes, absolutely. It works. I had IT band issues for a while and my foam roller was/is my beloved frenemy. And yes, it does hurt.

And, as others have noted, the swelling thing does not sound right to me. I would see a doctor.
posted by frumiousb at 4:48 PM on August 13, 2015

I guess I'll be the naysayer of foam rolling.
I enjoy foam rolling, it feels good, but it has never done significantly notable things for injury/imbalance related things I've had going on with my body. I think it can do minor improvements, but it's unlikely to make major differences in your body.

You need to see a doctor/PT. Your trainer is not doing you any favors here.
posted by ch1x0r at 5:48 PM on August 13, 2015

I'm thinking ligament, too.
posted by persona au gratin at 1:08 AM on August 14, 2015

Also, Active Release Therapy is worth looking at for sports injuries. (Though not if its a ligament.)
posted by persona au gratin at 1:09 AM on August 14, 2015

To further chime in on 3:

I feel like I've 'always' had wonky knees, but one christmas I asked for a foam roller. I started foam rolling my thighs and IT bands, and taking fish oil and one other supplement. 6-12 months later, it was a night and day difference. I think the foam rolling was the biggest element of success. Not sure whether the supplements helped at all or not. Periodically still, my knees get creaky, and a few foam rolling sessions seems to make a big difference.

Can't hurt to try.
posted by HighTechUnderpants at 12:55 PM on August 16, 2015

Response by poster: Thank you everyone for your tips and sharing your experiences.

Last night I saw a physical therapist who does dry needling and soft tissue release/myofascial release. Pretty much everything from my lower back down is VERY TIGHT, so she began some, gulp, release of those areas. It hurt a LOT in the calves/hamstrings/glutes but the acupuncture on my ankle after felt great, and I'm now doing ankle flexibility/strengthening exercises in addition to icing at night and some gentle foam rolling. I will continue to see her - I have no insurance but it's worth it - and here's hoping I won't be limping around the Louvre in September.
posted by operalass at 9:10 AM on August 18, 2015

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