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Nagging soleus (?) injury--what can I do?

 

Question: Nagging soleus (?) injury--what can I do?

Short version: I sustained a minor injury to my left leg, most likely my soleus, about 4 years ago, have partially recovered, but am still experiencing pain that prevents me from running normally.

Longer version:

My pain is on the outside of my left calf, not in the gastroc but more toward the side. The pain is concentrated about 2/3 of the way up to my knee, through it sometimes shoots down to about the halfway point in my lower leg. It was eventually diagnosed as a soleus injury, though not with 100% certainty. The pain occurs when I am running, when I’m pressing off the ground with my left foot. The pain increases if I try to increase my speed. After a run, the area will be sore for several days, though not so sore that it interferes with my mobility. I have noticed that if I turn my left foot inward while keeping the shin pointing forward, and then I move my foot up and down from that position, that increases my pain. I also notice that if I walk around wearing heavy winter boots all day, my left leg will be sore in the area of the injury.

History of the injury: 4 years ago I felt a very sharp pain on the side of my calf during a run. I stopped the run and walked home, but I did not ice it or see a doctor (I was in the Peace Corps and in a remote area). There was no noticeable swelling or bruising. The pain lasted for about a week, after which time I resumed my normal activities, which meant walking or biking long distances most days. I never had any pain walking or biking.

I returned to America one year later and tried running again, but could not do it for more than 30 seconds without the sharp pain in the side of my calf recurring. I had an MRI, which was inconclusive, but basically showed a very low-level injury. I saw a physical therapist, who diagnosed it as a soleus injury and treated me with laser therapy. I noticed some improvement, and I eventually worked myself up to being about to run about 4 miles comfortably, though not fast and only 2 or 3 times a week. During this process of working myself up to 3 – 4 mile runs, I had to take a couple of long (3+ month) breaks from running, because the sharp pain returned. After each break, I started over, working myself up from running ½ mile every other day, increasing the distance 10% each week.

This is where I am now, more than 4 years after the injury. If I try to run fast, or if I try to add distance, the pain comes back. Before the injury, I had been a competitive athlete, and was used to logging lots of miles at a high intensity.

I am becoming frustrated with the injury, since it was so long ago and seemingly very minor, and since I have taken several long breaks from running to let it heal. Is there something I am doing wrong? Should I be exercising it? Stretching? Thanks for your help.

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