Case Study: Movement Analysis Resolves Triathlete’s Calf Pain

The Problem

Our patient is a triathlete with calf pain that began gradually worsening with increases in mileage to prepare for a long race.

The patient couldn’t run more than 1 mile without calf pain causing him to have to stop. 

The Solution

Physical therapist, JJ Thomas, treated the patient’s calf 4 times along with posterior tibialis, and other supportive musculature in the lower leg

More detailed movement analysis revealed limitations in the right hip, specifically with right swing position in Left Single Leg Stance – Right hip showed hiking, and limited Femoroacetabular flexion (taking it through pelvis instead of hip joint).  

The Results

After calf treatment sessions, the patient was able to run 4 miles before symptoms began, but still, the symptoms would be pretty limiting once began at that point. 

Range of motion limitations in HIP flexion, external rotation/internal rotation – cleared with treatment to Hip musculature and Quads/HS.  

Following the first session of addition of hip treatment, the patient informed us he is able to run 6.8 mi without pain or limitation.  Following the second treatment to the hip, (nothing done to the calf or lower leg in the last session), he is able to run 10 miles pain-free and without limitation!

Dr. JJ Thomas, DPT, MPT, CMTPT

JJ Thomas is the owner and founder of Primal Physical Therapy, located in Bryn Mawr, PA. She is also the founder and owner of Primal University, a continuing education company for clinicians who are driven to excellence in their craft. In addition, lectures and speaks nationally on the topics of Dry Needling, Functional Movement Analysis, and Functional Anatomy. She has been published in IJSPT for her contribution to a commentary on dry needling and consults as a content expert for organizations such as the APTA and FSBPT. In this role, she played a large part in the addition of a CPT code for dry needling through the AMA and was on the task force that helped outline competency standards for dry needling education nationally. JJ works with US Field Hockey teams, and individuals from US Lacrosse, US Polo, USA Track and Field, NFL, NBA, PLL, MLB, and most recently traveled with and supported athletes in the 2024 Paris Olympics. In addition to working directly with athletes, JJ has been contracted to teach dry needling to the medical staff of several NFL teams.
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