Injury Update: Gastrocnemius Strain + Sacroiliac Joint Dysfunction

Yesterday morning at the Phalen Village Clinic in Saint Paul, Minnesota, William Roberts, MD, diagnosed me with a "strain of gastrocnemius muscle of left lower extremity" along with "sacroiliac joint dysfunction." The first was expected; the second was a surprise.

As to the first diagnosis, the doctor did admit that my symptoms could also be reflective of a strain to the popliteus muscle (which I wondered about last week). Since both the popliteus and the gastrocnemius overlap behind the knee, it is difficult to determine with certainty which is the culprit on an initial "encounter" (doctor lingo for "visit"). He was quick to add though that since treatment is identical for both types of muscle strains, there is no additional benefit to pursuing certainty.

As to the second diagnosis, I guess this is one of the main reasons to see doctors. They think outside the box, or my box at least. Apparently my left pelvis joint is slightly twisted, which causes my left leg to act a little shorter than my right. It's never caused me any pain, but would certainly affect the proper distribution of impact forces throughout the body. I'm not a doctor, but as an engineer I know that minimizing high stress areas is a good thing. He did not speculate how or when the twisting could have occurred.

The treatment for both injuries is relatively straightforward, thankfully. The muscle strain will require physical therapy to strengthen surrounding muscle groups (think: squats, toe raises, lunges, bridge raises, etc). It is still counter intuitive to me (again though, I'm not a doctor), but apparently strengthening surrounding muscles groups actually promotes healing to the strained region. Go figure. The doctor used words like "eccentric loading" to describe these types of exercises that tighten the muscles against resistance. And the joint simply needs to be realigned, which happened yesterday afternoon via my chiropractor.

The only mild frustration I had with the whole experience was that the doctor did not provide a timetable for returning to running—or suggest acceptable exercise alternatives. His basic recommendation was that if an exercise doesn't irritate the strain, it's probably fine. If it does irritate the strain, find something else to do. Well, since the last thing I want to do is aggravate the injury further, that sort of counsel leans me towards couch-sitting. My chiropractor though, who's also a runner and understood the diagnosis, suggested waiting another 2-3 weeks before testing with a short run. That would put a tentative return to running right around Christmas.

I can live with that finish line.