Hot "spot" on calf

I'm asking this for a friend. On our ride today, right around the 20 mile mark, she said part of her left calf, on the outside just below the knee, felt like it was on fire. She said it had happened on the last two rides, always around 20 miles. It was better by the time we hit 30, but was still there.

She said one of her tennis partners has the same thing going on, to a lesser degree.

She doesn't want to go to a doctor right away because she doesn't want anything labeled a "pre-existing" condition right now.

Any thoughts?

Itbs?

Hm, except it's below the knee - but I had not heard of Itbs before, maybe it's a related condition - same thing different place. I'll send it her way, maybe it will help narrow things down.

On the front of her leg just below her knee on the outside of her leg? I was having a similar problem recently. It was mostly affecting me climbing. It appeared to have been a combination of an old ankle injury, a muscle imbalance in my upper leg and misaligned knee caps (which I gather is something many women have - knees that aren't in alignment with our ankles).

Apparently the head of my fibula wasn't moving at all which was causing the "knee" pain. My PT got it (and my ankle) freed up and gave me some exercises to do to to help strengthen the weak muscles. It vastly improved after just seeing her once, though I have been back in for a bike fit/cleat fit tweak and two more sessions. I've got one more appointment, but she thinks I'm pretty much done and OK - and my knee isn't bothering me at all anymore.

Thats where my "spot" was/is...general consensus was that mine was likely a fibular stress fracture, but I couldn't afford a bone scan and decided it didn't particularly matter anyway.

After 6 weeks of not running, seems to be doing better. But I didn't really have pain on the bike unless I stood to pedal.

Mine was a bit different- the only time it didn't hurt (once it started bothering me, which was either after a significant climb and/or after about an hour of moderate riding) was if I would stand to climb. It would start as an ache beside my knee and progress to a pretty sharp pain at the knee, traveling down my shin and finish with an achy ankle. The knee/shin pain would stop completely off the bike, but my ankle would ache a bit for a day or so.

Just thought I'd throw this out there - one of the other potential diagnoses for mine was peroneal nerve inflammation. Ice packs and ice massages (the frozen paper cup method) were the suggested treatment. Might be worth a shot.