SALT ROCK PHYSIO TALKS CALF STRAINS

Calf Strains in Runners

As you start thinking about the various races in 2016 and training begins, we would like you to also make every effort to avoid any injuries in the pre-race work up and during the race itself. To lower your risk of injury you need all of three things: a strong body, good form and the right shoe. A runner’s best defence is a strong body. Strong muscles, ligaments and tendons will guard against impact, improve form and aid in developing a consistent gait. When the body is strong, the muscles are better able to brace for impact before the foot strikes the ground. The gluteal (buttock) muscles and the core contract to steady the pelvis and the leg. The foot and ankle muscles are activated at the same time and this provides a solid foundation to land on.

So we need to look at how we can reduce the load on the gastrocnemius as the foot contacts the ground. This is achieved by improving running form. That is, making sure that you get proper hip extension from the hamstrings and glutes so the leg passes under the body in a bent position, which takes pressure off the gastrocnemius.

What is a calf strain?

A calf strain is pain in the calf, as well as swelling, tenderness and muscle tightness, resulting from sudden overloading of the muscles and the muscle being stretched beyond it limits during speed work, hill running or running on uneven trails. It is a very common injury and it can range from mild stretching to partial tearing to a complete tear. If the strain is not severe, symptoms may not be present until the run is over. With a slight strain there can be feeling of cramp or tightness and slight pain when the muscles are stretched or contracted. With a Grade two calf strain where a number of muscle fibres are damaged or torn, the pain is usually sudden in onset and it can be very severe and sore to touch. A complete tear is a very serious injury and there is immediate pain and the runner will be unable to walk without pain.

Treat grade one and two strains with ice and anti-inflammatories. The ice is aimed at reducing the bleeding and secondary tissue damage. Wrap your calf with a bandage to provide compression. It should be tight enough to provide relief but not so tight that it cuts off circulation. This will also assist with limiting bleeding and swelling.  

Athletes don’t want to hear this, but calf strains require rest in order to recover. The rest period can range from a few days to several weeks depending on the severity of the injury. Your health practitioner will advise you accordingly. Many runners carry on running even after the initial signs of a calf strain. This further exacerbates the injury and a grade one injury can easily progress to a grade two injury if not given adequate rest.

Causes

·      Ineffective warm up and warm down routines

·      Excessive hill work

·      A sudden increase in mileage

·      Previous calf injury

·      Dehydration

·      Over pronation – the foot rolls over too much while you run, putting excessive pressure on the calf muscle and Achilles tendon

Calf Muscle Strain Prevention

·      Perform warm up exercises before you run

·      Do cool down exercises after you run

·      Stretch to maintain muscle length

·      Strengthen the hips and glutes to ensure that you generate enough power to prevent the leg from being straight as it passes underneath the body.

Strengthening exercises

Theraband Drive Back

With your foot or heel attached to a cable machine, stand facing the structure. Balance on one foot (it's OK to hold on to another object for balance) and bring your leg slightly in front of you. Drive backwards with your foot in the band. Focus on generating the movement from your glutes and hamstrings. Slowly bring the leg back up and repeat. Complete 20 to 25 reps with each leg.

Single-Leg Glute Bridge

Lie flat on your back with one leg bent, foot flat on the floor (or a stability ball for added difficulty), and the other leg flat on the ground. Slowly lift your pelvis off the ground by contracting your glutes and core while keeping your shoulder blades flat on the ground. Complete 15 to 20 reps on each leg.

Donkey Kicks With Theraband

Start on all fours. Insert a theraband so one end is wrapped around a fixed support and the other around the bottom of your foot. Extend your leg back and up, focusing on contracting with your glutes. Complete 15 to 20 reps on each leg.

     

Straight Leg Bounds

Run forward by keeping your legs straight and driving through the ground with your hips and glutes. Begin by running 50 meters. Progress until you can run 100 meters.

Lunges

Lunge forward with one leg. Focus on keeping your core muscles tight throughout the movement. Don't let the knee of your front leg bend past the tip of your toes. Advanced runners can perform this exercise holding a medicine ball and twisting when they bring their leg out for added difficulty. Work your way up to 15 repetitions on each leg.

Calf Stretches

1.  Standing calf stretch (gastrocnemius)

Stand about three feet from a wall and put your right foot behind you ensuring your toes are facing forward. Keep your heel on the ground and lean forward with your right knee straight. Rotating the toes in and out slightly will target the medial and lateral parts of this muscle separately. Hold this for 30 seconds. 

2. Standing calf stretch (soleus)

Stand away from a wall and put your right foot behind you and be sure your toes are facing forward.  Lean forward at the ankle while bending the right knee and keeping your heel on the ground. Because the knee is flexed, tension is taken off the gastrocnemius and placed on the soleus. You should feel the stretch lower down. Hold this for 30 seconds.

3.  Standing calf stretch (tibialis posterior)

In the same position as the soleus stretch, bend the back knee (right) inwards so that it is behind the left knee. You should feel the stretch move from the soleus to the inner part of your lower leg near the ankle. Hold this for 30 seconds.