calf strain - sports podiatry
calf strain anatomy
The calf comprises of three muscles: the two heads of the gastrocnemius and the soleus. The gastrocnemius heads arise from the posterior portions of the femoral condyles (back of the thigh bone). The soleus arises from the posterior aspect of the tibia and fibula (the two bones in the lower leg).
The gastrocnemius is a muscle that crosses three joints: the knee, the ankle, and the sub-talar joint (major joint in the foot). The functioning of these joints and influence of other muscles on these joints has a significant effect on the tension that occurs within the calf. As an example tight hamstrings impact the functioning of the ankle joint, the sub-talar joint, and increase tension in the calf. The soleus muscle does not cross the knee and is a biarticular muscle (affects the movement of two joints).
calf strain symptoms
Calf strain often begins with mild pain after exercise or running that gradually worsens.
Other calf strain symptoms include:
Recurring localised pain, sometimes severe, along the calf during or a few hours after running.
Morning tenderness in the calf.
Sluggishness in your leg
Pain when standing on tip toe.
Mild or severe swelling.
Stiffness that generally diminishes as the tendon warms up with use
Calf strain causes
The main causes of calf strain include;
Tight muscle groups.
Worn footwear.
Overtraining.
Excessive hill work.
Calf strain treatment in the acute phase
P - R - I - C - E
Protection - Your leg may be splinted, taped or braced to prevent further injury.
Rest - You should rest from all activities that cause pain or limping. Use crutches/cane until you can walk without pain or limping.
Ice - Place a plastic bag with ice on the affected area for 15-20 minutes, 3-5 times a day for the first 24-72 hours. Leave the ice off at least 1 1/2 hours between applications.
Compression - Wrap an elastic bandage from the toes to below knee, using even pressure. Wear this until swelling decreases. Loosen the wrap if your toes start to turn blue or feel cold.
Elevate- Make sure to elevate the leg above heart level (hip level is acceptable during class).
IF CALF STRAIN SYMPTOMS PERSISTS OR NUMBNESS/ DISCOLOURATION OF THE FOOT OCCURS CONSULT A MEDICAL PROFESSIONAL IMMEDIATELY.
calf strain stretches
Technique:
Hold each exercise 30seconds at a gentle stretch. Do not bounce!
Frequency:
6-10 repetitions/exercise, 5-7 days per week
Begin stretching regimen for gastrocnemius and soleus complex.
Warning:There should be no pain when doing this exercise. If there is stop!
Calf strain eccentric exercises
Eccentric exercises require the use of a theraband elastic rehabilitation tool.
Technique: Hold each exercise 30seconds at a gentle stretch. Do not bounce!
Frequency: 3 sets 10 repetitions/exercise, 5-7 days per week progressing to 3 sets of 15
Begin eccentric exercise program 7-10 days after pain has subsided.
Start with toes pointed, giving resistance through the theraband , slowly allow your foot into dorsiflexion.Warning: There should be no pain when doing this exercise. If there is stop!
Below the video shows how to use the rehab band (whole body).
Technique:
Hold each exercise 20seconds at a gentle stretch. Do not bounce !
Frequency:
6-10 repetitions/exercise, 5-7 days per week
Perform a toe raise on a 4-6 inch box or step with both legs. Once on your toes, lift the uninvolved leg and lower yourself slowly into dorsiflexion (heel down, toe up).
Warning: There should be no pain when doing this exercise. If there is stop!
Calf strain - Hamstring stretches
Why stretch the hamstrings when calf strain is the problem? Tight hamstrings cause the knee to stay flexed throughout the gait cycle. This has the 'knock on' effect of overloading the front of the calf muscles by causing early heel lift in the gait cycle. Tight hamstrings are one of the major causes of this problem that goes undetected.
Hamstring stretch
Rest the leg to be stretched on a supporting surface while keeping the knee from bending. Lean forward toward your toes by bending at the waist and keeping your back straight. You should feel the stretch but it should not hurt.
If calf strain symptoms worsen, stop!
calf strain - strengthening
Technique:
Hold each exercise 30 seconds at a gentle stretch. Do not bounce!
Frequency:
3 repetitions/exercise, 5-7 days per week, and
incorporate into warm up and cool down exercises.
Perform a toe raise on a 4-6 inch box or step with both legs. Once on your toes, lift the one leg and lower yourself slowly into dorsiflexion (heel down) with the other. Repeat on the other side
Warning: There should be no pain when doing this exercise. If there is stop!
How to prevent calf strain
Golden rule- Don't ignore the problem, it won't go away! If you have been afflicted by this injury it is virtually certain that you will have another attack sooner rather than later.
The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family).
The is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and to prevent re-injury is follow our checklist below. Overall costs for the average athlete will run into pennies per mile/hour of sport.
1. Check your footwear
Are your running shoes worn and in need of replacing? If so change them. Calf strain is often caused by worn footwear so a good running shoe is a must. For more advice on running trainers our running shoe advice page is worth reading. Read more->
Below are a selection of trainers that are ideal for athletes.
Trainers for a neutral or under pronating foot type
Trainers for over pronators
2. Rectify poor biomechanics with orthotics if necessary
The way your foot strikes the ground and the forces that are placed on it can have a direct effect on calf strain and can also delaying healing times. Check our biomechanics page for detailed information. Read more->
Bespoke Orthotics
Think you require bespoke orthotics for your calf strain symptoms? Visit our sports podiatry clinic pages for a clinic near you.
3. Strengthen weak leg muscles
Wobbleboard exercise is a great way to strengthen leg muscles and help prevent calf strain.
4. use heel raises
Calf strain can be made markedly worse by early heel lift during the gait cycle, particularly in running activities. Purchasing some shock absorbing heel raises is a cheap and effective way of normalising the gait cycle whilst improving shock absorbency and reducing unwanted ground reaction force. These little pads slip into the shoe and are not noticed by the athlete when partaking in sport.
Calf strain injury prevention checklist summary Rectify Biomechanics if necessary Check Running shoes Leg strengthening Heel raises
Calf strain returning to sporting activity
With calf strain, the goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your calf strain recover, not by how many days or weeks it has been since your injury occurred.
After suffering from calf strain, you may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
You have full range of motion in the injured leg compared to the uninjured leg.
You have full strength of the injured leg compared to the uninjured leg.
You can jog straight ahead without pain or limping.
You can sprint straight ahead without pain or limping.
You can do 45-degree cuts, first at half-speed, then at full-speed.
You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.
You can do 90-degree cuts, first at half-speed, then at full-speed.
You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.
Getting professional advice
If self treatment is not working or you are concerned regarding the severity of your condition it is always wise to gain a professional opinion. A good sports podiatrist is your best option preferably a clinic that is affiliated with other members of the multi- disciplinary team such as physios, sports rehab instructors etc.
However consultation fees can be expensive. If you are an athlete who needs regular treatment we highly recommend a healthcare plan. it will cover physio, podiatry and even dental bills and you can get cover for a few pence per day, for the whole family if need be. We recommend 'Simply health' to our patients as cover is comprehensive and cost effective.
WANT A PRINTER FRIENDLY VERSION OF THIS PAGE? CLICK HERE!
