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 bi-articular muscle (affects the movement of two joints).
symptoms
Calf strain often begins with mild pain after exercise or running that gradually worsens. Other 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.
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 SYMPTOMS PERSISTS OR NUMBNESS/ DISCOLOURATION OF THE FOOT OCCURS CONSULT A MEDICAL PROFESSIONAL IMMEDIATELY.
to restore normal function
It is vital that when stretching or performing any exercise that there should be no pain. If any tenderness is elicited then stop and re commence P.R.I.C.E
| Technique: | Sit with your knee straight and hold the foot position as long as possible. Do as frequently as possible for the first 3-10 days. |
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Pullback
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| Technique: | Hold each exercise 30seconds at a gentle stretch. Do not bounce! |
| Frequency: | 6-10 repetitions/exercise, 5-7 days per week |
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Begin stretching regimen for gastrocnemius and soleus complex. Warning: There should be no pain when doing this exercise. If there is stop! |
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stretching exercises
| 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 |
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Begin eccentric exercise program 7-10 days after pain has subsided Warning: There should be no pain when doing this exercise. If there is stop! |
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| Technique: | Hold each exercise 20seconds at a gentle stretch. Do not bounce! |
| Frequency: | 6-10 repetitions/exercise, 5-7 days per week |
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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! |
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strengthening exercises
| 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. |
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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! |
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to help prevent injury
Remember that virtually all calf strains occur at contact phase of gait (when the foot hits the ground) due to increased biomechanical stress at this point. No amount of exercising will influence what happens at the point of heel strike, mid-stance and toe off phases of gait. It is therefore vital to improve your biomechanics with orthotics designed for your chosen sport.
Athletes with a rigid foot type run a greater risk of all posterior group strains including calf strain. A rigid foot type results in early heel lift during the contact phase of gait meaning that the athlete is "on their toes" earlier than is mechanically efficient causing the muscles and tendons in the back of the leg to work harder.
Golden rule- Don't ignore the problem, it won't go away!
The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family). The way you function is set and cannot be cured. What you can do however is control lower limb biomechanics by altering foot position during the contact phase of gait. This can only be done by wearing a good shoe (see our shoe guide) and with orthotics (foot beds). This is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and from helping to prevent re-injury. Overall costs for the average athlete will run into pennies per mile/hour of sport. Orthotics are designed to alter the biomechanics during the time the foot is on the ground. They are also used to provide increased shock absorbency working in harmony with the sport shoe worn.
*please see terms & conditions
returning to sporting activity
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 achilles recovers, not by how many days or weeks it has been since your injury occurred.
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.
You can jump on both legs without pain and you can jump on the injured leg without pain.
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