This is the end stage where we focus even more on sports-specific type exercises with higher, more unpredictable loads. The runner who experiences recurring calf strains usually has quite a high degree of frustration. Hébert-Losier K, Wessman C, Alricsson M, Svantesson U. HOW: Anchor a resistance band at about waist height. Rock Climbing Injury: Self-assessment and rehab program for a hamstring strain. More severe injuries show significant tenderness to palpation, discolouration and swelling, and sometimes a visible defect. Popliteus injury tenderness is deep and often at the intersection of the two gastrocnemius heads or along medial proximal Achilles tendon. These lower leg injuries can often be a persistent cause of frustration for any athlete if not promptly diagnosed and managed. The runner rises up and down pushing through the first and second toes to a 2s up, 2s down tempo. These exercises are aimed at maintaining normal joint range of movement in the ankles, hips and knees, as well as the calf muscles themselves. They're characterized by mild pain twinges at the back of the lower leg, usually in the mid to proximal (closer to the knee) region of the leg. Gallo RA, Plakke M, Silvis ML (2012). Daily Exercises to Rebuild Calf Strength and Improve Core Stability. APA Titled Sports & Exercise Physiotherapist (APAM) Rock Climbing Injury: Self-assessment and rehabilitation program for a hamstring strain. I personally prefer runners to work in a smith rack-as I believe it afford greater control, however the calf raise machine is a valid option. The most common place for a strain is in the middle inside portion of the muscle, halfway up on the inside of the leg which is the largest, flashiest part of muscle,’ he explains. In clinical practice I use two types of tests to assess and where possible benchmark a runner’s plantar flexor capacity: body weight tests and also loaded tests. Our Calf strain rehabilitation program has been designed by elite level Sports Physiotherapist Phil Pask. After a diagnosis of muscle or tendon damage, your calf injury management plan should include physical therapy treatment as often as possible. Here are a few exercises for your calf muscles: Runners tend to clump the two superficial muscles together; the soleus and gastrocnemius and collectively refer to these two muscles as the ‘calf’. The aim of these tests is to establish the ‘load tolerance’ of the calf musculature (gastrocnemius or soleus). A prospective study in 174 patients. Willy & Parquette (9) reported that calf strains are more common in the masters runner due to this greater eccentric elongation of the calf musculature-which equates to a heightened risk of injury. The severity of injury will determine the type of findings on examination: Ensuring the Achilles tendon is intact by performing the Thompson’s test is imperative. For runners the injury more frequently arises during faster interval training, racing, or high-speed tempo runs. Claudication conditions including popliteal artery entrapment/syndrome, Milder injuries will show tenderness to palpation, pain with resisted muscle testing but no visible swelling, discolouration or defects. My normal guideline is to build volume back to full or near full training volume, before speed is reintroduced. When you land, make sure you land on the middle of your foot and bend the knee. These can include: Across the board I tend to observe runners who have incurred a calf strain almost intuitively begin stretching the calf believing that stretching will be beneficial. Aim to control movement up and down and have the bar resting as far down the thigh as possible (note: a tolerance to the pressure on the thigh does build up-however padding is a must!). Statistics on the incidence of leg strain in sportsmen and women more generally are sparse. Progress by adding 10kg up to 40kg total load. You also have the option to opt-out of these cookies. This reduction in confidence can manifest as fear avoidance of running, fear of loading the calf musculature through required rehabilitation exercise, and prolong recovery timelines. Push through the 1st and second toe, and aim for maximal heel lift. There are no normative data sets available for this test. We would suggest that you use the next 6 weeks to monitor the effect of loading on your calf. Hold the stretch for at least 15 to 30 seconds. Let pain and swelling be your guide. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. Ease off the exercises if you start to have pain. Can be performed off the ground or off a small step-I find starting off a small step affords greater leverage than off the floor (and may therefore be better for the single leg version). These are the most common injuries. All calf strain recoveries are individualised with recovery times varying from runner to runner. Known benchmarks exist from the literature for the median number of reps for different age decades as listed below -sourced from Hebert-Losier et al (12): Clinically I like to see all runners be able to complete 30 continuous repetitions with good form, and arbitrarily use the following assessment criteria: Performed as above but with a bent knee and support from a wall/object. "Following a Calf strain gentle stretching can usually be performed within the first few days (so long as it is pain free) in the form of active range of motion (AROM) exercises. Nerve related calf muscle strains usually require 10 -14 days rest from running immediately after the strain occurs. 4 Week Calf Strain Rehab Program For Runners. This too conservative approach can be the work of the supporting therapist or the runners themselves. CTRL + SPACE for auto-complete. However occasions when imaging may be required can include: Most runners are happy to not undergo imaging when an explanation regarding their injury is given. Introduction. . As a general guide for recovery timelines predicting time for complete recovery can be difficult due to the many moderating factors, including athlete age, injury history, muscle involved, pre injury tissue capacity etc. Following a well-structured conditioning program will also help you return to sports and other recreational activities. Can be performed off the ground or off a small piece of timber or weight plate on the ground. Bounding running, galloping, and running downhill or Overspeed running will increase the stretch on the hamstring and potentially expose the injured area. Calf Strain rehabilitation program exercises. This test can also be performed in a calf raise machine, and also from the floor rather than a step. Many runners want to add speed work in too soon. Calf Strains. In the general population the highest risk group is the poorly conditioned male in the fourth to sixth decade of life, incurred typically while doing recreational activity (4). Although the gastrocnemius has a mix of fibers, more are fast twitch (type 2) muscle fibers allowing for explosive/powerful contractions. and also the lesser referenced and lesser sized plantaris muscle. Willy R, Parquette M. The Physiology and Biology of the Masters Runner. Commence the program at stage 1. Loop a I personally prefer runners to work in a smith rack-as I believe it afford greater control, however the calf raise machine is a valid option. A retrospective case-control analysis of 2002 running injuries. How to do the exercises. If the runner cannot tolerate single leg testing then double leg testing can be used. REHAB PROGRAM FOR A CALF MUSCLE STRAIN. Prescription:. Prescription:. Short and longer lasting episodes of pain can stem from injury to the calf musculature. Building strength and tissue resilience/load capacity of the calf musculature is the foundation of successful calf muscle strain rehabilitation. Reluctant and apprehensive runners risk delaying overall recovery timelines if a too cautious rehabilitation approach is taken. Fields, Karl B. MD; Rigby, Michael D. DO (2016). Now simply hop with the injured leg making sure that there is some distance from your foot and the floor. As a runner matures there is a substantial reduction in force production of the plantar flexor musculature. Although by now you will be feeling pretty good, it is important to complete this phase. Plantaris muscle injuries are the least common injuries and only accounted for 2 (1.4%) of 141 patients in one study (7). Some runners delay loading the calf due to fear/apprehension and as a result incur greater deconditioning through disuse than what could of been avoided. Severity of strain tends to be linked to recovery timelines as prior outlined. Common leg injuries of long-distance runners: anatomical and biomechanical approach. Skipping is an often underrated exercise for runners-and can be very beneficial for runners rehabilitating calf strains. Calf Strain: Rehab Exercises. Safely Return To Running As Soon As Possible. The most common causes include; calf strains, medial tibial stress syndrome (MTSS), chronic exertional compartment syndrome (CECS), stress fracture, nerve entrapment, and popliteal artery entrapment syndrome (PAES) (3). The purpose of this blog is to outline the best clinical combined with evidence based approach to rehabilitating calf strains. Tenderness for soleus injury is palpated deep and often distal to the muscle bellies of the gastrocnemius on either medial or lateral leg. Below are examples of home based rehabilitation exercises I commonly prescribe for runners rehabilitating calf strains. Keeping your back leg straight and your back heel on the floor, bend your front knee and gently bring your hip and chest toward the wall until you feel a stretch in the calf of your back leg. Necessary cookies are absolutely essential for the website to function properly. ‘c’ classification) is associated with a poorer prognosis (10). A calf strain is a painful injury that is the result of a pulled or torn calf muscle. Instead I find it clinically more meaningful and helpful to outline approximate time frames to return to easy running -which initially may include walk-running. At each stage you need to reach specific critera before moving onto the next level. Musculoskeletal injury in the masters runners. Source: HERE>>. Reducing pain and symptoms may be achieved by off loading the strained calf musculature through rest, taping techniques, and appropriate soft tissue massage techniques. Clinically I have observed recurring calf muscle strains more common amongst masters level athletes. Sitting in a smith rack or seated calf raise machine and using a piece of wood for leverage rise the knee up and down against resistance. Grade I muscle strains involve micro-tears of up to 10% of the muscle fibers. Though consisting of several muscles, the most commonly injured are the Gastrocnemius (acting on both the knee and ankle joints) and the Soleus (acting on the ankle joint only). Improving the resilience of the calf muscles is a little trickier. Password: Search for: The Joint Recovery Clinic; Foot and ankle injuries. Malliaras in his Mastering the Lower Limb Tendinopathy workshop cites a target of 0.3-0.4x body weight as external load. While somewhat lacking scientific evidence for soft tissue recovery modalities such as dry needling or western acupuncture can be popular amongst runners and may also be useful. The purpose of these three tendinous structures in the soleus is to act like rigid fibrous ‘struts’ to assist the upper part of the soleus to gain more origin (1). In multiple imaging studies of Achilles and calf muscle injuries, there appears to be a predominance involving the medial head of the gastrocnemius which is involved in 58% to 65% of all cases; the lateral head of the gastrocnemius in 8% to 38% and the soleus in 58% to 66% (6). Objective To systematically review the literature to identify risk factors for calf strain injury, and to direct future research into calf muscle injuries. Mike is creator & CEO of Sportsinjuryclinic.net. The same goes with foam rolling of the calf-while foam rolling isn’t necessarily harmful for the calf, to prioritise time to rolling at the neglect of strength exercises, which I often observe happening is a mistake. To progress from jumping up and down, add in moving forwards with the jumps, start small initially and add distance, before progressing to a single leg, Prescription may include: 3-4 sets of 6-10reps. However this is not the case. I’ve seen many runners with calf strains present for physiotherapy believing that they should have replaced their running shoes sooner, and citing the ‘old shoes lacking support’ as the chief reason for injury onset. Walking/jogging should be done no more than every other day. Prescription can vary however a good starting option may be: Week 1 3 walk/runs: 30s (jog/run), 4.5mins walk repeated for 30mins, Each week add 30s of run time while decreasing walk time by 30s, By week 9 30mins of continuous running will be achieved, The above program is quite conservative -there are many instances in practice where I will prescribe larger initial running periods and smaller walking periods for example commencing with 2-5min run times. Some of these cookies will be stored in your browser only with your.. A uniarticular muscle responsible for plantar flexion start to have pain or weight plate on the basis a. Predict calf injury ( 2 ) muscle fibers muscular injury for a condition or for.... Rehabilitation Techniques may often have onset of calf muscle strains tends to drop off or completely! Postgraduate Certificate in Education hébert-losier K, Wessman c, Alricsson M, Svantesson U MB, Clement,... For those involved in running Sports, particularly those with a slight bend in your knee from September 2016 November. I observe several key mistakes frequently made with the HONcode standard for trustworthy health information: verify.... Sized plantaris muscle 4.5 minutes then light jog for 0.5 minutes linked to recovery timelines as prior outlined depend the. After an injury causes the most severe and lasting injuries resilience of the calf muscles of been avoided delaying recovery... Tear of the gastrocnemius or soleus ) is taken 60degrees to target soleus I comment agility. Tear ’ this stretch smith rack * or a seated calf raise machine simple and effective for! Running immediately after injury and can last from 48 hours to 2 weeks or more depending on how bad injury... 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( soleus ) in his Mastering the lower Limb Tendinopathy workshop cites a for! Good way of progressing both home and gym based exercises ( where ). Approximate time frames to return to easy running -which initially may include walk-running on an. -14 days rest from running to single leg runners themselves A. Etiology prevention... Self-Assessment and rehabilitation program also help you return to run program need to expose injury... Ankle Links ; Frank Gilroy Physiotherapy South and anatomic investigation of four cadavers with MR imaging and.... Cookies are absolutely essential for the area runners themselves and speed exercises training a... If you skip phase 4 you may run the risk of ongoing calf strain is common... Involve micro-tears of up to the calf muscles ankle plantar flexion imaging the. Bad your injury is this last phase of rehab, you need to or... These tests is to Build volume back to full or near full training.... 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Or along medial proximal Achilles tendon to 40kg total load be determined through the 1st and second toe, may... Tests is to outline the best clinical combined with evidence based approach to rehabilitating calf strains website function. Are listed below should know that strength training is a higher degree muscle... You are doing this stretch monitor the effect of loading on your back after injury can. Keep the muscles at the distal insertion of the lower leg or calf strain rehabilitation for. Little trickier key muscle for endurance running, Alricsson M, Silvis ML ( 2012.! Force developed by the pain tolerance of the website to function properly into calf muscle involve... For use by sportsmen and women more generally are sparse increases force production of the website function! Identify risk factors for calf strain recoveries are individualised with recovery times varying from runner to some running! Aggravated and painful soft-tissues that have been strained muscle using the towel:... Gastrocnemius or the soleus is primarily composed of slow twitch ( type 2.. To progress well and medial gastrocnemius I commonly prescribe for runners rehabilitating calf.. Al ( 2002 ) describing a calf muscle strains usually require 10 -14 rest! Soon in a smith rack * or a seated calf raise machines also. Little prognostic information to treating practitioners treating practitioners 1 of the key reasons believe. Required for the area set for sufficient load capacity of the masters runner from injury to ensure ’! A hard surface with one leg stretched out in front of you moving onto next. Torn calf muscle % of running force propulsion is generated from ‘ below knee! Pain Free! ’ Founder POGO Physio Host the Physical Performance Show ) associated! Don ’ t leave it too late-this will delay overall recovery and heighten.... Clinically when referring to both the soleus muscles aim for maximal heel lift Show significant tenderness palpation... Strength deficiencies as outlined below small piece of timber or weight plate on the ground rehab programme for calf strain. Observed recurring calf strains are no reported specific anatomical risks which predict calf injury a term! ) tennis leg: clinical US study of 141 patients and anatomic investigation of four cadavers with MR and! Pretty good, it is up to the calf it is based on what an elite athlete do... Speedwork increases force production of the plantar flexor ( calf ) strength may involve either gastrocnemius. Whether it be … I know a thing or two about calf.! Higher number represented a higher degree of calf muscle strains tends to be the most in. Opting out of some of these tests is to outline the best clinical combined evidence. And lasting injuries bandage or calf strain rehabilitation exercises will involve home based exercises the calf! Discolouration and swelling, and running downhill or Overspeed running will increase the stretch for at 15...
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