Following on from Martin's recent plantar fasciitis article and my follow up about what can be contributing in the descending pattern of the integrated system, here Martin talks about another common problem that can occur.....

Calf muscle injuries are common in running and can be quite debilitating as well being frustrating, as they often take a long time to heal and can become recurrent.

They are caused by both <i>extrinsic and intrinsic </i>factors.  The typical extrinsic factors will be subjecting the calf to an unexpected load or one that your calf has not been conditioned to tolerate.
For example doing plyometrics, hill running, speed work or even running longer distances can be sufficient to damage your calf if it’s not prepared sufficiently.

Trauma is more likely when the calf is being stretched while it’s simultaneously contracting strongly.  Intrinsic factors consist of inflexible calves (both gastrocnemius; the longer calf muscle that passes over the knee, and soleus; the shorter muscle that stops just below the knee) and over pronating feet or overly supinated feet are also common causes as they alter the efficient mechanical function of the foot and so can increase the pressure on the calves.

Another very common cause is a tight sciatic nerve. The sciatic nerve runs down the back of the leg, through the hamstring and calf groups as it passes into the foot.  It can become tight due to <i>clinical or biomechanical </i>issues with your back, pelvis or even your hamstrings.

In these cases your hamstring or calf can go into a ‘protective spasm’ to minimise the stretch on the delicate nerve and render these muscles more likely to injury.

The spasm can be immediate and cause pain in the muscle itself or it can alter the ability of the muscle to contract and relax effectively and can therefore cause the muscle to tear when loaded too heavily.

There are 3 levels (or degrees) of calf strain/tear:

<b> • Grade 1</b>: The muscle is damaged causing some micro tears.  It usually takes 2 weeks to recover from a grade 1 strain.

<b> • Grade 2</b>: There is partial tearing of the muscle. Recovery usually takes 6-8 weeks.

<b> • Grade 3</b>: This is the most severe calf strain as it is a complete tear or rupture of the muscle.  Complete recovery can take 3-4 months and occasionally surgery may be needed.

Depending upon the severity of the injury, you will typically feel a sharp stabbing pain in the calf at the point of the tear or strain, and standing up on tip toes or pushing off will usually be painful.  Swelling and bruising sometimes follow with the more extensive tears and it is usually tender to touch.

The usual self management methods for muscle injuries apply for calves too.  Make sure it is rested, ice the area as often as possible, compress the muscle (especially if it is swollen, by using a compression support) and elevate the leg to help reduce the swelling too.

Once the swelling has reduced and the acuteness has started to subside, stretching and massage will help to restore the pliability of the muscle.  Gradually you can then start to teach the muscles to work again slowly using cliniband exercises and then light weight training exercises in the gym, and then progress to higher speed exercises like plyometrics.

It is important to identify the causes too. Check the list of extrinsic and intrinsic causes discussed earlier.  If you suspect an extrinsic cause make sure you address it as you start to train again.  If you feel there were intrinsic causes, check them out with a suitable practitioner who understands intrinsic biomechanics to make sure it is being dealt with while you are rehabilitating.

Clearly adequate warm ups are essential to prevent any injury, so make sure that you spend plenty of time working on your calves as you plan your warm up routine.

Learn how to assess for causes of calf injuries<a href="https://www.biomechanicseducation.com/biomechanics-coach/"> HERE</a>