If you are a runner, chances are you have sustained some pain in your calf, whether a mild tightness, or something a bit more serious like a major tear. The calves support you when standing and play a major role in propulsion when moving, producing force to initiate movement. They allow you to rotate your ankle, flex your foot, jump and ‘lock’ your knee, so they can take quite a lot of impact when running.
The calf is made up of 2 main muscles – the gastrocnemius which is the one you can see the outline of when you stand on your toes, and the soleus which is deeper in the leg. The gastrocnemius makes up the bulk of the calf muscle and joins the knee and ankle joint, running down the back of the leg and attaching to the Achilles tendon above the heel. The soleus is wide and flat, starting just below the knee and running down to also connect to the Achilles tendon.
There are 3 main types of calf pain and injury.
1. Acute Strain/Tear
A calf strain happens during a sudden contraction of the muscle, often when jumping or pushing off during acceleration. It feels like a sudden sharp pain, cramp or spasm, or a pulling in the leg that doesn’t disappear. The soleus is the most commonly strained and if it is severe, it’s likely you won’t be able to put weight on it.
Increased age is a factor in calf strains as there is a loss of muscle mass and strength with aging, older people tend to be heavier, they tend to play sports socially and without training, or take a break from sports and suffer injury when they return.
Treatment:
● Firstly, rest for a week. The calf benefits from deload and rest – use crutches if you need to.
● Improve calf endurance and strength with calf raises and other movements – a sports physiotherapist will be able to give you helpful exercises specific to your situation.
● Slowly return to running. Slowly! You may feel ready after a couple of months of a gradual increase to fast running, but it’s too easy to re-injure a calf if you take on too much too soon.
● Finally, return to playing team sports.
2. Neural Tension
Pain in the calf can also be caused by the nerves in the leg becoming wound up. The sciatic nerve runs from the spinal cord down through the glutes, hamstring, calf and into the foot. Any nerve tightness along this pathway can be referred into the calf.
The pain can feel like a gradual build-up of weakness or numbness, along with some possible tightness in the back. Previous back injuries or a sedentary lifestyle may be precursors to neural tension. This pain is quite common in distance runners, and it can come and go because the nerve issue higher up in the body isn’t addressed properly. An experienced sports physio team like Melbourne Sports Physiotherapy can address and treat neural tension.
Treatment:
● Loosen tight nerves with nerve stretches and glides.
● Strengthen the lower back, glutes and hamstrings to stop any nerve impingements.
● Keep moving to create freedom in the hips and lower back.
● Gradually increase load on the calf and slowly build up running and sports.
3. Silent Strain
When there is a deep calf strain without the acute pain, it is known as a silent tear or strain. It is identified as lingering soreness or tightness in the calf that doesn’t go away, often following a long bout of exercise – it is caused by the constant activity and fatigue in the soleus muscle.
It’s critical to treat the underlying cause as it is common for this pain to reoccur, and it can be tricky to differentiate a silent strain from neural tension. An MRI scan is often used for professional athletes to give a clear understanding of the cause of pain.
Treatment:
● Rest and deload for a week, using crutches if weight bearing is painful.
● Improve calf endurance and strength with exercises like calf raises.
● Slowly return to running, steadily increasing speed and distance.
● Return to your usual sports if you play team or ball sports.
Preventing Calf Pain
Once you are fit and pain free again, there are some general rules to abide by to help you prevent further calf injury and pain in the future.
● Keep your calf muscles strong, with calf raises a good exercise to perform regularly.
● Keep your body conditioned. That is, try to stay active and avoid lots of time off. If you do have a break from sport or are returning following an injury, gradually build up your fitness and condition so you are ready.
● If you play a team sport, make sure you stay conditioned in sprints and change of direction. Keep in mind that being able to run 5km is very different on the body to a fast-paced game of footy.
Don’t put up with calf pain any longer. Want to get back to pain-free and moving again? Contact the specialist team at Melbourne Sports Physiotherapy – call to speak to someone today or book an appointment online.