Calf muscle strain:  Our calves are one of the strongest muscles in the body.  (The heart in number one, especially in runners.  If it takes a five-minute break, you’re dead.)  It takes about 2000 steps to run a mile.  It does not matter if you are taking short, choppy strides or the race winner taking those long, graceful strides.  Your calf has to push of a zillion times.  With that much work, it is easy to strain your calf muscle.

History:  Most calf strains happen when we are pushing off in the last phase of our running cycle.  It is pretty easy to happen when we are doing speed work, running uphill, or giving that big effort during a race.  If it is not too severe, most runners will push through the injury and keep on running.  All to often, we have to stop running right there and limp to the finish. 

Self-Exam:  Here are some things you can look for in yourself. 

1)      When you try to do a heel raise it HURTS. PH 

2)      Running uphill or speed work are more painful than flat ground. VID . 

3)      Your calf may be hot to the touch. VID

4)      You may have some swelling or even bruising in your calf or ankle.

Treatment:

1)      Manage the pain:

a.      NSAIDS will help. 

b.      Kinesiology taping support your calf.  LIN

c.       Ice or heat can relieve your pain.

d.      If it is a new injury, ice for the first 1-3 days.  Then:

                                                              i.      Ice right after you get done running

                                                            ii.      Heat on non-running days

e.      Continue running but avoid aggressive speed work and hill repeats.

2)      Restore full motion:

a.      Easy calf stretches.  When you get done you should feel good.

                                                              i.      Sequential short-term running will address these muscles.  VID

b.      Stretching does not have to be part of your warm-up or cool-down.  But it HAS to be part of your training program. LIN

3)      Begin non-weightbearing exercises to restore strength without all the pressure on the joints

a.      Begin with isometric exercises to reduce the stress on the muscle.  VID  Put a packing strap around a chair leg and do isometric exercises.  VID

                                                              i.      Progress to tubing exercises in all directions for your ankle.  VID

b.      You will not be at this level very long; we just need to increase your strength while minimizing stress on your ankle.

4)      Begin body weight exercises with emphasis on control versus strength and power.

a.      Wear your brace when you start your weight-bearing exercises.

b.      These are done slowly, with a short range of motion, and STOP BEFORE IT HURTS.

c.       Wall slides VID

d.      Eccentric calf raises.  LIN

e.      Progress to double leg calf raises VID

f.        And then to single leg calf raises VID 

g.      You need to incorporate proprioceptive exercises in your recovery program.  There are a BUNCH of them included in the strength training for runners section.

5)       Correct running mechanics.

a.      Gradually return to your previous running.  Start on relatively flat ground or even on a treadmill.  The best part of returning to running with a treadmill is that you can actually hear your footsteps.  Also, a lot of treadmills are in front of a mirror so you can see your hands move and your feet move.  If your arms or legs swing weird, you may want to have a physical therapist complete an evaluation before you return to full running.  Listen and ‘feel’ how you run.  Is one leg hitting the ground harder than the other?  Does one arm swing differently than the other?  Until you can run without pain and with fairly symmetrical running mechanics, you are still at risk of reproducing your old injury or creating a whole new injury to another part of your body.

b.      As soon as you can run without pain and without a limp you can return to your normal running routine.

6)      Return to running speedwork and hills.  After you have been able to run on flat ground for a week with your with your normal training and have not had any pain, you can begin to add speed and hill training to your program.

7)      My favorite step, get back to full running!  Have fun.  Eventually you will bust something else and be back to the website to fix that. 

8)      If you follow the steps on the website for 2-6 weeks (depending on how badly you hurt yourself the first time and on how long you tried to ‘run through the pain’) and your problem does not resolve, then call our clinic for an appointment and we can do something Dr. Google cannot do.  We can complete a hands-on evaluation, in-person evaluation to determine the cause of your pain.