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Willsmere Health

CALF STRAINS


When we are talking about the calf we are talking about 2 muscles in particular; The gastrocnemius and the soleus muscle. These 2 do most of the heavy lifting in the lower leg. The gastrocnemius has 'two heads', it is the muscle you can see on the back of peoples legs. The soleus sits underneath and they both have very different functions. The soleus generates most of the force in the calf and allows YOU to change directions and jump. The gastrocnemius has a high concentration of fast twitch fibres, which are used in explosive muscle actions. The fibres of the gastrocnemius muscle kick in late in activity, while the soleus is constantly active through out the movement.

I think I have torn my calf...how do I know?

Initially we talk about and understand the mechanism of the injury...how was the leg injured? That can be a good starting guide. Traditionally a lot of people get ultrasound for calf strains but we now know that ultrasounds don't show the deeper structures in the leg enough. The gold standard for a complete diagnosis of a calf strain is an MRI. For example, in a PHD study on AFL players (Australian football league) they found that 85% of calf "strains" were to the soleus muscles. So if these players had have had an ultrasound, the tear would have been missed.

Besides professional sports persons, is a calf strain an old man injury?

In a review by the British journal of sports medicine. The 2 main risk factors for a future calf strain are an increase in age, and any history of a previous calf strain. So is it just old age? Yes, and no....We know that the calf muscles are some of the quickest to atrophy (lose power and mass) as we age, we also lose half of the fascicle length (muscle fibre), and we also lose stiffness in the calf muscle/tendon complex. Importantly, all of these age related changes are modifiable. Exercise rehab can change these factors. Research doesn't put gender as a risk factor, but prevalence does seem to sway towards men.

How do I know if my calf muscles are strong enough to start exercise?

A nice basic way to test strength and endurance of your calf is a single leg calf raise. Research suggests you should be able to keep good form and perform 25-35 repetitions on each leg. This is a basic test, not sport specific; example, for someone who wants to run we might expect them to do 3 sets of 25 of good form. If you want to try some calf raises, focus on lifting up through your second toe. Don't roll out on your foot as you come up. Rolling out only uses half the muscles we are targeting and over stresses other tissues. Once you lose form stop the exercise.

Another way of testing strength- endurance is against external resistance. This requires a weight machine or a smith machine at the gym. At a minimum you should be able to preform 6-8 reps of your body weight.

Strength-endurance is one thing, but it is also important to rehab your calf doing plyometric or explosive exercises. This may involve exercises like skipping or single leg hops. Rehab needs to be sports specific, so general strength and endurance is necessary in a sport such as running where the calf is used heavily even at slow speeds. But with something like basketball, where there is a heavy amount of acceleration, deceleration, change of direction and jumping, rehab would need to be more specific to these actions.

As well it is important we look at your overall training volume, this can be critical as well.

Feel free to contact us with any questions or book an appointment online HERE for any calf or lower limb issues.


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