Calf Strain: A Running & Jumping Athlete’s Nightmare

Source: Pixabay
Source: Pixabay

He sits on the bench with an ice bag on the back of his lower leg.  A calf strain is a common sight with athletes young and old.  Everyone wants to know why.

Looking at athletes at every level of athletics, calf strains have become the Great Equalizer. It’s an injury that is way too prevalent.  One of my favorite running buddies is wrestling with a strained calf and I know, as both a certified athletic trainer and a competitive athlete, calf injuries suck!

In the NFL, last year was a bad year for injuries to the calf.  Fans, coaches and players were frustrated to consistently see way too many calf injuries on the NFL injury reports each week.  These slow-healing injuries negatively impacted NFL fantasy football rockstars like Victor Cruz (NYG), Crockett Gillmore (Balt) and Sammy Watkins (Buff).

The hamstrings on the back of the thigh get all the hype when it comes to what we call “soft tissue injuries” in the NFL.  But when you ask skilled players like wide receivers, running back and defensive backs what muscle injury frustrates them the most, calves and groins typically head up that list.

What is a Calf?

A small cow?  Yes, but that’s not important right now.Calf cow 22

The “calf” or calves (plural) is made of two long muscles on the back of the shin bones.  The gastrocnemius or “gastroc” is the bigger of the two muscles and it’s the more superficial of the two.  When you look at a calf “belly,” you’re looking at the gastroc.  It starts from two tendons above the back of the knee and it extends over the backside of the knee and anchors into the top of the Achilles tendon.

The deeper of the two calf muscles is the soleus.  It starts below the knee and it extends downward joining the gastroc at the top of the Achilles tendon.

Simply stated, the two calf muscles merge together to form the Achilles tendon, which we know attaches to the heel bone below the ankle.

The next time you look at a fast player’s calves, you’ll notice that most of these skilled players will have smaller muscle bellies that tend to be closer to the knees.  The bigger, slower players will typically demonstrate a bigger and lower gastrocs.

What Does the Calf Do?

Here comes the fun part.  The calf is not a big or powerful muscle but it’s a very important muscle group.  When running or pushing, the calf transfers all of the power from the legs, hips and back to the ground in a timely manner.  If the timing of that transfer of power changes ever so slightly, which can easily happen due to injury, fatigue, change in the surface area and/or a change in body mechanics, the calf muscle(s) can tear.

Because the calf crosses both the knee joint and the ankle joint via the Achilles, it raises the heel when running and it assists in bending the knee.  Both of these actions are vital when running fast and changing directions.  THAT’s why a calf strain can quickly bring fast players to a screeching halt.

What to Do When a Calf Goes Pop

Tear = strain = pull

When a muscle is injured, the small muscle fibers that make up the muscle belly pop or tear similar to cutting small rubber bands.  The more fibers that tear, the worse the injury. These fibers have a blood and nerve supply so when muscle fibers tear, they bleed into the wound and create pain.

NFL fans saw first hand in the 2014-15 playoffs how Aaron Rodgers’ ability to move and throw quickly changed because of his calf strain.

Initially, an injured calf muscle needs more rest than it needs fancy physical therapy techniques.  Scar tissue is a calf’s best friend.  Scar tissue fills that new injury wound/hole in the muscle and, in a sense, pulls the healthy fibers together.  A common mistake in aggressive sports medicine settings is to over-treat a calf strain by doing too much too soon.  As with a fresh calf injury, being too aggressive early will cause more bleeding, more pain, weaker scar tissue and a longer recovery.  NFL players are in great hands because NFL athletic trainers are exceptional at properly treating these injuries.

I strained my calf three times within two months as I trained for an Ironman triathlon in Austria in 2009.  It was a frustrating and painful injury for me.  It proved to be very valuable for me as an athletic trainer and physical therapist.  It positively changed how I treat NFL players with calf strains.

Truth be told: Rehabbing athletes is much more enjoyable than rehabbing yourself!

The Bottom Line for a Calf Strain

Calf muscles heal slowly.

The key physical therapy pearl that I learned from rehabbing my own calf and dozens of NFL calf strains since then:  When you think the athlete’s calf is ready to return to full speed with no limitations, give the healing calf one more week.  Your calf will thank you.

Runner’s Guide to Managing Calf Pain

Source: Pixabay
Source: Pixabay

It wasn’t a good workout but it was a great run.  I just finished a 5:30 AM run in Santa Clara, CA for 3 1/2 miles and I was thrilled.  Sure, it was only 58 degrees with no humidity, a nice treat from the Florida heat I’m used to, but my excitement was from the fact that I was able to run without calf pain.

I’m out in California with the Jacksonville Jaguars as we prepare to play the Oakland Raiders tomorrow.  I had a few quiet hours this morning before rehab for the players so the timing was perfect for my daily workout.  I didn’t run hard nor did I even burn many calories but I RAN and that was the best part.

Calf Strain Made Easy

Ten days ago I started my day with a calf strain 3 miles into an early 5 mile run.  When I look back at the run that started the pain in the calf, the reasons it happened were obvious.  I suffered a calf strain because I did the following stupid things:

  • Poor Warm-up – I got out of bed at 4 AM and was literally running 11 minutes later.  I skipped my morning soft tissue rolling and stretching routine.  I had to be at the Jags’ EverBank Field earlier that day so was trying to save some time.  Big mistake!
  • Shoe Change – I ran in a new pair of running shoes.  “It wasn’t the time to be breaking in new shoes, Einstein.”
  • Started Too Fast – I was convinced I could finish my 5 mile run in record time and that mindset started as soon as I took the key out of my front door.  I have a steep downhill incline at the end of my driveway.  I remember feeling both of my calves and hamstrings tighten as I ran down that section of my driveway at a 5:30/mile pace 20 yards into my run.  How smart am I??
  • Ignored the Blinking Light – I recall feeling leg pain in both of my calves along with low back tightness about 1 mile into the run.  What did I do?  Nothing.  The dashboard warning light was blinking and I ignored it.  It proved to be the final step in a bad sequence of events on my part that resulted in a calf strain.  I knew better and I only have myself to blame.

Managing Calf Pain

When an athlete hit the 3 decade mark in life, leg pain isn’t too far away.  Calf pain and a pulled hamstring are at the top of the list.  Managing a calf strain is not difficult if you start the sports medicine the right way immediately after the injury.  If not, the pain in the calf becomes chronic and the recovery time is tripled.

  • Ice Immediately – Stop the bleeding and minimize the inflammation.  Pack it in ice for 15 minutes or ice massage it for 10 minutes as soon as possible.
  • Shorten the Heel Cord – Adding a bilateral 1/2″ heel lift in both shoes will decrease the tension on the heel cord – includes the Achilles tendon and the two calf muscles – when walking throughout the day.
  • Apply Compression – Compressing an injured muscle is always a positive thing to do.
  • Lengthen to Strengthen – With a calf strain, gradual lengthening of the fascia and muscles should always take place before calf strengthening begins.  I love the downward dog stretch for this injury to elongate the fascia from the low back to the arches.  This is a key step to decrease calf pain after the initial symptom of muscle “grabbing” is gone.
  • Think Functional – Avoid the urge to aggressively stretch and strengthen a calf strain. Boring functional activities like bike riding and walking will get you pain-free sooner than trying to run while the muscle continues to “knot-up” or “grab”.
  • Soft Tissue in Time – Any early massage or soft-tissue work should be minimal for the first 3-4 days post-calf strain. Trust me, I’ve been there with the mindset: “If I could just get this little knot in the calf muscle to relax, I’ll be fine”.  Digging into the muscle early on will only delay the healing and triple the length of your time to return to pain-free running.

Avoiding Pain in the Calf

Calf pain sucks.  Preventing leg pain is a high priority for MikeRyanFitness.com. Here are a few sports medicine tips to help you avoid calf pain:

If the Wrong Shoe Fits, Give it Away – Use common sense when it comes to shoes, athletic and dressy.  Why use a “light weight” racing shoe for a training run?  Maybe that new minimalist shoe feels good walking around the house but is it the best shoe to do a CrossFit workout after work?  The pretty dress shoes may look good but spending 8 hours a day in a high heel will benefit the foot doctor’s W2 more than it will your 10 km time this weekend.

Rule-Out a Blood Clot – If deep calf is experienced, especially after prolonged inactivity or a surgery, see your doctor ASAP to ensure the pain in the calf is not a blood clot.  This is a very important point to stress.

Spend Time With Man’s Best Friend – The downward dog stretch should become part of everyone’s daily routine.  That’s how strongly I feel about its effectiveness in keeping calves healthy for athletes of all ages.  Stretching may not be as sexy as doing curls for the girls but if you want to keep running pain-free, flexibility needs to part of your plan.

Support Early & Often – Whenever possible, calf-high compression socks should be worn.  To work, especially on an airplane and during workouts, compression socks/sleeves will help support the entire shin and keep your calves happy.