Calf Strain: A Running & Jumping Athlete’s Nightmare

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.

Running Injuries: My Pain Management Plan

Running Injuries: My Pain Management Plan

It’s 6:55 AM.  I’m wrapped in ice while scarfing down a healthy bowl of cereal and writing this post.  I just got home after an invigorating 4:40 AM run with my friends Rushton, Rob and Dawn.  We logged 9 1/2 miles in the cool morning breeze, which felt great…for about the first 6 miles.  That’s when my other buddies decided to join in for the last 3 1/2.

You may in fact know them.  They go by many names…Mr. Ache, Mr. Twinge, Mr. Tightness, Mr. Cramp, Mr. Stitch, and, my least favorite, Mr. Stab.  Call them what you want, but together, they hold the keys to a club where the password to get in is PAIN.  

This morning, the Pain Gang made their arrival known when I suddenly felt lower-back tightness, which quickly shortened up my stride.  A half mile later, I felt a tweak in my right arch followed by a grabbing sensation in my left calf a little further down the road.  My mind quickly went to work thinking, I need to get this running pain under control, stat.

When I mentioned my pain to Rushton about 8 miles into the run, knowing my sports medicine background, she challenged me with one stern question: What are YOU going to do about it?

Keeping Little Pains From Becoming BIG Injuries

I’m sure you’re wondering what a professional like me would do to solve training woes like the ones I encountered.  You’re in luck!  Here is the plan I immediately put into action to combat my three running injuries and keep them from forcing me to walk home and/or miss my big race next weekend:

During the Run

1. I slowed my pace while slightly shortening my stride to balance the sound and feel of my foot strike on both sides.  I noticed that I was striding too short with my right leg and too long on my left.  Balance your body played on a loop in my head.

2. Every 3 minutes, I performed three Carioca drills on each side while keeping my knees low to emphasize trunk rotation and loosen my hips and lateral thighs.  I do this during all my long runs and races as well.

3. I switched to the other side of the road to change the road angle to relax my legs.

4. I trusted my body’s ability to work through the problem instead of adopting a very disruptive Damn, this is just my luck that I’m injured again! mindset.

After the Run

1. I drank 15 oz of a water and Gatorade mixture to hydrate my inflamed tissues.   (1 minute)

2. I elevated my legs against a wall while pumping my ankles, wiggling my toes and setting my quads to help drain leg waste products produced during my run.   (4 minutes)

3. I aggressively rolled out my quads, IT bands, hamstrings and calves.   (4 minutes)

4. I performed Active Release Techniques on my right plantar fasciitis and left calf strain.   (3 minutes)

5. I quickly stretched my hip flexors, quads, hamstrings, calves and toe flexors under the enthusiastic supervision of Marshall, my official Flexibility Advisor.   (4 minutes) 

Marshall, Flexibility Advisor

6. I took 600 mg of Advil.  (30 seconds)

7. Finally, with my legs more relaxed, my muscles more pliable and my mind more at peace with my injuries, I iced my calves and thighs with my 110% Play Harder cold compression sleeves.   (30 seconds)

Is This Worth 1.2% of My Day?

Do the math.  It took me a grand total of 17 minutes to complete my post-workout rehab to reduce my running pain by 80%!  That represents about 1.2% of my day.  The old I just don’t have time to take care of my injuries is simply not part of my vocabulary, and I suggest you adopt the same rule.

Simply put, I just can’t afford to disrupt my training or let running pain interfere with my busy schedule, and neither can you.

Take Home Points

  • Addressing a running injury quickly and properly is key for mature athletes to stay in the game.
  • Time to treat injuries won’t just appear out of thin air.  Instead, make the time, and remember that a significant time commitment is not required.
  • The first step to get healthier below the neck is to get your mind right above it. Visualize yourself as a healthy and happy athlete, then do what is needed to make this become a reality!