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?
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.