Can you do 25 single leg calf raises? Are you running, hopping, and maybe jumping off river waves like me? I wish I had forced myself to build up the strength to do 25 single leg calf raises to prevent the recurrent calf strains I have been dealing with for the past few months. Don't make the mistakes I did! Read on to learn how to prevent calf strains yourself, or how to rehab properly and prevent re-injury.
Calf muscle injuries can result in 3 months of time-loss from sport, so it is important to do our best to prevent them, and address them properly when they do occur. A systematic review of 5397 athletes found that chronological age and previous history of a calf strain were the strongest risk factors for future calf muscle injury.
Why is age such a big risk factor? With age comes lovely changes, such as age-related neuromuscular maladaptations and loss in skeletal muscle tissue quality and function.
While we can't defy aging (oh, but if you figure it out, do let me know!), and can't modify if you have had a previous calf muscle injury, there are plenty of modifiable risk factors that we CAN address. Some of these include
Coordination
Calf strength
Fatigue
Running biomechanics
Ankle range of motion
Other lower body strength deficits
Re-exposure to running workloads or intensity after time off from sport
Changes in running/walking surface
Changes in footwear
There are two muscles that make up the calf, with different roles. Hence, different mechanisms of injury, and a different way to address rehabing/strengthening them.
Soleus
Onset: cumulative, most common with steady-state running or gradual onset of symptoms
More type I muscle fibers/slow twitch fibers, that make it great for long, steady workloads
Suddenly increased running workloads
Sensitive when stretched while knee is bent
Gastrocneumis
Onset: most common with acceleration, jumping, sprinting
More type II/fast twitch muscle fibers, which are great for ballistic movements like jumping and sprinting
Sensitive when stretched while knee is straight
Below is a rehab progression recommended for a calf injury.
(If you are just trying to prevent injury, start with wherever you are weak, i.e. if you can't do 25 single leg calf rasies, start there. If this is easy, consider adding some ploymetrics into your routine.)
Normalize walking pattern
Specific calf loading just below individual’s pain/strength threshold. For example, for a soleus injury perform bent knee band exercises, or standing double leg calf raises with knees bent if tolerated.
Load injured muscle 3-4 times per day - make sure exercises are pain free
Continue to train uninjured parts of body as intensely as possible
Build up to a capacity of 25 single leg calf raises
Progress to weighted single leg exercises
Progress to plyometrics and ballistic exercises
Progress to running
For expert guidance on rehab and injury prevention, schedule a Free Consultation Call!
References
Green B, McClelland JA, Semciw AI, Schache AG, McCall A, Pizzari T. The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians. Sports Med Open. 2022;8(1):10.
Green B, Pizzari T. Calf muscle strain injuries in sport: a systematic review of risk factors for injury. Br J Sports Med. 2017;51(16):1189-1194.
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