With the start of the New Year came the start of new fitness regimes for many people. For those of you sticking to that new morning jog, and even for those more hardened runners, risks to your calf is something you need to be aware of.
One of the most common injuries for runners is a calf strain or a tear. This usually happens when there is a repetitive and heavy load put on to the calf muscles. This could be because of a sudden pushing off movement, or from over-stretching in a jump or quick change of direction.
It could be something as simple as your running technique, or an issue in another part of the body, that would make the calf muscles work harder.
The severity of muscular strains are classified in terms of how many fibres have been disrupted or ruptured.
• Grade 1 calf strain - A minor tear with up to 10% of the muscle fibres involved
• Grade 2 injury - A more severe tear involving up to 90% of the muscle fibres
• Grade 3 injury - Usually a very severe strain or complete rupture of the muscle
Treatment and Rehabilitation:
A structured rehabilitation program is important for optimum recovery from a calf strain or tear. Initially, the R.I.C.E principal should be followed:
R - Rest
I - Ice
C - Compression
E - Elevation
Other methods used to help with soft tissue healing include therapeutic ultrasound, dry needling, sports massage and taping. Sports massage, however, should not be performed until the acute phase has passed, which is three days or more.
Approximate timescales for rest are:
• Grade 1 strain - 3 weeks
• Grade 2 strain – 4 - 6 weeks
• Grade 3 tears may require surgery followed by a 12 week rehabilitation program
As with any injury, exercise-based rehabilitation is key to avoiding recurring or secondary injuries. Secondary injuries often occur if your body has been using other muscles to compensate for the injury, which might then become habit.
The rehabilitation period is also an ideal opportunity to target areas usually ignored in weekly training routines. Core stability and gluteal muscles are great to focus on when activity is restricted. Research has found the stronger these muscles can become, the more likely a successful outcome in terms of injury recovery, injury prevention and performance.
Stages to rehabilitation:
Stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence are:
Regain Full Range of Motion. It is important to lengthen and move the healing scar tissue via massage, muscle stretches and neurodynamic mobilisations.
Restore Concentric Muscle Strength. Calf strength and power should be gradually progressed from non-weight bear to partial and then full weight bear and resistance loaded exercises.
Restore Eccentric Muscle Strength. Most calf muscle tears occur during the controlled lengthening phase. The physiotherapist will guide the patient on an eccentric calf strengthening program.
Restore High Speed, Power, Sense of Movement and Agility. Most calf injuries occur during high speed activities. In order to prevent a recurrence as the patient returns to sport, the physiotherapist will guide them with exercises to both prevent a recurrence and improve their sporting performance.
Return to Sport. Depending on the demands of the chosen sport, the patient will require sport-specific exercises and a progressed training regime to enable a safe and injury-free return to their chosen sport.
Early intervention is the most important part in helping these patients achieve the best and fastest results possible. Physiotherapy is an essential ingredient in treating calf injuries.
If you ever wish to discuss our treatment protocols, or co-management of patients, please do not hesitate to get in touch.
At Wolli Creek Physiotherapy & Pilates, you’ll be looked after by highly experienced and passionate young physiotherapists with a range of specialist skills and qualifications. We treat and heal all injuries and pain problems, for all kinds of people.