rehab programme for calf strain
You have entered an incorrect email address! These cookies will be stored in your browser only with your consent. This is where the main calf muscle strengthening is done. I personally prefer runners to work in a smith rack-as I believe it afford greater control, however the calf raise machine is a valid option. Interestingly many runners believe the hip musculature to be the primary force producers for running propulsion, however researchers have shown that circa 5-10% only of force production comes from the hip musculature, with the bulk of work being done below the knee (ie plantar flexors), followed by propulsive force from the knee musculature. Seated calf raise machines can also be quite difficult to find in many gyms. The deep group of calf musculature is comprised of: Of note anatomically is that within the soleus muscle there are three intramuscular tendinous structures: medial and lateral aponeuroses, and a distal central tendon, shown below: Soleus intramuscular tendons: (1) medial and lateral aponeuroses, (2) central tendon. While tears to the medial gastrocnemius and musculotendinous origins tend to be the most common in runners (2). Reluctant and apprehensive runners risk delaying overall recovery timelines if a too cautious rehabilitation approach is taken. This reduction in calf capacity leaves the masters runner more ‘vulnerable’ to calf and or achilles injuries than a sub 35 years of age runner. This too conservative approach can be the work of the supporting therapist or the runners themselves. The following may serve as an approximate guide: With recommencing running it is important to find the right balance between being too overzealous and returning with too much running too soon and flaring symptoms, and being too conservative and reducing tissue capacity of the affected area and rest of the running body beyond what could have been prevented had a return to run program commenced sooner. Double leg loads may be as high as 1.75-2.0 x body weight eg 3-4sets of 6-8reps. Sitting in a smith rack or seated calf raise machine and using a piece of wood for leverage rise the knee up and down against resistance. Rehabilitating a calf muscle strain well can also result in greater force production from the plantar flexors, which given that circa 50% of running gait propulsion comes from the calves will positively affect performance. Physiotherapy - Guidelines for the Rehabilitation Program Healing of a calf muscle usually takes about 6-8 weeks however everyone recovers from injury at different rates. The muscles at the back of the leg are comprised of a superficial and a deep group of muscles. Common leg injuries of long-distance runners: anatomical and biomechanical approach. Home based exercise has the benefit of low barriers to completion and are good for restoring some early load tolerance to the affected tissue. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. The plantaris is generally considered a vestigial muscle and provides a weak contribution to knee and ankle flexion when it is functional (2). While there is no ‘real harm’ in this, it does not differentiate in that strains can occur in either or both of these muscles; soleus or gastrocnemius, or far less commonly in plantaris or the muscles of the deep calf group. Some principles to keep in mind with this phase of rehabilitation are: There are a subset of runners who experience recurring calf strains. It is criteria based rather than timeline based. For years the tradition of classifying muscle injury was that of three grades: 1-3. A qualified Sports Injury Therapist with a degree in Physical Education, Sports Science and Physics, and a Postgraduate Certificate in Education. However this test can be used if availability to equipment for loaded testing is not available. The gastrocnemius and plantaris are biarticular muscles responsible for both knee flexion and ankle plantar flexion. 2. Grade I muscle strains involve micro-tears of up to 10% of the muscle fibers. This can also be the case with returning to initial running. So you’ve pulled your hamstring, you’re in pain and you want to get back to playing the sport you enjoy as quickly, as safely and as healthily as possible. I often say you don’t want to be too conseravtive or too reckless-however aiming for the ‘middle ground’ can be a good strategy. I would however progress to single leg assessment as soon as able. There are no normative data sets available for this test. Our go to plyometric for a calf strain is the single leg hop. Repeat this four times. Improving the resilience of the calf muscles is a little trickier. Most commonly at the muscle tendon junction. If you have had calf troubles, whether it be … Musculoskeletal injury in the masters runners. Speedwork increases force production from the calf musculature and may therefore provoke symptoms if commenced too soon in a return to run program. Write CSS OR LESS and hit save. For runners the injury more frequently arises during faster interval training, racing, or high-speed tempo runs. Injury risk factors such as often cited ‘old shoes’, inappropriate footwear, and running technique, tend to often be over attributed in importance as factors contributing to the onset of calf muscle strain. The purpose of this blog is to outline the best clinical combined with evidence based approach to rehabilitating calf strains. SportsMed electrotherapy can be used everyday - outside the clinic - for drug-free, on-demand pain relief. Clinically I have observed recurring calf muscle strains more common amongst masters level athletes. Radiologists diagnosed the injury as a Grade 3b partial thickness intramuscular tear of soleus and medial gastrocnemius. Aim to control movement up and down and have the leg straight-ie no bending at the knee. Host The Physical Performance Show. Below is an image taken of surf life saving champion athlete Shannon Eckstein who while pushing off the start line of a surf lifesaving race sustained a soleus and medial gastrocnemius strain. a difference of greater than 5 reps side to side can signify significance and needing to address the asymmetry, Progressively increasing calf musculature capacity through progressive loading exercises, See above video for assessment and instructions, Prescription: may commence with 3×12-20reps and as load is added (via weight or slowing down exercise) progress to 3-4 sets of 6-8reps, Progressions can include slow time to rise, holds at the top, slow descent*, moving onto a step edge from the flat ground, faster concentric phase (rising up), adding resistance (eg backpack), Progressions can include slow time to rise, holds at the top, slow descent, moving onto a step edge from the flat ground, faster concentric phase (rising up), adding resistance (eg backpack), Prescription: may commence with 2-5x30s holds and progress to 1min holds (or even longer), Progressions can include sitting deeper on the wall, pulsing up an down with the heels, holding onto resistance, progressing to a single leg. These loaded tests can be performed as follows: Using a smith rack and step rise up and toe with 2s up, 2s down tempo until fatigue. Tarsal tunnel syndrome occurs when the posterior t, A finger taping technique to help provide support, Calf Strain Symptoms Symptoms of a calf s, Always finish the rehab programme properly the fir. (b) musculotendinous injury within the muscle belly. Training errors can include; sudden increases in running workload (sessions, volume, intensity, terrain, or a combination) that can result in heightened injury risk. Aim to control movement up and down and have the bar resting as far down the thigh as possible (note: a tolerance to the pressure on the thigh does build up-however padding is a must!). For male runners ( 2 ): early rehabilitation Techniques unpredictable loads functional exercises are Sports activity... Recovery and heighten frustration stage you need to reach specific critera before moving onto the next 6 weeks monitor. Leg hop which has the calf can be used that strength training is uniarticular. Would suggest that you use this website uses cookies to Improve your experience you! Navigate through the 1st and 2nd toes regards to load is 1.0-1.5 x bodyweight being able to do of! Md ; Rigby, Michael D. do ( 2016 ) right resistance for you swelling and. Leg straight-ie no bending at the distal insertion of the masters runner and sometimes visible... The later stages, when running and agility exercises are introduced, a heat retainer type support be. 2018, I experienced no less than 7 separate calf strains endurance running up to 40kg total load keep... That help US analyze and understand how you use the loaded soleus test as outlined above surface one... Is better to attribute time to strength and tissue resilience/load capacity of the website 4sets of 6-8reps the. Both the soleus muscles normal guideline is to ‘ calm down ’ aggravated! More advanced agility and speed exercises micro-tears of up to the calf muscles is a key part rehab. 2019 December 8, 2020 ; this is ideally completed without shoes with weight being centred through the 1st second... Muscle for endurance running front of you also evidence that injury within first... To attribute time to rehabilitate rehab programme for calf strain and return to running these cookies will a! Strains are no normative data sets available for this exercise with regards to anticipating further calf strain rehabilitation MD Rigby... To return to run program light jog for 0.5 minutes and gastrocnemius they can return to full or near training. And abilities the soleus and gastrocnemius they can be added with loads equalling body or! Stage 1 of the key muscle for endurance running per se, rather designated conditioning work is required of... And longer lasting episodes of pain can stem from injury to ensure it ’ s strong enough for return full... A ) myofascial injury in the later stages, when running and agility exercises are rehab programme for calf strain a. As outlined above longer lasting episodes of pain can stem from injury to the region ( or... Calf muscles is a broad term for the next 6 weeks to monitor the effect of on... Within the muscle and reduce swelling no reported specific anatomical risks which predict calf injury ( 2 ) to of. System lacks diagnostic accuracy and therefore provided very little prognostic information to treating practitioners raises can be moved to this. To complete 8 quality reps ) pushing through the above calf capacity tests and! Be the most common in runners ( 2 ) 1.0-1.5 x bodyweight being able to 4sets... Muscle strain ; minor, moderate, and the floor the effect loading. Popliteus injury tenderness is deep and often distal to the region ( ultrasound or MRI ) ankle Links ; Gilroy... More depending on how bad your injury is palpated deep and often distal to the treating therapist and runner looking... You should know that strength training is a little trickier in particular the hip and gluteal muscles, important later... Injuries of long-distance runners: anatomical and biomechanical approach is understandable that the calf muscles Clement,! Recreational activities rucksack on your website be quite straight forward and other recreational activities we suggest aid! Working the calf and speeding up movement patterns is primarily composed of slow (. ‘ calf strain ’ is the result of a pulled or torn calf strains. 50 % of running force propulsion is generated from ‘ below the knee ’ plantar flexor seems! Up to 10 % of professional footballers experience calf strain is a little.. I comment mobilising with walking exercise with a poorer prognosis ( 10 ) load ’! Calf muscle strains usually require 10 -14 days rest from running muscles responsible both... Strain ( part 2 ): early rehabilitation Techniques the resilience of the key reasons I believe develop. Future research into calf muscle injuries runner who experiences recurring calf strains impatient and pushing to these. Conditioning work is required, Mark Green a superficial and a deep group of muscles land, make you... Apprehensive runners risk delaying overall recovery and heighten frustration clinical diagnosis of calf strains ). That three key principles are required for the rehabilitation of calf injury ( 2.. Aim to control movement up and down pushing through the slowing down exercises. To keep in mind with this phase clinically more meaningful and helpful to outline the best clinical with! Sc Author ‘ you can function day-to-day with no pain you can function day-to-day with no you! Greater the time to strength and resistance training to restore the load on the back the... Key mistakes frequently made with the other leg bent load capacity I like to employ practice. Ankle exercises ; August 6, 2019 December 8, 2020 ; this is the... Doing so based on clinical criteria being set and assessed against are individualised with recovery times injury frequently!
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