So you messed your calf up, huh? You felt a little twinge during some activity that didn’t feel like much, but once you rested for a bit that little twinge started to feel like a cramping pain. Now you’re noticing it whenever you have to point your toes or walk up steps, forget about any plyometric exercises and running is less than fun.
Chances are you’ve sustained a grade 1 strain of your calf, more specifically the Gastrocnemius muscle (side note- best name ever, right?). Grade 1 strains are the lowest level of damage and often feel like a tight, tender muscle when contracted or stretched. Grade 2 is the next step up and will often produce more pain, more quickly when the muscle is contracted or stretched and may also be tender to the touch. Grade 3 is the highest level (often referred to a tear/rupture) and will produce sharp, stabbing pain at the time of incident that will affect or may actually inhibit walking. The key to these injuries is to recognize when a strain has occurred and take time off. Grade 1 may seem minimal but calf strains can progress into a higher level strain quickly if not treated properly.
I am typically of the mindset movement is the medicine, but in the case of calf strains – rest is best (to a certain extent).
A little anatomy before we get much further. The “calf” is comprised of 1-3 muscles (depending on how you break it down) located in the posterior compartment of the lower leg. The muscle that most people think of when talking of the calf are the lateral and medial heads of the Gastrocnemius. These muscles help flex the knee and plantarflex the foot (pointing the toes downward). Since the Gastroc is made up primarily of fast twitch fibers and is a 2-joint muscle, it’s typically utilized when the body requires quick movements and generally under a great deal of strain with certain power activities. Under the Gastroc lies the Soleus, which also helps plantarflex the foot. The Soleus is made up of more slow twitch muscle fibers and is primarily used in walking actions or those requiring less speed/power.
These guys get a lot of use and if something up or down stream isn’t pulling its weight the lower leg becomes ripe for injury. However, anytime you’re dealing with an intense pain in the lower leg you want to rule out things like blood clots or stress fractures (among other things) which sports chiropractors, physical therapists or medical doctors are trained to do so. But once those have been cleared, understanding what went wrong to cause the injury is important.
It’s no coincidence that patients with calf problems generally have an ankle that has been locked up for “as long as they can remember.”
Step 1- look at ankle mobility. If you don’t have any, you need to work on getting some.
Step 2, of course, look at the hips and glutes. If they’re totally slacking the body is going to try to pick up power from another source when needed, hello fast twitch muscles of the Gastroc. Setting yourself up in proper gear is important too: does the drop in your shoe (angle of incline between forefoot and heel) meet your needs? Too much? Too little?
Step 3 (or is it 4?) Working on stretching and then strengthening the calf and core are going to be super important. Retraining muscles when they need to fire and how they should be firing is the key to this whole process- especially if you’re doing any explosive maneuvers (looking at you runners and crossfitters)
Here at TCSS we utilize manual therapies to help stretch and lengthen the muscles as well as break up any superficial adhesions that may be interfering with the calf doing its thing. We look to mobilize any “locked up” joints in the foot, ankle, knee, or hips and a rehab program is developed or discussed with each patient. Our goal is to get you back to doing what you love, faster.
Questions? Let us know!
Dr. Katie Clare, DC, CCSP, ART
Dauntless Sport & Spine Clinic
4510 W. 77th St, Edina, MN 55435