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Injury Prevention 101: Calves

Updated: 5 days ago

Chances are that if you run or play any sports that requires a bit of running, you would have experienced discomfort in your calves at some point. This article is a summary of the final session of the Injury Prevention series where I’ve looked at calf injuries, their most common causes and what you can do to prevent them. You can watch the livestream of this episode on replay in the Sports Injury Support group. Other topics that I’ve covered in this series include Position Sense, Core Stability, Glute Med, Glute Max, Quads and Hamstrings.

In this article:

  • Why does stretching my calves not always help?

  • Overuse injuries

  • Training errors

  • Strength imbalances

  • Calf strains and tears

  • Your sciatic nerve may play a role

  • Flexibility exercises for tight calves

  • Receive exercises as PDF

  • In summary: How to deal with calf pain

Why does stretching my calves not always help?


I often get people in my clinic complaining of tight and sore calves despite doing regular stretching and foam rolling. The reason for this is that the tightness or discomfort that they experience is only a symptom and it won’t go away if they don’t address the cause.

You can divide the causes for calf pain or tightness into 3 broad categories:

  1. Overuse injuries

  2. Calf strains or tears

  3. Nervy reasons

I can pretty much write a chapter on each of these, but I’m going to try and keep it succinct!


Overuse injuries


Overuse is by far the most common cause I see in practice for calf injuries. What does it mean to overuse your calves? It means that you’ve asked it to work too hard, too often and it’s not had enough time to rest and recover.


Training errors obviously fall into this category, but you can also overuse parts of your calf muscles if other muscles e.g. your glutes aren’t strong enough. So it may be useful to break this section into Training Errors and Strength Imbalances.


Training Errors


I’ve written in the past about the importance of allowing the body enough time to recover after exercise. When you train, you sustain micro-injuries to your muscles and tendons etc. It then needs a period of rest to recover and rebuild itself. If you give it enough time to recover, the muscles and tendons become stronger over time. If, however, you train again and again and again BEFORE you have fully recovered, that muscle or tendon will break down faster than what it can recover and you end up with an injury.


This can also happen if you do a bout of exercise that’s a lot harder (longer or more intense) than what you’re used to. In this case you end up with an injury because the muscles or tendons are just not strong enough for what you're doing.


Changing your running style to running more on the front of your foot or wearing flatter shoes than normal will also make your calf muscles work a lot harder than normal and can cause calf and Achilles tendon pain.


The most common training errors that can lead to overuse injuries of the calves are:

  • Increasing your weekly mileage too quickly

  • Increasing the intensity of your training too quickly e.g. by adding in hilly runs or ramping up speed work or both!

  • Introducing other activities or sports that also uses the calf muscles e.g. dance or basketball

  • Switching to flatter running shoes.

  • Changing your running style to run more on the front of your feet.


Strength imbalances


Weak or switched off glutes can cause quite a few issues for the calves. Firstly, the glute max has to help propel you forward when you run. If it’s switched off or weak, your calves may have to work harder which can lead to strains.


Secondly the glute max and glute med are very important hip stabilisers. They should stop your legs from rolling in excessively when you run. If they aren’t doing their job properly, it will cause your foot to over-pronate (roll in) which over time can cause a variety of injuries around the lower leg including soleus strains, tib post tendinopathy and medial tibial stress syndrome (shin splints). All of these injuries can make your calves feel tight and sore.


I should really mention shoes again. Wearing really flexible running shoes that provide little to no stability can cause similar problems for some people as they can also make your foot over-pronate.


I’ve written in the past about how you can test your hip stability. You can also find exercises to strengthen your Glute Max and Glute Med in the previous articles of the Injury Prevention series.


Calf strains or tears


Not all calf tears have to be sharp and bruise or swell. Tears in the Soleus muscle often just feel like persistent tightness. It’s really important to carefully strengthen your calf muscles if you have sustained a strain or tear. You will find yourself suffering repetitive calf strains if you just rest it and don’t strengthen it before you go back to running or sport.



Your sciatic nerve may play a role


Your sciatic nerve runs from your back, through your buttocks and down the back of your legs. When it’s irritated it can cause a wide variety of symptoms in the calf ranging from strange sensations (e.g. tingling), sharp pain, numbness, weakness, cramping or just a feeling of perpetually tight calves.


If you’re experiencing very sharp pain that does not want to subside, funny sensations, numbness or weakness, you’ve likely got an injury to your lower back. I would suggest that you consult a physiotherapist as they can test it properly and provide you with a treatment and exercise plan to help this heal.


You don’t always have to have a back injury to have an irritated sciatic nerve. If your problem is just very tight and sore calves without any funny symptoms, your sciatic nerve may just be a bit stuck.


Your nervous system is continuous from your brain to the tips of your toes. When you walk and move the nerves slide happily in their sheaths. Tight muscles or other structures can sometimes hold on to or press on the nerves and prevent them from sliding, causing increased neural tension and symptoms lower down in the limbs.


A very common culprit, that can affect the sciatic nerve, is the piriformis muscle in the buttocks. In some people the sciatic nerve runs through or under the piriformis and gets squashed when this muscle becomes very tight. Tight buttocks often go hand in hand with a tight lower back and I find it most effective if you improve the flexibility in both areas.


It is very easy to test for this and I’ve demonstrated it in the livestream I did in Facebook. You can watch the video on replay if you join the group and search inside the group for #calves101 .


Flexibility exercises for tight calves


For the reasons listed above, it should be obvious that you should be stretching more than just your calves. I always get my clients to work on the flexibility around their lower backs and glutes (to free the sciatic nerve up) before they stretch their hamstrings and calves.


Glute stretch

Purpose: To improve the flexibility around your pelvis and lower back and help your sciatic nerve to slide more freely.

Starting position: Supine with both knees bent up.

Movement: Place the outside of your left ankle just above your right knee. Take hold of your right thigh with both your hands and pull it towards your chest. You should have a pillow under your head if you struggle to keep your neck in a good position. You should feel the stretch in the left buttock/thigh/back depending on which part is the tightest.

Aim: Hold the glute stretch for 30 seconds and repeat on the opposite side. Repeat 3 times.



Piriformis stretch

Purpose: To stretch your piriformis and allow your sciatic nerve to slide freely.

Starting Position: Supine with both knees bent up.

Movement: Cross your right leg over your left leg. Place your right hand on your right knee and your left hand on your shin. Pull with both hands at the same time so that your knee moves diagonally towards your left shoulder. You should feel a stretch in your right buttock.

Check that: You also pull with the hand that is on the shin – this twists the hip and increases the stretch. Make sure your knee moves across your body.

Aim: Hold the glute stretch for 30 seconds and repeat on the opposite side. Repeat 3 times.



Hamstring stretch

Purpose: This is a gentler hamstring stretch.

Starting position: Lie on your back. Bend your one knee up and grab hold around your thigh.

Movement: Gently straighten your leg until you feel a comfortable stretch at the back of the leg.

Aim: Hold the stretch for 10 seconds. Then bend your knee again. Repeat 12 times with each leg.



Calf Stretch

Purpose: To improve the flexibility of the calf muscles.

Starting position: Stride stand with the foot to be stretched at the back. Your toes must point straight forward.

Movement: Keep your heel on the floor and bend the knee of the front leg until you feel a stretch in the calf of the back leg.

Aim: Maintain the calf stretch for 30 seconds before switching legs. Repeat 3 times with each leg.



Receive the exercises as PDF



In summary: How to deal with calf pain

  1. Identify the cause and address that. A health professional who specialises in sport can help you with this if you’re struggling to identify the reasons for your symptoms. This is also something that I can easily help you with via an online physio session.

  2. While you recover, cut your training down to a volume that you can do without causing or increasing your symptoms e.g. shorter runs or running on flatter surfaces or grass etc. If your calves are very painful, you may have to ease off running and cross train by swimming or cycling.

Let me know if you have any questions. You can also consult me via Skype for an online diagnosis of your injury and a treatment programme tailored to your needs.

Best wishes

Maryke


About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.



References:

  1. Bryan Dixon J. Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries. Current Reviews in Musculoskeletal Medicine 2009;2(2):74-77. doi: 10.1007/s12178-009-9045-8

  2. Orchard JW, Farhart P, Leopold C. Lumbar spine region pathology and hamstring and calf injuries in athletes: is there a connection? British Journal of Sports Medicine 2004;38(4):502-04. doi: 10.1136/bjsm.2003.011346

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