There are a few common running injuries, including calf strain. In this blog series, we want to help take the pain out running, read on to find out more.

The calf muscle is part of a group of muscles we call the triceps surae. This includes the gastrocnemius, soleus, and plantaris muscle. The gastrocnemius has 2 heads and acts on the knee and ankle joint. Underneath lies the soleus which acts only on the ankle. The triceps surae group share a common tendon, the Achilles, which attaches into the calcaneus (heel bone).

What are the Causes of Calf Strain?

Strains to the gastrocnemius are more common than soleus. Injury to this muscle group is most common on medial aspect (gastrocnemius), lateral aspect (soleus) and can also occur at the musculotendinous junction (or where muscles join to Achilles tendon). Injury to the triceps surae group is most often the result of the following:

  • Sudden Acceleration or Contraction: i.e. stepping onto a kerb and the heel suddenly drops.
  • Previous injury: A previous strain may result in the build-up of scar tissue. This is characteristically shorter and weaker than normal, healthy muscle tissue.
  • Training Errors: Taking on too much too soon, ignoring warning signs, taking inadequate rest can all contribute to calf injury.
  • Poor flexibility and Muscle Conditioning: Inadequate strength and flexibility affects the overall function of muscles and joints. Poor musculature balance can cause overload, increasing an individual’s risk of injury.
  • Inappropriate footwear: Appropriate running shoes is the most important purchase of any runner. Altered foot mechanics such as overpronation can cause internal rotation of the tibia, and fibula, this can force all structures into unwanted positions

What are the Symptoms of Calf Strain?

  • Sharp tearing sensation in the muscle at or near the musculotendinous junction.
  • Often painful to walk/run, stairs and hills may often cause pain.
  • There may be swelling and bruising present depending on the extent of the tear.
  • There is usually pain while stretching and contracting the muscle.

How you manage Calf Strain is dependent upon the grade of the injury:
Grade 1: Few fibres are torn, minimal pain and disruption to gait.
Grade 2: Anything from a few fibres to just before a complete rupture, usually significant pain and disruption to activity.
Grade 3: Complete rupture, often reduced pain due to complete rupture of nerve endings, there will be significant disruption to activity.

How to Manage Calf Strain

Reduction of any pain and swelling is essential. Rest from aggravating activity, and the use of ice, compression and elevation are essential in the early stages (first 24-48 hours). Use non-steroidal anti-inflammatory medication at this stage to minimise pain.

Cross training as soon as pain allows (Swimming, cycling, cross trainer).

Initiation of flexibility and strengthening program as soon as the pain has reduced. Progression through non-weight bearing, to gradual weight bearing, to full, to single leg exercises will ensure you load the muscle appropriately.

Correct any training errors.

Self-massage with a foam roller (only when pain and swelling have gone completely to avoid further injury).

How to Avoid Common Running Injuries

Overpronation and under pronation can significantly affect the function of the foot. Wearing the correct running footwear is essential. Visit a specialist footwear store such as Run4It to ensure you are measured correctly for the most appropriate shoe for your running style.

N.B. It is not advisable to get fitted for running shoes if you are experiencing pain and discomfort following injury. The discomfort may alter your normal running technique.

Sports massage and mobilisations have been found to be an effective method of reducing the pain associated with a calf injury. Increasing mobility at the joint and improving the muscles flexibility will allow you to perform the necessary strengthening exercises essential to a speedy return to running. Sports Injury Scotland will provide diagnosis and treatment of any musculoskeletal injury. They also offer advice on the management of pain and how to avoid recurrence.

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