We were recently asked some advice from a regular recreational runner. It’s a story that we hear a lot of here at goPhysio (not always calf related, but the same principles apply), so we thought it warranted a little blog post!
The runner in question was concerned, as they’d picked up a calf injury when out for a run a few weeks previously. Nothing major, but felt a bit of a tug on the calf when they had to move suddenly during the run. The calf was painful, so they did what they thought they should and rested for a week from running. The calf then felt fine, so they went back to running. Since then, the calf pain comes and goes. They don’t only feel it when they try and run but can feel it driving, going up & down stairs and first thing in the morning.
The dilemma is……….what is the best thing to do? Carry on running (because they love it and it they were progressing so well!)? Stop running (because it’s making the injury potentially worse)? Exercise? Ice? Heat? Strapping? New trainers? Taping? See their GP? Have a sports massage? Ask a friend? Use a foam roller????????? So many questions?
This is a really common story that we hear a lot in physio. A simple calf tear should take 3-6 weeks to repair itself, however its easy to get stuck in a cycle of tear, rest, repair, tear again, making the recovery much longer and much more frustrating.
How do we break this cycle?
Whilst rest is important it is not enough to adequately repair our damaged muscle to take the strain of running again, which is why it keeps being re-irritated. If we continue to do this we cause a lot of scar tissue to form in the healing muscle. Scar tissue is neither as strong nor as flexible as normal muscle fibres which make it easy to re-tear when stressed by anything more than day to day activities.
In the early stages of recovery from an injury, relative rest is important to help with healing. What that means is avoiding any activity which aggravates the injury, but trying to do alternative activities or modified activities so that you aren’t resting totally.
However, the important thing is to rehabilitate the calf muscle during the ‘rest’ period – gently stressing it with progressive strengthening exercises and stretches to regain its normal strength and elasticity. Ready to run again!
Physiotherapists are experts at guiding you through this process, making sure you are exercising at the optimal level for your stage of healing. They will make sure you are doing the right exercises (technique, loading, reps etc. all carefully worked out) and that you progress them at the right stage – all tailored to you individually and your own goals.
A programme for a minor calf tear for an ultra marathon runner would look very different to a programme for a severe tear in a Saturday morning Park Runner. There isn’t a one size fits all approach and although ‘Dr Google’ or Joe Bloggs at running club who also had a calf injury can be useful resources, relying on such information won’t always give the best long term outcome!
In addition to a specific exercise programme, Physio’s can also carry out a range of other treatments such as hands-on therapy, ultrasound and taping which can help to speed up your recovery. They an also advise on treatments you can do at home, such as foam rolling. A crucial part of your recovery is obviously returning to running at the right time. We know taking time out of running can be very frustrating, so we limit this as much as possible, guiding you with your return programme so you don’t do too much too soon and risk re-injury. If you have a specific event or race coming up, this is factored in.
So, if you love running and are worried about a calf injury, don’t hang about, book in to see an expert to guide you out of the injury cycle and back to running!
Here are two great simple exercises for a calf tear
Heel raises – standing on both feet, slowly rise up onto your tip toes then lower back to the ground. If you can manage 20 or more of these try doing it just on the injured leg, holding onto a support for a little balance, remember slow and controlled is key!
Calf stretch – stand in a long stride position with the injured leg behind. Bend the front knee and gently press the back heel down towards the ground until you feel a stretch in your calf. Take it to where you feel a mild to moderate stretch (but not pain!) then hold for 30secs.
More information
Treatment of calf pain in runners
Top Pilates exercises for runners