- Bob and Brad,
the two most famous physical therapists
on the internet.
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together, we're the most famous physical therapists
on the internet.
- In our opinion, of course.
- Brad, this is a little bit of a remake of,
we weren't really happy with how the first one turned out.
This has probably been a couple years ago,
so we're gonna redo it.
Calf strain or calf tear.
What is the absolute best self-treatment you can do?
And we're gonna show you from start to finish
what you should do.
- Right.
A number of different techniques, different options, and
- Right.
- A few things said
- We're gonna show you a neat trick at the end.
- There you go.
- By the way, a neat one
- A neat one.
- Yeah, I can't wait. - Okay
- So this, now this is a common injury.
This could be the weekend athlete, you know,
running the bases on a softball tournament or
- Right
- Very common among tennis players.
They actually call it tennis leg.
- Sure. Sometimes
- Yep. Someone hiking up a mountain.
- Yep. Using the calf muscles quite a bit.
You start to feel that pain in there.
It might be even, you know, somewhat severe, the pain.
- Yep.
- But, and you've torn some of the fibers of the muscle.
Not completely torn it, but enough that, you know,
it hurts and that you have trouble walking on it.
- And I think the location of this Bob from,
you'd probably agree, is oftentimes
- Mid calf.
- Right, where you get that change from the gastroc
and the soleus, right in there oftentimes.
- Yes. And it tends to be more medial,
which means towards the other leg.
- Right - On this side
- Between the, yeah
- That's the more common side.
It can happen over here too,
but that's where it tends to happen.
Well, when it first happens,
you certainly wanna put some ice on it.
That's the, you know, do the compression thing, right?
Compression, ice, elevation.
- One thing you do not want to do
is right away start stretching it out.
- No, no.
- You've already torn some tissues.
You don't need to keep it aggravated
- No.
And you may want to need, you may want to use crutches.
The other little hint right now,
which is a cool thing to try,
is to actually take a piece of carpet
or a piece of something that you can put in your shoe.
That's gonna elevate it a little bit.
- Right. Ideally like, go ahead.
- This is too thin.
- Yeah. Yeah.
- So you cut it in this shape.
- You can go to the hardware store a lot of times
and get some cork.
- Oh yeah, cork can work good.
- Right? Yeah, and you can get various thicknesses
about a quarter inch at the very most probably.
- Right.
- And then cut it like
- Like this
- Right under your heel, it's gonna go.
- Yep, and then you put it in your shoe, in your heel,
and that's gonna raise it up a little bit
and that's gonna take some of the pressure off the muscle.
- Right. Puts it on slack a little bit.
You're not gonna leave it in there long term.
It's temporary.
- All right.
The next step then, after a day or two,
when things are starting to calm down a little bit,
you're gonna start a cross fiber friction massage.
This is from Cyriax, he's the father of orthopedic medicine.
This is the crux of the treatment, Brad.
- Dr. James Cyriax.
- Yeah. - Yep.
- So what you're gonna do is, let's,
I'll do it on this one, Brad.
- Yeah, go ahead.
- So again, it tends to be more on the inside here,
towards the other leg. - Yep
- As the muscle starts to heal,
it heals in a kind of an erratic fashion.
It's laying down scar tissue, which makes like a web, right?
- If you think of a, like when you fly a kite,
and all your string gets all matted up together,
that's kind of what's going on,
but we need to get everything in line.
- Yeah. - With the muscle fibers.
- The problem with, yeah, being like this
is that it tears again easily.
So you're gonna go, oh, it's feeling better.
I'm gonna get back to what I wanna do.
And all of a sudden, boom,
it starts hurting right away again.
- Right? Yep. You go start your activity.
- When you get in the cycle of, you know
you injure it, it heals, you re-injure it, it heals.
And so you need to break that cycle by doing this massage.
- Sure.
- And it often gives you relief right away too.
That's what's nice about it.
So you're gonna go ahead and you're gonna take your fingers
and you're gonna go across,
you're gonna massage across the muscle like this.
Now this is, you are gonna start off,
You can start off real light coz you know,
that's all you might be able to tolerate
and it's nice to have the muscle somewhat on slack
- Right.
- but eventually you're gonna really push down hard.
- As far as, when not to do this, Bob,
like you said, initially it's gonna cause some pain,
but after 20 to 30 seconds,
if that pain is not coming down or
- At least stabilizing
- Stabilizing, if it gets worse after 30 seconds,
- Yeah - Stop.
- You're gonna stop.
And you can go back to the ice.
- Exactly. - Yeah.
But if you start this and after 30 seconds to a minute,
it actually even starts to numb
or it feels even a little bit better.
- Right? - Yep.
Then you're doing the right thing,
and again, start off light
and then you're gonna work to the point
where you really get in there and rub.
- So that's about at that 20 to 30 second point,
when it's starting to feel better,
then you get into it more.
- Yep, you start and you know, at one point
you can push almost nearly as hard as you can, Brad.
- Yeah.
- And the time limit of this now,
Cyriax would recommend doing this for 20 minutes.
There's nobody on earth that's gonna do this
for 20 minutes, Brad.
- Well, we're gonna find someone that does this.
- Yeah, that's right.
- There's always those people who are.
- And he would say 20 minutes, three times a week.
What I tend to do is, I've had these myself Brad,
I'll do it for like five minutes.
- Yep. - If I can even do that
and I'll do it every day.
- Right. And the reason you cannot go more than five minutes
is because your fingers start to hurt.
- Yeah. It just, they start to wear out.
Sometimes people go one finger over the top of the other.
- Sure. - But you'll find the spot,
you'll find the tender spot
and that's where you want to hit it.
And again, this is the crux of the treatment.
This is the one part of the treatment
you don't wanna, you know, miss.
- I don't wanna go off on a side note
but this also works on tendonitis
in the Achilles tendon too. - Oh yeah.
Yeah, we did a video on that.
So works out really good.
All right.
Now let's say you've been doing this,
it's starting to feel better.
Now you are gonna wanna start incorporating
stretching and strengthening.
- Right.
This may be a week, two weeks afterwards.
- Right
- It all depends on the severity
- Because you wouldn't wanna just do this and then go,
I'm ready to play softball again and just take off.
I mean, you gotta build up some muscle now
and build up the strength.
So one of 'em that you want to do
is what we call eccentric strengthening.
- Eccentric
- Can you bring that chair over here, Brad?
So I can hang on to something
- [Brad] I've been called - The chair.
- Oh the chair. - So I can hang on.
- I've been called eccentric.
- Yeah, no kidding.
More than once in his life too.
So you can go up onto the staircase,
just get focused down here, Lonnie.
And you're gonna just put your feet
up on the end of the stairs like this.
And what you're gonna do is you,
this is the side that's involved
- Right here. - Yep.
So what you're gonna do is actually put the foot up,
start up like this.
So you're just,
you're not really using the muscles to lift it up
and then you're gonna lower it down like this.
- Make sure you have a good traction right here.
Because if your foot slips off, it's not gonna feel good.
- The strength occurs on the way down.
I don't want you lifting up like this.
I want you to go ahead and you got this foot up here.
Just put it up like this
and now come up and then lower it down.
- Now you can't
- See, it's called decentric.
- You can't see this, but when he's up,
his left opposite foot is carrying the weight.
- Yeah, I'm doing all the work on the left side
to get it up, now lowering it down
and you can lower 'em both down at the same time
if you want, just to
- Sure - take some of the stress off
but I want you to go ahead and do a good 10, 15 of those,
lower it down.
- Two to three times a day?
- Yeah, two to three times a day
- Yep.
- And then while you're in that position,
you can go ahead
and start giving it a little bit of stretch, right?
- Sure, you bet.
- Yep, and that will help realign those fibers too.
- Listen to your body.
No sharp pains.
- Yeah, minute or two stretch. - Sure.
- And eventually you're gonna do a one foot stretch here.
- Yep. - Like that.
- I never have the patience to go that long,
but you probably should.
- I do longer stretches so,
- I know, I wish I could.
- By the way, you probably should too, also,
when you start stretching it,
you're gonna do the stretch with a knee straight.
And you're also gonna do the stretch with a knee bent.
- And oftentimes you probably,
a lot of people know this as a wall stretch
where you can put your hands on the wall.
But here, the bend in the knee is right here.
We're getting the stretch here.
Nice gentle stretch, relax the foot.
- You're stretching two different muscles there.
And that's why it's important to do that.
All right, this is the trick now, Brad,
we're gonna show you.
This is right after you injure it.
If you want to go ahead and tape the calf muscle,
there is a way to tape it,
to help decrease stress on the muscle.
- Sure.
- And help you walk around better.
So why don't you get the tape, Brad?
- Okay then
- It's very simple, a very simple taping technique.
- Yep. - You wanna come on this side?
- Sure, Bob.
- So if the pain is on the inside,
all you're gonna do is take a piece of tape
and start it here,
attach it on the inside and pull it to the outside.
- There you go.
- If the pain is on the outside,
which is the example we'll show right now,
pain is right here.
He's gonna attach it right here,
and he's just gonna pull the tape over.
- So I'm gonna start the tape here
and you're gonna pull and stretch.
And if you could, if Lonnie was able to zoom in,
you can see some wrinkles in the skin that you're pulling,
relax the muscle, pull, pull, pull
- Pull really hard on that tape.
- Yep. And you need to have some decent tape,
some tape that's made for it.
- Yeah. Kinesio Tape is what we're using right here.
It's probably not the best one.
You wanna use a stiff athletic tape.
- Right - Wouldn't you say Brad?
- Yep - We use the Kinesio tape
coz you can see it.
- Right.
- But this isn't the tape I'd rather normally use.
I'd rather use a stiff athletic tape
that has no stretch to it.
- Right, yep.
- And once you pull that over, what that's doing,
is it makes the muscle concave here
and it takes the stress off of it.
Now I would do this.
I would put it on,
walk first without it, put it on, walk.
Did it decrease the pain?
- Sure. - Yes?
Keep it on.
If it didn't, take it off.
- Right.
- I mean there's no harm in trying this, so
- Yeah, you'll notice right away that it feels better.
- How are we doing Lonnie, did you give us thumbs up yet?
Okay, we're good.
Remember we can fix just about everything.
We can fix calf muscles and everything
but we can't fix, Brad?
- A broken heart
but I think we can, look at this, this Kinesio tape.
Look at that.
Get that on there.
- I don't have a heart, there's the heart.
Thanks for watching.