be demonstrating a number of exercises you can use straight away to help your calf muscles
recover and get stronger, allowing you to better meet the demands of running.
So, very quickly, there are a few things we need to appreciate when it comes to those
calf muscles.
Generally speaking, we refer to the muscles at the back of the lower leg as the calf,
but there are a few different muscles back there.
The two I want to think about specifically in this video are gastrocnemius (gastroc),
the big meaty, more defined muscle we all think of as the calf, and soleus, a muscle
that sits a little deeper and below gastroc.
Both of these guys attach to the achilles tendon, which then attaches to the heel bone,
the calcaneus.
We talk about these muscle as being plantar flexors of the ankle, creating the movement
of pointing your foot downwards.
But it’s important to realise that they work together to control dorsiflexion as we
weight-bear over the top of the foot when walking and running.
Also, gastroc has an important role in passively transferring force from the powerful hip muscles,
like the glutes and hamstrings, down into the ground to push us forwards. This propulsion
is as an important part of your running stride.
There are a number of different risk factors when it comes to calf injuries in runners.
Topping the long list has to be the ‘too much too soon’ factor. This isn’t just
relevant to newer runners, who do often suffer with calf problems as their bodies adapt to
the new demands that running imposes, but also to experienced runners who try to increase
the milage too quickly, or add speed work into their programme too quickly.
Biomechanics also have an important role to play as causative factors for calf injuries.
I’ve written an article on one of the most common hip-related biomechanical issues I
see in runners, which leads to calf and lower injuries.
I’ll leave a link to that article in the description here on YouTube.
On a similar note, one of the most common self imposed causes of calf pain I see in
runners, is when previously heel striking runners attempt to adopt a forefoot strike
pattern and end up running too far forwards on their toes. This, combined with too much
For most distance runners, a mid-foot strike is as far forward on the foot you’ll need
to come. You certainly want to avoid aggressively forefoot striking like a sprinter.
When it comes to your calf pain, it’s important to realise that there are a number of different
grades of muscle strain, classified on a scale graded from one to three.
A grade one calf strain will feel a little painful but more significantly tight. You’ll
feel discomfort on walking, running and certainly stretching the muscle.
More significant is a grade two strain, which is essentially a partial tear of the muscle
tissue. This will result in localised pain both during activity and when touched firmly.
Worse still is a grade three tear, which is a total rupture of the involved muscle tissue.
This is a serious injury, where weight-bearing will be extremely painful, let alone walking
or running.
Of course, the only sensible course of action if you’re experiencing calf pain after running
is to get it properly assessed by a physio, so you know exactly how serious your injury
is, and which factors potentially caused your specific problem.
Knowing this will help to guide your rehab plan.
As with most soft tissue injuries, the initial acute phase of injury requires you to protect
the injury, rest the area, and use ice, compression and elevation to help manage any pain and
swelling.
Don’t forget that the inflammatory stage is an important part of the healing process.
You can speak to your physio or doctor about using any anti-inflammatory or pain meds.
If you’ve had a more serious calf injury, you’ll know how it affects your walking
gait. As the pain subsides over the initial week, it’s important to reestablish your
normal walking pattern, as any limp you may pick-up as a result of the calf pain will
potentially have negative consequences for your hips and back.
The last thing you want to pick-up is a secondary low back injury as a consequence of your calf
problem. Believe it or not, it happens.
At this point, non-weight bearing exercises such as glute bridges and hip mobility exercises
are worth focusing on. Your calf may be injured, but there’s 95% of the rest of your body
you can work on, as long as you’re careful.
When you get to the point where you can balance on the injured leg pain free, you can begin
working on proprioceptive exercises, to gently start to challenge the muscles of the lower
leg, foot and ankle again.
Stretching is something I’m often asked about. It’s important to keep the area mobile,
so exercises like writing the alphabet with your foot are really important. But be careful
when it comes to more aggressive calf stretches, like the classic calf stretch against the
wall. Being too vigorous with this type of exercise, too soon can potentially set the
injury back a few days.
Even once the pain has begun to significantly subside, it would be worth getting some gentle
soft tissue work done on the area, rather than aggressively stretching yourself. Also
speak to your physio about when they feel you’ll be ready to re-introduce your calf
muscles to the foam roller!
The next stage is to begin progressively loading the injured tissue, building the resilience
back up to eventually be able to tolerate a return to running.
Everybody’s timescales will be different here, so be sure to take the advice of your
physio.
Differing varieties of heel drop exercises provide a simple but effective progression
to build your calf muscles back up to running.
You can initially work on isometric ‘heel drops’ off a step. These are similar to
your more typical heel drops working through range up and down, but without the movement.
Stand with the balls of your feet on the edge of a step, hanging your heels backwards off
the step, keeping your foot on the level of the step.
Initially with both feet at once, hold yourself in this position for 20-40 seconds, then rest.
Repeat this 5-6 times. Do this initially with straight knees, to bias the gastrocnemius
muscle, then do the same with bent knees to bias the soleus muscle.
You can then progress this to preform exactly the same exercise one leg at a time.
As a progression, you should add plantarflexion and dorsiflexion at the ankle. Initially working
both legs together, begin with the balls of your feet on the edge of the step and push
yourself up onto your tip-toes.
From there slowly, with control, allow yourself to lower your heels down as low as they will
comfortably go. This should be well below the level of the step. Aim to come up on the
count of 1 and then down again on the count of 3.
Once you can do three sets of twenty pain-free, both straight leg (gastroc biased) variety,
and bent kneed (soleus biased), you can progress to working one leg at a time.
When performing single leg calf raises, you should maintain the same 1-up, 3-down tempo,
but initially use two legs to push up, and one leg to control down.
The last progression here is to work up and down just on one leg throughout.
As with all injuries we rehab, there are almost limitless options available in terms of exercises
you could legitimately use, depending on the individual case.
Other exercises you may wall want to consider include single leg squat variations to improve
single leg stability, and the balance-reach drill to specifically develop soleus - often
weakness in soleus can result in calf injury.
As you progress towards your return to running, simple jumping, skipping and hopping exercises
provide a good means of further strengthening the lower legs in general, preparing them