Following the closure of gyms and group training programs during the ongoing pandemic, more people have been running. This has been observed by many in the community, however, the impact has been seen at Fairfield Physiotherapy with an increase in calf injuries. This type of injury is usually the result of overload. Many people are eager to get outside and are running more frequently and further or some are new to running and have run too far too soon. While many have the fitness to run reasonable distances, they may not have the physical adaptation to do so.
The Calf Muscle
There are two main muscles in the calf, the soleus, and gastrocnemius. The soleus is the deep/short calf and is the primary engine with long-distance running that can be susceptible to overload injuries [1]. While the powerful gastrocnemius is the long calf and often associated with more dramatic injuries and tears. The soleus is required for endurance activities, especially running. If it is not adequately conditioned, it is susceptible to fatigue/failure. As these injuries are typically less dramatic and given soleus’ specific function, it is often overlooked in strengthening and conditioning. Consequently, the soleus is more commonly injured during running.
Take Baby Steps
The activation of the soleus muscles has been measured as up to 2.4 times higher with jogging at 8km/h than walking at 4km/h which unsurprisingly peaks when you land [2]. Adaptation to this kind of load and exertion takes time and training, so to start running from a low baseline can mean that the muscle doesn’t have time to adapt to the physical demands on it. So the idea here is to start slowly and move gradually.
Rest, and Seek Treatment
As with most acute injuries, rest is almost always required and will help settle the pain and loss of function associated with the injury. However, following calf injuries, it is common to have deconditioning and weakness that can result in recurrent calf strains or even tears. For this reason, rest alone is not enough to recover from a calf strain, however minor. Treatment of calf injuries needs to include specific strengthening for the activity and function it is required to perform. This is typically done through a progressive calf strengthening program specific to the patient’s needs and physical demands.
Adopt a Workout Plan
Equally, returning to the gym or group training exercise in the coming weeks and months could result in a similar spike in calf or other muscle injuries. Much like adapting to different forms of exercise, those returning to their typical programs following a break need a plan. They need to ensure that their body is ready to commence training and plan a return to activity that is appropriate and safe.
We are Open
At Fairfield Physiotherapy, we see many different calf injuries and no two are alike. While uncommon, we do screen for DVT and other pathologies that can present like a calf strain. Should we detect anything indicating this, we will refer you to your GP to further investigate. If you do have a calf strain you can rest assured that with correct management and a tailored strengthening and rehabilitation plan, you will be able to return to your sport or activity as soon as possible.
If you have experienced a calf strain or are due to return to exercise after a period of rest, you may be worried about susceptibility to injury. Contact us at Fairfield Physiotherapy for assessment, treatment, and advice to ensure your return to exercise is a good one and is sustainable.
References:
[2] – https://physoc.onlinelibrary.wiley.com/doi/epdf/10.1113/jphysiol.1987.sp016794
