Calf pain is a common compliant and if not managed correctly, they can persist for months and cause a lot of frustration. The calf muscles refer to two major muscles; the gastrocnemius and soleus and the small plantaris muscle. These muscles have a joint tendon called the Achilles tendon, which inserts into the heal.

As the upper part of the calf crosses both the knee and the ankle, it is more susceptible to injury. Muscle strains generally occur on the inside of the calf muscle. Soleus muscle strains are also common; tenderness is more often felt on the outside of the leg deep to the calf muscle. Stressing the muscles with the knee straight or bent can differentiate between the two injuries.

A sudden burst of speed, over-stretching or direct contact with a player or equipment may cause an acute injury. With chronic injury people often present with cramping pain in the calf that seems to come and go. This may be due to previous calf strains and weak scar tissue that hasn’t recovered fully.

Certain individuals can naturally be more susceptible to calf cramps, these may occur during exercise or at rest after activity. This is most likely due to excessive fatigue. Improving the strength and endurance of the calf muscles can improve these symptoms.

Collapsing of the upper part of the foot can overload the calf muscles as they are trying to push the body forward during running. This can lead to muscle tightness and soreness and increase the risk of muscle strains or tendinopathy.

Recovery from calf strains require progressive loading to prevent tight scar tissue developing, helping the tissue to repair. Chronic strains require more time to heal as scar tissue remodelling is necessary to reduce the chance of a recurrence. This is achieved through loading the tissues as they are lengthening  and shortening. Assessing the movement patterns during functional activities such as jogging, lunging, jumping and landing is used to help find the route cause of the issue. Looking at how the individual is adsorbing, distributing and creating forces that push them forward is a key component to understanding the cause of the injury. If necessary corrective training can then be used to help prevent injury reoccurring.

Catherine Simpson

MISCP, MSc Sports Medicine

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