rehab programme for calf strain

Rehabilitation should then target the strength deficiencies as outlined above. These tests involve capacity testing above body weight through either the use of resistance  by way of holding onto dumbells or resistance through machines such as those found in a gym: seated calf raise machine, or a smith rack. Learn More about the 5 Week calf Tear Rehabilitation Program. At each stage you need to reach specific critera before moving onto the next level. Such runners tend to lose confidence in their calf musculature and can feel ‘vulnerable’ with regards to anticipating further calf strain incidents. Hamstring Strain (Part 2) : Early Rehabilitation Techniques . Delgado GJ, Chung CB, Lektrakul N, et al. However this classification system lacks diagnostic accuracy and therefore provided very little prognostic information to treating practitioners. In order to 'stretch' the calf muscles in this fashion, simply sit on the floor with your knees straight and bend your foot towards you using the muscles on the front of your shin. This exceeding of tissue tolerance of the calf musculature can come as repetitive and therefore relative overload of the tissue through multiple repetitions, or as a one off absolute overload-such as attempting to sprint or run at high exertion. This will take many weeks of progressions and consistent completion for both home and gym based exercises. To try this exercise: 2  Wrap the band around the end of your foot and press down into the band, extending your toes and engaging the calf. This site complies with the HONcode standard for trustworthy health information: verify here. Repeat this four times. Following a well-structured conditioning program will also help you return to sports and other recreational activities. The soleus is primarily composed of slow twitch (type 1 muscle fibers) and is the key muscle for endurance running. Push through the 1st and second toe, and aim for maximal heel lift. Instead I find it clinically more meaningful and helpful to outline approximate time frames to return to easy running -which initially may include walk-running. Calf strains can occur to any runner. Guided Return to Running Program To Safely Build Volume. The  higher number represented a higher degree of muscle strain; minor, moderate, and complete injury. These can be performed as single leg calf raises initially to isolate the musculature and give the runner an appreciation of any side to side differences that may exist. Start each exercise slowly. Sc Marathoners may often have onset of calf pain within the first 24hours after their long run or even after a race. Rather progressing will depend on the runner/therapist doing so based on clinical criteria being set and assessed against. Failing to reach or move towards these through rehabilitation may heighten risk of ongoing calf strain symptoms or possible injury recurrence. I know a thing or two about calf strains. One drawback with double leg testing is that it does not isolate each side to determine side to side differences in calf capacity, and does not provide an accurate or useful guide of the affected calf strength. During stage 1 of the program you should walk for 4.5 minutes then light jog for 0.5 minutes. However occasions when imaging may be required can include: Most runners are happy to not undergo imaging when an explanation regarding their injury  is given. Simply stand on the leg which has the calf issue, with the other leg bent. Willy & Parquette (9) reported that calf strains are more common in the masters runner due to this greater eccentric elongation of the calf musculature-which equates to a heightened risk of injury. Severity of strain tends to be linked to recovery timelines as prior outlined. Below are examples of home based rehabilitation exercises I commonly prescribe for runners rehabilitating calf strains. Claudication conditions including popliteal artery entrapment/syndrome, Milder injuries will show tenderness to palpation, pain with resisted muscle testing but no visible swelling, discolouration or defects. Make sure you only get a gentle pull and not a sharp pain while you are doing this stretch. Prescription can vary however a good starting option may be: Week 1 3 walk/runs: 30s (jog/run), 4.5mins walk repeated for 30mins, Each week add 30s of run time while decreasing walk time by 30s, By week 9 30mins of continuous running will be achieved, The above program is quite conservative -there are many instances in practice where I will prescribe larger initial running periods and smaller walking periods for example commencing with 2-5min run times. Reducing pain and symptoms may be achieved by off loading the strained calf musculature through rest, taping techniques, and appropriate soft tissue massage techniques. Foot and Ankle Conditioning Program Purpose of Program _____ After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. In the general population the highest risk group is the poorly conditioned male in the fourth to sixth decade of life, incurred typically while doing recreational activity (4). Brukner, P, Khan, K (2017) Clinical Sports Medicine, 5th Edition. Given the force developed by the calf it is understandable that the calf can be a potential site of muscular injury for a runner. I observe several key mistakes frequently made with the rehabilitation of calf strains. Most strains (muscle tears) are caused by a simple mismatch between loading and a runner’s capacity to deal with that given load. contact us via phone or email. Progressing a runner as soon as possible to be able to achieve 10mins> 15mins> 25min> 30min> up to 60min continuous running is both motivating for the runner and are important milestones on the way to a full return to training loads. The first aim of rehabilitation is to ‘calm down’ the aggravated and painful soft-tissues that have been strained. For example an 80kg runners would look to perform  4 x 8-12reps of 27kg external loaded calf raises single leg. Calf Strains. APA Titled Sports & Exercise Physiotherapist (APAM) A runner that cannot continue to run and pulls up limping at the time of injury is likely to have incurred a greater grade injury than the runner who feels a ‘pull’ and is able to run on. Repeat 2 to 4 times. Hold the position for three seconds, then slowly return to the starting position. Some runners delay loading the calf due to fear/apprehension and as a result incur greater deconditioning through disuse than what could of been avoided. Calf Strain Rehabilitation Exercises You can begin gently stretching your calf muscle using the towel stretch right away. This is where the main calf muscle strengthening is done. The program should be performed step by step. Introduction. Skip Navigation. The aim of phase 1 is to reduce pain, inflammation, and swelling as well as protect the tissue from re-injury and delaying recovery. The runner who fails to restore the load capacity of the calf musculature may experience … It is…, Both stretching, strengthening and sports specific exercises are important for…, Calf strain injuries are categorised into grade 1, 2 or…, Calf pain refers to pain at the back of the…, Tight calf muscles at the back of the lower leg…, Deep Vein Thrombosis or DVT is a blood clot in…, Cramp is an involuntary contraction of the muscle which can…. Can be performed off the ground or off a small step-I find starting off a small step affords greater leverage than off the floor (and may therefore be better for the single leg version). We also use third-party cookies that help us analyze and understand how you use this website. Author ‘You CAN Run Pain Free!’ They can be debilitating, painful, and require reduced or complete cessation from running. The program is based around 4 phases with an aditional 5th injury prevention/mitigation phase. Runners of all abilities: beginner, recreational, recreationally competitive, and the elite, can incur a calf strain. Greater than 50% of running force propulsion is generated from ‘below the knee’ plantar flexor musculature. CTRL + SPACE for auto-complete. 2. There are no normative data sets available for this test. HOW: Anchor a resistance band at about waist height. Here are a few exercises for your calf muscles: I personally prefer runners to work in a smith rack-as I believe it afford greater control, however the calf raise machine is a valid option. Loading the calf and exposing it to stimulus as soon as possible is key to a successful and timely rehabilitation outcome. Malliaras in his Mastering the Lower Limb Tendinopathy workshop cites a target of 1.0-1.5x body weight as external load. The runner who fails to restore the load capacity of the calf musculature may experience ongoing symptoms or possibly even injury recurrence by way of recurring strain or strains. Maffulli N. (1998) The clinical diagnosis of subcutaneous tear of the Achilles tendon. These are designed to keep the muscles firing and toned. However this test can be used if availability to equipment for loaded testing is not available. The below image shows the degree of muscle atrophy (wasting) evident approximately 8 weeks after the injury which ended the athlete’s season. Hébert-Losier K, Wessman C, Alricsson M, Svantesson U. Rock Climbing Injury: Self-assessment and rehab program for a hamstring strain. B.Physio/ B. Ex. (a) myofascial injury in the periphery of the muscle. I coach injured runners that three key principles are required for the rehabilitation of calf injuries to progress well. While there is no ‘real harm’ in this, it does not differentiate in that strains can occur in either or both of these muscles; soleus or gastrocnemius, or far less commonly in plantaris or the muscles of the deep calf group. Starains can occur with a vertical muscle orientation such as shown below with the soleus of an Ironman triathlete (former rugby league Australian representative player) who sustained an 11cm vertical tear of the medial and lower 1/3rd of the soleus around the central tendon, less than a week out from his event. 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