calf pain and training

[karin]

I am a new runner who has been carefully following the training guide...unfortunately, I seem to have injured my left calf. It started to hurt half way through my training today and I am sitting here at the end of the day with my leg up and an ice pack on. I am planning to take at least a couple of days off and am worried about "completing" my training and being ready to run on May 10th. Any advice?

[Gene Zeitler DC MS ART]

Hi Karin,

Sorry for the delay in my response I just returned from vacation.

I’m sorry to hear about your calf. It sounds like you strained your calf muscle. I will direct you to my response to the post “Calf Issue” on 4/4/09. This will answer some of your question-i.e. warm-up, cool down, stretching etc…

The question with all athletic injuries is when can you return to sports participation. The answer is you want to progress as quickly as possible without causing a re-injury. First, if walking aggravates your calf then you obviously can’t run. In this case you want to do non-weight bearing activities or reduced weight bearing activities as tolerated so that you can try to maintain your cardiovascular fitness. Although cross training can be effective it is not as good as training in your sport, in this case running. This is what is called the SAID Principle. Specific Adaptation to Imposed Demands (SAID) says that the muscles, tendons, ligaments, cartilage, bone and the cardiovascular system are changed by the stresses they are placed under. So the body adapts to the training you perform. We get better at running by training in running. While cross training is good at keeping you cardiovascularly fit and strong and can be effective at reducing repetitive stress injuries it is not as effective as training in your sport. This means you have to get back to your sport as quickly as tolerated.

At this point you should try to cross train in swimming, biking, or using an elliptical machine or stairmaster. If you have access to a pool try pool jogging. After a few days reintroduce walking or a light jog. Test the leg in a controlled environment such as a track or treadmill. This allows you to stop right away if you have problems and return to home quickly and easily. It also allows you to train on surfaces that are more forgiving then the road, therefore, causing less stress and fatigue on the calf muscle. Go about 50% of the distance that you left off at. If you can do this without discomfort for 1 week then you can increase the distance by 10% per week (the 10% rule) if it doesn’t aggravate your symptoms. Since your overall training volume will be lower in running you have to make up the difference in cross training activities. After each bout of exercise ice the calf for a couple of cycles of 20 minutes to help decrease any inflammation. You can also try wearing a sports compression sock. It may look a bit strange, but it can help reduce muscle oscillation and fatigue. Also, it can keep the calf warm on colder training days.

The 10% rule is very effective at reducing injuries and returning you back to your sport as quickly and safely as possible. Depending on the extent of your injury you may be able to progress faster. Treatment can help you progress faster and give you more appropriate guidance with regards to returning to sports. I typically use manual methods (Active Release Techniques, SASTM, stretching etc…) to help stimulate the healing process and to promote effective, efficient healing.

I hope this helps!

Gene Zeitler, DC, MS, ART