Need advice with a torn calf muscle

Discussion in 'Health & Fitness' started by Texas Scrambler, Feb 18, 2012.

  1. Texas Scrambler

    Texas Scrambler New User

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    Tore my calf muscle (soleus I think) about 3 weeks ago and have reinjured it twice. Agreed, I am not to bright to reinjure but little warning from "Great it is healing" to "Not again, I am just walking".

    How have you healed from a torn calf and how do you know how hard to push it. Also, any beneficial physio techniques / thoughts are welcome. I am pretty sure my tear is a Type II and not a total tear. Significant enought to limp around for a couple of days until the healing process starts.

    How long does one do RICE? Of course while painful but when to transition back to activity?
     
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  2. Mike Hodge

    Mike Hodge Rookie

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    torn calf

    I had a moderate tear of the gastroc about a year ago. Not a total tear, but serious enough that it was a month without tennis.
    After a month, I could play mini-tennis and hit lightly. All in all, it was probably three months -- with fairly intensive rehab (massage, strengthening, stretching, etc.) from a PT --- before I could really go full speed.

    It was a long, tough process. Not sure how serious your tear is, but I'd get it checked out by a PT, get a prognosis and a rehab program. Hopefully, your tear is not as bad as mine was.
     
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  3. Chas Tennis

    Chas Tennis Hall of Fame

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    Recent thread on calf injury

    A recent thread on calf injuries

    http://tt.tennis-warehouse.com/showthread.php?t=387259

    I read that tendons take 2-6 months to heal. ? When and how can you use tendons while they are healing? Consider that stressing tendons while they are healing can lead to chronic conditions. These are complex issues requiring a Dr.

    Preventive exercises and stretches are for conditioning healthy tendons to prevent injuries and not for injured tendons where they may cause additional damage.

    You should see a Dr to greatly improve your chances of a correct diagnosis and for getting optimal treatment.
     
    Last edited: Feb 19, 2012
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  4. Posture Guy

    Posture Guy Professional

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    I posted the below on the other thread that chas mentioned. this injury really sucks. I came back way too soon and kept reinjuring it. Was told by a PT I really respect that this is a minimum 4-6 week injury, even just a light tear. Take the time to make sure it's completely healed. One note: just because it FEELS well doesn't mean the injury is completely resolved. You've discovered that.

    I'll add one thing to what I wrote previously. Once I felt like I was ready to get back on the court, I first started jogging barefoot in the neighborhood park on the grass. Very slowly at first, then building up to sprints over the course of maybe 10 days. Once I was able to do that, then I'd put my tennis shoes on and get out in our street and basically go through tennis motions. Moving forward, back, side to side, insuring that all movements felt ok. Then my first times back on the court I took it easy, didn't play sets, just hit lightly, didn't go hard after balls in the corner or short shots. Took about two weeks until I wasn't thinking about it anymore.

    Good luck. Here's what I posted on the other thread, hope it helps.

    ______________________________________________________

    This injury is a bear. I'm recovering from one myself. Did stupid stuff, including coming back from it WAY too soon. Here's a key: just because it feels all healed up doesn't mean the tissue actually IS all healed up. Based on a combination of professional and personal experience, here are a few things I'd do:

    1. Go see the best physical therapist you can find and get evaluated. I resisted this but I finally relented, went to someone who is expensive and doesn't take insurance, but also looks at the body in a far more comprehensive way than the typical PT. We found that my gastroc complex as a whole was firing properly but that when the medial and lateral segments of my gastroc were asked to fire independently (by rotating the position of the leg and then doing certain movements), they were almost shut down. I'm an exercise therapist by trade (but not a PT), and she taught me a few very useful new exercises to incorporate into my rehab. You want to make sure all the muscles of your legs and hips are working properly so you don't place undo strain on any one of them. Tennis requires a lot of 'ballistic' movement, much different than just running in plane. We are all well served to ensure our bodies are working in as comprehensive a way as possible.

    2. 'The Stick' is a great idea. I also found a very cool company that sells some amazing products for self-myofascial release work. check out www.tptherapy.com. I ordered one of each of their products and I'm VERY impressed. I was using the smaller roller on my calf last night, especially on the soleus, and wow, it just does a much deeper, better job than I can do with a stick roller. and if you do foam rolling, get "The Grid". I already had 3 different foam rollers. Bought this one to try it out and I'm throwing the others away.

    3. Use a combo of ice and heat to pump more blood through the injured area. That can help moderately accelerate healing and reduce scar tissue formation.

    4. Stretch a lot, walk a lot, but do it to tolerance. Pain is a signal you're doing something your body isn't ready to do. Don't try to run until you can walk without ANY pain for at least 7-10 days. Try walking up steep hills before running, that's a nice test.

    5. Once you start running, if you normally run where you contact the ground first with your forefoot (like the Pose technique), you may wish to consider temporarily going to heel strike. That will lessen the demand on the posterior chain of your leg. Then you can migrate back to a forefoot strike as your leg demonstrates it is ok with this demand.

    6. Once you can do that ok, do some VERY light jogging backwards. Puts a very unique demand on the calf complex. Then once that's ok, I'd go out to a court and start 'running the lines'. Or you can do it in a park, or an empty side street. Do lateral shuffles, forward movements, backward movements, all that stuff. Make sure that all feels ok. Start REALLY slow and then ramp up. If those are ok, then go to sprints.

    7. The zensah calf sleeves are a great idea. Use compression when you come back.

    8. Static stretching has its place but not immediately before a match. Use charlie's advice on dynamic warmup. Once you start playing again, get to the court earlier than usual and go through a FULL dynamic warmup routine.

    9. Engage in a leg strengthening program that doesn't just strengthen your calves, but strengthens ALL the muscles of your leg. When working your calves, make sure you are working both the gastroc AND the soleus. An exercise that works one does little for the other. Work on the hamstrings, work on the quads, the glutes, the hip flexors, ALL of it.

    being out is a bummer but use this time to get your legs into the best shape the've been in for years and you'll come back better than ever. Good luck to you and keep us posted on your journey back.
     
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  5. Torres

    Torres Banned

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    6-8 weeks, and not before.

    I tried to come back after 4 weeks, very tentatively, as I was very bored sitting at home, but it was a bad idea. Fortunately, Christmas and New Years holiday period took over which allowed me to stay off until roughly the 2 month mark, but if its a 'pop' / 'twang' type of tear with you not being able to walk properly 2 or 3 days afterwards, or having to walk with a stick, you'll be looking almost certainly at around the 6-8 week mark.
     
    Last edited: Feb 20, 2012
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  6. Posture Guy

    Posture Guy Professional

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    Torres' estimate is sound.

    For me, it was the kind of thing where I was limping pretty good that evening and the next morning, but I was able to walk without assistance and go up and down stairs without trouble. After a couple of days I was walking basically normally with very little pain, but could feel it wasn't right. Much less severe than what many here have experienced. It was probably somewhere between a grade 1 and a grade 2 strain. That was a 4-6 week injury. I'd think that if you tear it badly enough that you need assistance to walk, or you're genuinely hobbled for 2-3 days or more, then yeah, 6-8 weeks if not more.

    This injury is a real bear.
     
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  7. wao

    wao Professional

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    PG, you where off the court for 4-6 weeks? I strained mine last friday in a match. can walk and feel some minor discomfort.
     
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  8. Torres

    Torres Banned

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    The credit should go to my physio for the estimate as she came up with it based on how I described the injury occurring. I told her that I would prove her wrong but it turned out that she was right after all! I guess when you see lots sports injuries too tend to know what you're talking about....

    Her words:-

    "6-8 wks. Need to start treating in 3 days. Inflammatory phase will take 10days. 2-4 wks stability and strength then back to impact. This wk is the most important 2 ensure u get max strength back."
     
    Last edited: Feb 21, 2012
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  9. Posture Guy

    Posture Guy Professional

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    That makes perfect sense.

    When I finally wised up and went about it right, basically, I waited to do much of anything until I was relatively pain free. Then I just walked as much as I comfortably could, quitting before the onset of any pain. Did very light foam rolling and massage.

    Then as it felt better, I just started working deeper. Walking more, getting weekly sports massage where they'd really dig in and work. I wanted to minimize the formation of scar tissue, make sure the repaired muscle fibers were properly oriented, all that stuff.

    Once I was completely pain free and feeling normal, I wanted another 2-3 weeks to start doing any kind of strength work, and even then, started slow. One of the early things I did was stand on the stair step just one step above a landing, and then lightly jump with both feet to the landing and land in a coiled athletic position. Would do that 10-20 times and call it a day, see how I felt the next day. Then if that was ok, would jump down and land on one foot and alternate back and forth. When that was ok, I'd go up to the second step and jump with both feet, then when that proved ok, to the third, then finally up to the fourth and that's as high as I wanted to go.

    Then I did some light plyo stuff jumping over stacks of pillows and landing on one leg, then back over to the other leg, box jumps up, more jumps down, then finally light running barefoot in grass, then to sprints, etc...

    Crawl before you walk before you run and give yourself plenty of time to ensure the damaged tissue IS in fact healed.
     
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  10. Torres

    Torres Banned

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    ^ My physio would definitely like you - you've described the proper treatment protocol. I went for one session with my physio and then disappeared, never to be heard from again lol. Fortunately, my physio is also a friend of mine but that didn't stop her from voicing her disapproval!

    Looking back I do wish I had done more to treat the calf tear rather than just sitting at home eating potato chips. Although I don't have a problem with the calf now, from time to time, I do feel like there's a 'piece of something' (presumably scar tissue) inside the fleshy part of the calf. It doesn't hurt or stop me from doing anything, but it just feels like there's something in there.
     
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  11. beeveewee

    beeveewee New User

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    38 years old, tore mine 6 months ago. Classic 'pop'. I thought I would just take time off and recoup by myself with internet research, etc. but thankfully my doctor talked me into seeing a PT. That was definitely the thing to do. She put me through stretches, exercises, and workouts that I never would have or could have done on my own. It greatly accelerated my recovery and I was playing careful tennis again in 4 weeks and going full out again in 6 weeks. I paid for the PT out of pocket and didn't regret the expense.
     
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  12. Posture Guy

    Posture Guy Professional

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    Wao.....when I injured my calf the first 3 times (yes, you read that right, 3 times. Because with breathtaking ease I can alternate between reasonably intelligent and mind numbingly stupid), I figured I would wait until I felt no pain walking around, then give it another couple of days and I'd be good to go. I did not appreciate the nature of this injury.

    So each time I came back too early, I'd play one match and be ok, then play another and boom, it went again. Was driving me nuts. Finally went to a PT who said what we were discussing above, that this is a minimum 4-6 week injury. So when I treated it as such, then I progressed and got back on the court.

    Do NOT come back too soon from this. Once you can walk around without pain, that does NOT mean the injury is healed sufficiently to withstand the severe load demands tennis presents. Just trust that this is so and follow the advice above. If you don't, you'll likely regret it.
     
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  13. Posture Guy

    Posture Guy Professional

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    The other thing I did in all of this was to use our own (Egoscue) stuff to really insure that the position of the ankle to the knee to the hip was sound, and that this kinetic chain was intact and functioning properly. Too complex a concept to delve into on a message board, but here's one way to think about it. Standing in front of a full length mirror wearing shorts and no shoes. Orient yourself head on to the mirror. Now, close your eyes and march in place for 20 seconds. Then with your eyes still closed, come to rest where your feet feel they naturally want to be. Now open your eyes. Then observe a few things...

    1. Are you still facing head on to the mirror or did you rotate clockwise or counterclockwise?

    2. Do your feet point straight, or out to the side? Do they do the same thing on both sides, or different?

    3. Do your knees point the same direction as your feet?

    4. Are your hips level?

    5. Are your shoulders level?

    These are some simple postural tests you can give yourself. If any of these are off, you're compromised and that will also increase strain on some of your muscles. Getting the body back into sound postural position is a fundamental prerequisite for optimizing athletic performance.
     
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  14. tennis_tater

    tennis_tater Semi-Pro

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    Just curious...for those who have suffered this injury, how many of you have sustained a re-injury of the same calf muscle AFTER going through the proper motions (RICE, Physical Therapy, no tennis for 2-3 months, and incorporating new stretching and leg strengthening exercises to your daily routines, dynamic warm-up and proper hydration pre-match? I've done each of the above, yet have continued to have issues with the same calf after the initial tear in the gastroc.

    Also, for those who have made it back to playing tennis within 6-8 weeks, do you feel as good as new on the court and have no problems or hesitation with you pushing off on the injured foot when going to poach or step into a service return?
     
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  15. Posture Guy

    Posture Guy Professional

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    Knock on wood, I've had no problems since returning.

    If you keep reinjuring it, I would take a very close look at what is happening posturally. For example, if your femur is 15 degrees externally rotated so that now your knees and feet point out instead of straight, that completely changes muscle engagement through that entire kinetic chain. Parts of the calf will now receive very little load demand, and other parts will be hyper-loaded.

    Good luck, I hope you get it dialed in.
     
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  16. Texas Scrambler

    Texas Scrambler New User

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    I am two weeks in

    No pain after two and half weeks and starting to amp up the exercises. I discovered swimming the last two weeks with all four strokes. What a great upper body workout.

    I am skating lightly (no hockey yet) and riding the stationary bike. All is well so far but danger lurks on the horizon as i am booked for Newks in 10 days and back country skiing in 30 days.

    I don't have the will power to forego some of my favorite activities.

    Great advice in the above and does the scar tissue eventually go away?
     
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  17. tennis.yellow.balls

    tennis.yellow.balls New User

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    3 months

    had a partial tear and it took me about 3 months. reading the posts, the one thing that i agree with is -- you need time for it to heal and even when it seems heal, you really don't know, so always take it slow in the beginning. it's a horrible injury and even though, i feel i can go full speed, there are times, i still feel it :(
     
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  18. Spin Doctor

    Spin Doctor Professional

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    deleted.....
     
    Last edited: Feb 22, 2012
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  19. equinox

    equinox Hall of Fame

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    Mate did his in 2004, took years before he was good again.
     
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  20. Texas Scrambler

    Texas Scrambler New User

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    Living Dangerously and Got away with it

    So after doing everything wrong initially and reinjuring my calf after taking a week off each time, I changed tactics. I took 5 weeks off, swam and jogged in pool, watched lots of TV tennis (aka couch potatoe), and hit yoga 1-2 time a week. Then I eased back in by going straight to Newks and hitting tennis balls for 7 hrs a day. I escaped the penalty box and all is good even now.

    I highly recommend the first portion of healing but do not recommend the second part. I ran into EVW at Newks and was quickly in over my head but loving every minute of being back on a tennis court.

    Hope all in this chat site are over their torn calf muscle. It is one of the few time where it pays to be lazy.
     
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  21. tennis_tater

    tennis_tater Semi-Pro

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    Unfortunately, I had numerous instances where I popped my left calf playing tennis last year. Three times popped it on the tennis court - first one was severe, the last two more minor strains. After doing PT, was discharged last November, and haven't had problems with the left calf since.

    However, earlier this year, out of nowhere, I suddenly began having issues with the right leg - right calf, IT, and hamstring "discomfort" and/or weakness. While I haven't 'popped" the right calf, anytime I play tennis, the right calf feels "tighty" and and very achy/tender the days after. It's a little different from my left calf strains last year in the since that there has never been an event during the tennis matches where I had a "pop," had to quite playing, and had trouble bearing weight on the toes immediately after like I did when I strained your left calf.

    After I first began having issues earlier this year with the right, I decided to hang up the tennis racket for a few months and decided I was going to use a couple of months to implement a corective posture execise program, which included leg strengthening/core stregthening program with a trainer, in the hopes of finally putting an end to the recurring calf issue. After doing the program for a few months, I finally decided to go out and try and play again. However, two matches in, the issues with the right calf returned post-match - extremely tight, dull, achy feeling. After undergoing some ART therapy on the calf this week, the therapist was able to pin-point the spots on my innner right gastroc and, after doing a gait analysis, he noticed that my right foot, for whatever reason, has over pronated and he opined that this over pronation is now causing hyper stress on my inner right gastroc and possibly other issues on up the leg.

    When I asked the therapist what I could do to correct the issue, he mentioned doing some exercises for the arch of the foot (which I couldn't do) and adding some ankle exercises to the rest of my corrective exercises. When I asked about orthodics, for whatever reason, he didn't seem too keen on gonig that route.

    All that being said, has anyone with over pronation had calf issues? If so, what have you done, if anything, or can you do, to correct this issue?

    Also, Posture Guy, I have read many of your posts and see you have referenced a book by Egoscue many times. Does that book contain the exercises that you used to make sure everything was sound from "your ankles to you hip?"
     
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  22. Chas Tennis

    Chas Tennis Hall of Fame

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    Pronation of the foot involves how the bottom tends to interact with the ground, its tendency to tilt.

    Looking down at your feet, how much do your feet point outward as if your knees were turned out? I am not sure how to measure this. For myself I sort of lift the feet up and down in a relaxed manner finally put them down in the most naturally feeling way. I can see that my feet point out. I check walking also.

    I recently looked at people walking towards me on a sidewalk. It was a revelation. Their feet were often pointing out. Typically the younger people were more likely to have their feet pointing straight ahead and the older people more likely to have outwardly turned feet. I believe that this posture issue might result from tight hip muscles or other muscles. Tight Piriformus? I'm not knowledgeable in this subject but I believe that if people's feet point outward it may stress everything and especially the knee and foot. There are other similar posture problems.

    By "PT" did you mean a 'physical trainer' or a medically trained 'physical therapist' (terms as used in the USA)?

    Posture issues are very complex and not often emphasized. You need to find a highly qualified Dr, specialized, to examine you and evaluate your posture.
     
    Last edited: Aug 23, 2012
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  23. tennis_tater

    tennis_tater Semi-Pro

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    I walk with my feet pointed straight. But I do have over pronation on my right foot now, and I do bear more weight on the right side of my body. This may have been a result of the multiple injuries to the left calf last year...maybe resulted in me shifting weight to the other side to compensate for the injury...and then in turn led to the leg muscles weaking/over pronation of the right foot...which has now led to hyper strain on my right gastroc.

    All that aside, my feet are pointed straight and I have issues. I see others who walk with their feet pointed out like a duck, yet they seem to not have the issues I have.

    Re: PT, I was seen by a medically trained physical therapist who addressed my left calf issues on three separate occasions last year. RICE, stretching, ASTYM, leg strengthening. The three different sessions went 8-12 weeks.

    The last three months, I have been working with a "holistic" personal trainer at a facility that focuses on corrective exercises. They did a "posture evaluation" at the outset, along with a recent gait analysis, and ART therapy (similar to ASTYM without the tools).
     
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  24. Chas Tennis

    Chas Tennis Hall of Fame

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    Next issue to research - What occurs when you bear more weight on one side - maybe your gluteus medius is tilting your pelvis slightly to relieve one side? Was it weak before your first injuries? Did it get weak for your last injuries? Did you do exercises to strengthen your gluteus medius.

    You can research the gluteus medius and the Trendelenburg test

    http://en.wikipedia.org/wiki/Trendelenburg's_sign

    http://en.wikipedia.org/wiki/Trendelenburg_gait

    I believe that the Trendelenburg is a very basic posture test and you probably have been examined already. ?

    Are you already doing exercises to strengthen your gluteus medius? Clamshells, Firehydrants, Monster Walks, all with resistance bands, etc.? The gluteus medius gets weak in some tennis players, I guess that they don't use it enough. ?

    I've had experience with just a few of many possible injuries and posture issues. But I believe that they are common posture issues.
     
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  25. tennis_tater

    tennis_tater Semi-Pro

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    When I started my physical therapy for the injuries to my right leg five or six months ago, I was also complaining at that time of an upper quad strain. At the initial examination, the therapist had me stand on a step-stool with one leg and reach down to touch the ground with the other leg. I could maintain my balance when my left leg was on the step stool, but when it was reversed and I tried to balance my body by standing on one leg with my right leg, my leg wobbled and I couldn't do it. My therapist told me at that time that my right hip was weak. I then spend the next 6 weeks working primarily on the hip. I started out solely doing elipitical and cycle, followed by light stretching, and ASTYM for the right calf, quad/hip. Was also doing leg strengthening for the upper quad with leg raises in three different positions. By week two or three, we then moved into hip strengthening exercises - Clamshells, Firehydrants. After two weeks, we then added Monster Walks with resistance bands + resistance bands to the claimshells and then light ankle weights to the leg raises. By the time I was discharged, my quad/hip felt fine, but we never did any leg strengthening for the calf.

    After my insurance approved visits for PT expired, the PT told me to continue doing these exercises at home and then work on doing a core/leg strengthening program. Again, at this point, I decided to hang up the tennis racket for a while to focus on the core/leg. I then began going to a fitness club that is being on corrective exericses for postural imbalances. At the outset/initial evaluation, there were a number of tests done. To begin with, I was asked to put my left foot on one scale and right foot on another scale. the right scale showed that I was bearing approximately 30 more pounds on the right side of my body.

    I did a Myokinematic Alignment Evaluation. I don't recall doing the Trendelenburg test, but I do recall laying on the training table and the examiner noting a negative for some test on my left hip and a postive on the test for my right hip.

    You asked when I started having problems with the right hip. When I had all of these issues with my left calf last year, where I was truly "popping" the calf muscle, I had never had any sort of weakness in my right leg, whether lower leg or upper quad/hip. It wasn't until I was playing in the early spring that towards the end of a match, I all of a suddent felt like my entire right leg was weak - from the upper quad down to the calf. It's just a guess from my part, but I'm thinking that all of these injuries to the left side last year, I gradually began shifting more and more weight to the ride side...and maybe it became too much, especially with the amount of tennis I played at the begining of the year as I was so happy to be back on the court after getting over the left leg injuries.

    Anyway, after this initial evaluation, a program plan was developed and I had spent the better part of the past two months doing a myofasical stretching program with the Trigger Point foam rollers/ball, stretching for calfs, hamstrings, hip (90/90 stretch), corrective spine exericss (cobras and a few others), and then core strengthening exercises with the swiss ball for the core/glutes, and using a cable exercises for the shoulders and lats.

    Other than stretching the calves on a daily basis, I hadn't done any calf strengthening exerises.

    Here and there, I have felt some discomfort with my upper quad area. I wasn't sure if was the quad or hip flexors, but the trainer kept saying it was an IT band issue and just to foam roll it out.

    With the calves not really being a problem of late, although, granted, I hadn't done any strenuous exercise pushing off with the calves, I decided to finally give tennis a go again after basically taking off 6-8 weeks. Again, I made it through two matches, although towards the end of the second match, I suddenly felt the on-site of extreme fatigue/leg weakness. Then, the next day, my right calf just felt tight/inflammed, but there was never any swelling. I tried going through the RICE process for the first week, and after not going any relief, went in for some Active Release Technique therapy. That's where the therapist noted that the calf muscle was all balled up and then opined that the over pronation of the feet was a likely cause. Maybe its the weak hips. At this poing, I don't think anyone can figure this out.
     
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  26. Chas Tennis

    Chas Tennis Hall of Fame

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    Thanks for taking the time for the detailed explanation. It sounds as if you have had a lot of well-directed care.

    The stool test sounds as if it might have been a version of the Trendelenburg test.

    There were some long threads in the last year on calf injuries and the difficulties of healing them. I have noticed that my life style tends to hold my calves in a shortened state much of the time, basically the toes are too pointed, plantar flexion.

    http://tt.tennis-warehouse.com/showthread.php?t=419204

    http://tt.tennis-warehouse.com/showthread.php?t=387259
     
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  27. Posture Guy

    Posture Guy Professional

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    I started with that book ("Pain Free") but quickly realized that I had more issues than I felt the book could successfully address, and that my situation was somewhat complex, so I started making the 3 hour drive to get to the San Diego clinic for personal therapy. That's what I used to restore postural balance and functional integrity.

    Re over-pronation, that will absolutely cause calf issues, particularly to the medial (inside) portion of your calf complex. But from my clinical experience, pronation or supination is rarely a foot/ankle problem, per se. It's almost always the hip putting the foot into a compromised position. To see this at work, stand up in bare feet wearing shorts so you can see your shin bone and your knee. On that one leg, stand in an overly-pronated position, so the outside of your foot is almost coming off the ground. Now, watch your shin bone and knee closely as you come out of that and settle the foot more evenly into the ground. See what just happened? Your entire leg rotated from the hip.

    People tend to think (including many podiatrists) that pronation or supination is simply a foot problem, and that the answer is to use orthotics to 'shim' up the foot back into a more neutral position. That will invariably and inevitably cause more problems than it remedies. The problem is not that the foot is tilted incorrectly. The problem is WHY the foot is tilting incorrectly, and that problem could be many different things. Impossible to tell without a thorough assessment.
     
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  28. tennis_tater

    tennis_tater Semi-Pro

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    Just curious, if you don't mind me asking, and I certainly know every case is differnt, but how long did it take you get to get to the point where your believed your postural balance was restored?

    In my case, I know the initial evaluation revealed that my right hip was "tight" and I've been given a number of stretches to help loosen it up. However, since being discharged from physical therapy five/six months ago, I really haven't done much in terms of hip strengthening exercises. Just stretches. So, I feel that in addition to having tight right hip, I also have a weak right hip (maybe I'm off, but I'm guessing that hip weakness and hip tightness can be two separate things).

    Anyway, if the hips are the problem, and that has resulted in posture change to the lower leg and foot, which has resulted in a strain on my right calf, I'm just curious that if I came into your facility and a comprehensive evaluation revealed the overpronation (which isn't severe) and calf issues were related to weak hips, what kind of timeframe once must consider or be looking at in terms of trying to correct the misalignments caused by the hips. Are we talking something like 6-8 weeks? 3-6 months? A year? Year plus?
     
    #28
  29. Posture Guy

    Posture Guy Professional

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    Tennis_tater...great question.

    First, I want to stress something. I'm NOT suggesting anyone go to a clinic for therapy. I'm trying to walk a fine line here because I want to share information and perspectives that I hope are of value to others, and I absolutely do not want to make anyone feel like I'm trying to solicit business for any of our clinics, mine included. My assumption is that for the vast majority of people here, I'll never work with you, but I hope you have gotten some measure of value from what I've shared here.

    So now to answer your question, yeah, it depends. Now, my expectation is that a client walks out of their first visit with their body working better right then and there. So if a client walks in with moderate over-pronation, my goal is by the end of the first visit, I'm seeing improvement.

    Now, what I typically see is similar to what I experienced as a client. The improvement curve is steeper at the front end of the therapy, and as issues begin to clear up, the curve flattens and further gains take longer to achieve. So we might get really significant change in the first few weeks, with further positive change ongoing but the rate of change slowing over time.

    Now with me, bear in mind I was digging out of a REALLY deep hole. When I started with Egoscue as a client, my goal was not to make subtle changes to body function. I was trying to stay out of a wheelchair. I was feeling significantly better within the first month, but I'd say it took about 6 months before the idea of running again really seemed feasible, then another couple of months to work up the courage to try it. A year after I started, I was running and playing tennis again, pain free. And I was told by numerous medical professionals that after my accident that would never ever happen.

    For someone with moderate issues trying to get performance dialed in, change will happen much faster. I've worked with runners with knee pain because of a hip mis-alignment causing a knee torque and a distortion of foot strike where one session was sufficient to get enough improvement to eliminate pain and allow them to resume training for a marathon. Usually takes a few more visits than that, but not always. The body can change with stunning speed if given the proper stimulus.

    It's been a long day and I'm running a bit on fumes, so if I rambled a bit and didn't exactly answer your question, feel free to point that out and I'll take another run at it.
     
    #29
  30. Posture Guy

    Posture Guy Professional

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    #30
  31. Texas Scrambler

    Texas Scrambler New User

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    Torn Calf Muscle nearly a year later Update

    Good to see the thread growing since this is likely a common tennis injury. The calf is 95% healed with the 5% being the scar tissues gets tight with prolonged use. More stretching and targeting the scar tissue with the foam rollers is working well.

    Another epiphany was I was drinking protien powder mix for convenience after exercising and it had Creatinine in it. I firmly believe the Creatinine was responsible for the muslce tear. So for me, no more Creatinine and no more muscle tears.

    Hope all this helps and thanks for the earlier great advice on healing.
     
    #31
  32. Chas Tennis

    Chas Tennis Hall of Fame

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    Why do you feel that Creatine had some influence on your calf tear?

    I believe that I read that Creatine builds up within the muscles and that it also causes some extra water to build up within the muscles. Someone said that the water bulks up the muscle a bit. Do you think that is true?
     
    #32
  33. Bobby Jr

    Bobby Jr Legend

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    As some who had calf issues for a long time what has worked really well for me is daily use of a rolling pin... > done as in this video in case you do it differently: http://youtu.be/DgHoePuZaPw

    I found the foam roller wasn't nearly as good as a solid one.

    I do this every nightl without fail and also as part of my warm-up before I play tennis. I do it before I even leave home for the club and then walk/light jog for about 10 minutes before I get onto any other sort of stretching.

    After tennis, again, I walk for at least ten minutes - no matter how exhausting the match was.
     
    #33
  34. Posture Guy

    Posture Guy Professional

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    This is the roller I started using on my calves and I think it works REALLY well. When I first got it, it was pretty intense even though I'd already been rolling them several times a day on a pretty firm roller. But as it got progressively less uncomfortable, the calves felt better and better.

    Gotta go slow, find the tender spots, and linger, just slowly work it. But it's like a self-administered deep tissue massage.
     
    #34
  35. Bobby Jr

    Bobby Jr Legend

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    Nice.

    I agree with the tender spots part. People who haven't tried it should - you'll discover your calves have more knots and lumps that you ever realised.

    There's a good reason why top athletes get physio almost daily. A calf roller is a somewhat similar idea and, conveniently, one of the only parts of your body you really can work on well at home once you know how.
     
    #35
  36. Posture Guy

    Posture Guy Professional

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    Bobby Jr.....completely agree. The calves lend themselves very well to this type of self work. Other parts of the body can be more difficult to mobilize. But the muscles and fascia here lay out beautifully. The right tool can get in there very effectively.

    I would also encourage those who have had this injury to wait a few weeks before you start, allow the injury to heal to some degree, THEN start rolling it. I'd also recommend deep tissue massage from a quality practitioner who can really dig in, feel where scar tissue is forming during the healing process, and can work on breaking that up and ensuring the tissues all heal up with fibers running in the appropriate directions. Sometimes the collagen will be laid down at an oblique angle to the way the fibers in the area normally run, and that creates increased potential for reinjury.
     
    #36
  37. tennis_tater

    tennis_tater Semi-Pro

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    Just curious, if its the hip (and when I strained my calf/upper quad in early march, my physical therapist did say then that my right hip was weak), then would you think simply hip strengthening exercises could "re-correct" or "re-align" the tilting leg?

    Also, if its not the hip, what other possibilities would there be?

    ETA - seen my pt and orthopedist since my last posts. Despite the fact I'm not having any back pain complaints, both are convinced the root of my calf issues finds its origins in a back injury to my discs over 10 years ago, with discs at two lower levels in the lumbar pinching nerves, in turn causing leg weakness and making calves vulnerable to repetitive strains.

    Posture Guy - is that something u would have considered as a possibility?
     
    Last edited: Oct 8, 2012
    #37
  38. tennis_tater

    tennis_tater Semi-Pro

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    Posture Guy: I've been looking at some of the Egoscue books online and trying to decide which one(s) to get. Is there really that much difference between the books? Also, what are your thoughts on the Egoscue 2 disc DVD set? I read many positive reviews on Amazon, but then one bad review in which the reviewer noted that the videos shouldn't be used until one has mastered the exercises in the books (which the reviewer claims was later relayed to him by an Egoscue employee).
     
    #38
  39. Posture Guy

    Posture Guy Professional

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    Tennis tater....sorry I missed your earlier post. Never got an email notification of a new response on the topic, for some reason.

    Re the first questions, yes, that would've been a possibility in my mind. If I see a chronic injury site, the problem could be ANYWHERE in the body. The body really does work as an integrated unit, with strings of muscle and fascia connected in such ways that a mispositioned left shoulder can cause problems in the right calf, for example. If I were looking at you, my goal would be to try to very precisely figure out what is your body NOT doing that it should be doing (dysfunction), and then what is it doing in compensation that it should not be doing in order to deal with that dysfunction. Then we go after that dysfunction.

    Re the second post, yes, each book is very different. I wouldn't go to the videos, I'd go to one of Pete's books. I would agree the videos are more appropriate for someone who is out of pain and just looking to maintain and strengthen. Pete's first book (Health through Motion) is the one I recommend for people wanting a bit more technical understanding of how Egoscue works and how we look at the body. If a PT or trainer is wanting to learn more about what we do, that's where I send them. If it's a 'layman' just wanting to understand more why they hurt and how to make it better, I'll send them to Pain Free.

    Hope that helps. Let me know if you have any further questions.
     
    #39
  40. Texas Scrambler

    Texas Scrambler New User

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    Will Take the Advice

    Great calf rolling advice to switch from a foam roller to a rolling pin and then if I can find one a knobby rubber roller. I still have a few scar tissue issues so need to keep working on the rolling.

    How do you know if you are rolling too hard? Do your roll before or after exercise?

    And thanks for the good information
     
    #40
  41. Posture Guy

    Posture Guy Professional

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    I do LIGHT rolling before exercise with a smooth roller, and before my dynamic warmup. I save the intense rolling for either well before exercise, or after. Typically after.

    How do you know if you're rolling too hard? You'll know. Honestly, it's hard to generate excessive pressure on the tissue via rolling. And pain is always a great indicator. Some discomfort in a tender area while rolling is ok. Intense pain, not so much. Trust your instincts. Don't be afraid to go deep, but don't go crazy.
     
    #41

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