Calf strain--I got hit

[Chas Tennis]

Horse tendon injury recovery & another link

This tendon injury discussion is clear even if it is for horses.

http://www.athletic-animals.com/tendon.htm

Another on human calf injuries:

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

An important controversial question is: How do anti-inflammatory drugs affect the healing process?

 

[Champs990411]

Do anti-inflammatories make you more susceptible to injuries? The first time I hurt my calf (almost exactly a year ago) was a team match where my arm was killing. I gutted it out but took 6 Aleve before and during the first set. Hurt the calf at the end of the second.

 

[FuriousYellow]

Do anti-inflammatories make you more susceptible to injuries? The first time I hurt my calf (almost exactly a year ago) was a team match where my arm was killing. I gutted it out but took 6 Aleve before and during the first set. Hurt the calf at the end of the second.

I was just listening to the radio interview on ESPN with Dr. Robert Klapper, the Orthopedic Surgeon whose been discussing Kobe Bryant's ligament tear in his wrist. He was saying anti-inflammatories delay healing and you should be using Tylenol instead. He also said Vitamin C helps with the healing.

Interview here:

http://espn.go.com/espnradio/losangeles/play?id=7376894

 

[Posture Guy]

Yep, there are a number of studies showing NSAIDS actually delay/impede the healing process. I'll use them only in acute situations. For example, after an initial injury, I'll use a prescription strength dose for 48-72 hours trying to manage initial inflammation. I would never use them for chronic issues and I recommend to my clients that they don't, either. Limited benefit, and a LOT of other issues.

 

[Morgan]

Charging up the ball machine - should be ready for some light hitting tomorrow. First time since 2 Nov.

 

[Champs990411]

Good luck.

4 months since my last relapse. The 4" PVC has been quite valuable IMO.

 

[Chas Tennis]

Another source of leg pain-Chronic Exertional Compartment Syndrome in Runners

FYI. This condition may not be related to the described injuries in this thread.

Chronic Exertional Compartment Syndrome in Runners

http://www.theacc.com/sports/c-track/spec-rel/061005aab.html

Onset of pain is often just a few minutes after starting exercise (but can vary). Need a specialist to diagnose this issue.

 

[Torres]

3 months now after my return to tennis. No 'performance' issues that I'm aware of but one thing I've noticed is that the area around the original tear gets sore if I've played several long matches over several consecutive days. I suspect the scar tissue 'gluing' up the surrounding muscle fibres. My right calf (the one I originally tore) still feels tighter and shorter if I stretch it lengthwise (eg. lie in bed straight on your back and pull your toes up to your head).

Accordingly, one thing I'd recommend to anyone dealing with a calf tear is that if you want to have as clean a recovery as possible, get proper physio and massage on the area as part of a proper rehab programe with rehab exercises, to prevent / minimize the formation of scare tissue. I just sat at home and waited, which in hindsight, probably isn't the best.

 

[tovli]

Great article on grading and treating calf strains

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697334/

 

[Posture Guy]

Terrific resource, thanks for sharing it.

 

[tennis_tater]

Anyone use the SpiderTech Precut Calf, Arch and Achilles Tape following a minor calf strain? Just curious as to what type of support this might provide when making your way back to the court. Would wearing this tape be any different than wearing a calf sleeve/compression sock/sleeve on the court?

 

[Posture Guy]

I didn't use that specific type of K tape, but I did get some therapy where they gave me K tape in a similar configuration. Honestly, I didn't feel much benefit from it.

I did, however, feel benefit from the Zensah compression sleeves. Completely different purpose and feel than K tape.

 

[G34]

Yeah a few years ago I injured my calf (slight tear) and took a few months off to heal. I found this cool compression sleeve and I've been using it everytime I play. Hope this will help some of you out there.

http://www.dme-direct.com/bioskin-calf-skin-bio-skin-support-sleeve-brace-shin-splint

 

[ollinger]

^^ you injured it a few years ago and use a compression sleeve?? What for? To reduce circulation to the muscles and make them more vulnerable to injury?? Perhaps people do things at times without considering what the point is. What do you expect the sleeve to do?

 

[tennis_tater]

^^ you injured it a few years ago and use a compression sleeve?? What for? To reduce circulation to the muscles and make them more vulnerable to injury?? Perhaps people do things at times without considering what the point is. What do you expect the sleeve to do?

I can't speak for the poster above, but both my physical therapist and orthopedist suggested wearing a compression sleeve/sock during activity in addition to post-activity for recovery for recovery purposes.

 

[ollinger]

^^ as a physician I can promise you that both orthopedists and particularly physical therapists often recommend things for no particularly good reason. I can't see a purpose to wearing such a thing, certainly not several years later.

 

[tennis_tater]

^^ you injured it a few years ago and use a compression sleeve?? What for? To reduce circulation to the muscles and make them more vulnerable to injury?? Perhaps people do things at times without considering what the point is. What do you expect the sleeve to do?

Well, many of the manufacturers market this product for "prevention" purposes in addition to an aid in recovery. Maybe since they are being marketed this way and since some health care providers are suggesting that it may be of benefit to wear these things during activities, people aren't necessarily wearing them "without considering what the point is." Maybe your opinion as to the benefit of wearing these sleeves is just simply different from other health care professionals.

 

[tennis_tater]

Since calf cramps can lead to calf strains, just curious if anyone with calf/lower leg problems has used the Cramp 911 product for lower leg issues, either for relief, or for preventative measures.

http://www.cramp911.com/concept/

 

[Morgan]

I've been playing doubles and hitting often (singles or ball machine) - but still tentative, even though it has been nearly 8 months since my injury. Very difficult to back off and not sprint to balls that you used to be able to get to. I'm wondering when the next calf strain will happen. Revisited this thread to get a few reminders on what type of stretch/preventative things I can do. My strains were 3 yrs apart, but you've got to believe it'll happen again, unfortunately.

 

[Morgan]

^^ you injured it a few years ago and use a compression sleeve?? What for? To reduce circulation to the muscles and make them more vulnerable to injury?? Perhaps people do things at times without considering what the point is. What do you expect the sleeve to do?

Compression sleeves might work in the same manner as kinesthetic tape...reminds me to not make unnecessarily quick sprints to balls (middle-aged, here).

 

[Ronaldo]

Compression sleeves might work in the same manner as kinesthetic tape...reminds me to not make unnecessarily quick sprints to balls (middle-aged, here).

Find a partner with two legs and a racquet. Let him sprint.

 

[Chas Tennis]

Morgan,

You should do the calf conditioning before going back on the tennis courts especially if your life style tends to shorten/tighten the calves.

Did you see a Dr? Did you have any imaging that located your injury? Physical therapy?

What has happened, running activities, etc. in the months since your last reply in January when you were about to use a ball machine?

Great to hear that you are back as calf strains sound like difficult injuries to deal with.

 

[Morgan]

http://www.youtube.com/watch?feature=endscreen&v=oLCkpEXqG-g&NR=1

good general guidance video for those who have this injury....

 

[Morgan]

Morgan,

You should do the calf conditioning before going back on the tennis courts especially if your life style tends to shorten/tighten the calves.

Did you see a Dr? Did you have any imaging that located your injury? Physical therapy?

What has happened, running activities, etc. in the months since your last reply in January when you were about to use a ball machine?

Great to hear that you are back as calf strains sound like difficult injuries to deal with.

Never saw an MD - called my clinic and they said to go to the ER. I decided to self treat again (crutches, RICE). Next time it happens, I'll get a physical therapy consult for guidance and treatment. I need to be more diligent, especially after 2-3 hrs of tennis or running to stretch properly. I tend to stretch before, but not enough post-exercise stretching.

 

[Chas Tennis]

Calf Flexibility and Range of Motion - Ankle Dorsiflexion

The flexibility and range of motion of the calves normally limit dorsiflextion of the foot.

I read in Stretching Scientifically(2003), T. Kurz, that one sign of a tight Soleus is difficulty in squatting. I believe that tight Soleus is a problem of mine. I have balance problems squatting (plus other ROM issues from an old knee injury).

To determine whether the range of motion of a joint is within some norm the ROM has to be measured or otherwise estimated (wall test, etc.). Here are some sites that bear on issues of measuring/estimating ROM for dorsiflexion, squatting, stretching, and some discussion of possible genetic dorsiflexion limitation, etc..

If injured, forcing stretches or measuring/estimating range of motion may risk farther injury.

I just started reading these links and have not evaluated them very much.....

Calf - ROM & Stretching (See the wall measurements for estimating ROM.)
http://www.raqs.co.nz/safedance/calf.html

Does stretching increase ankle dorsiflexion ... [Br J Sports Med. 2006] - PubMed (You can view the full text by clicking on the "Free.." icon upper right.)
http://www.ncbi.nlm.nih.gov/pubmed/16926259

Squat Technique & Ankle Dorsiflexion
http://www.maximumtrainingsolutions.com/Squat-Technique.html

Frozen Ankle, Ankle Mobility, and Squatting | Eric Cressey
http://www.ericcressey.com/frozenanklesuglysquatting

Calf Exercises & Stretches
http://www.exrx.net/Lists/ExList/CalfWt.html#anchor1928832

High Performance Training, Personal Training Wall Bent Knee Calf Stretch
http://www.exrx.net/Stretches/Soleus/Wall.html

Re: Reasons for Limited Dorsiflexion (Is the ankle just too stiff or somehow bone limited and tight calf muscles are not the limitation?)
http://newsgroups.derkeiler.com/Archive/Misc/misc.fitness.weights/2005-07/msg00276.html

 

[Morgan]

those are helpful sites/links - I'll go through them all - thanks for posting them - and I'm sure others with the same injury will find them useful as well.

 

[chrischris]

Great thread.. i 'popped ' my left calf 10 days ago. need to digest and learn from you guys as i havent been very good at doing the right thing since then.
Used ice and cold showers for a while and steam baths with ice cold shower after , feels good.

 

[Morgan]

Unfortunately, I think once it has happened (calf strain), you're prone to a recurrence to the same spot. I had the same area strained twice, three years apart. Miserable injury.

 

[Chas Tennis]

Great thread.. i 'popped ' my left calf 10 days ago. need to digest and learn from you guys as i havent been very good at doing the right thing since then.
Used ice and cold showers for a while and steam baths with ice cold shower after , feels good.

I have not had this injury but it sounds serious.

The healing right after the injury can be very important. It is hard to even walk around without stressing the calf so you should see a well qualified Dr.

 

[chrischris]

I have not had this injury but it sounds serious.

The healing right after the injury can be very important. It is hard to even walk around without stressing the calf so you should see a well qualified Dr.

OK, yes i hope i will be fine. Are you a doctor?

 

[Chas Tennis]

No, not hardly.

I've had a few tennis injuries and try to inform myself.

I read some comments by a Dr to the effect that stressing injured tendons for a very short time can lead to tendinosis or defecting healing on the microscopic level (not tendinitis). People should take tendon injuries seriously right away.

I believe that playing on unknown injuries for a short time to 'see how it will do' and using pain killers results in a great number of avoidable chronic injuries.

What is your injury and should you now be in a boot?

 

[Crispvolley]

Great thread.. i 'popped ' my left calf 10 days ago. need to digest and learn from you guys as i havent been very good at doing the right thing since then.
Used ice and cold showers for a while and steam baths with ice cold shower after , feels good.

I just popped mine late last week. Went to see an orthopaedic surgeon and here is what my diagnosis and protocol is:

Partial tear of the calf muscle, apparently some people tear the Soleus which gives more pain towards the achilles, but mine is the inside calf muscle. I need to be in a boot/aircast for 2-3 weeks and wear a heel lift. My doc really stressed the importance of not stretching the calf during this time, and to keep if immobile so it heals properly. The nice thing is that with the boot on I am able to continue working out at the gym since it is keeping the calf from engaging.

Once the boot comes off I will begin physical therapy to help recondition the muscle and work out the scar tissue. The goal is to be back on the court competitively in 6-8 weeks. I imagine I will be on the court before then but only for light hitting and to test it out with some light running drills.

I am definitely going to be conservative in terms of not rushing back. I have a friend that tried coming back too early and reinjured it. He also did not go through PT and even though he is back on the courts now, he still has tightness in his calf and is very tentative. I am guessing that is a result of not letting it heal properly and not utilizing PT to help with the scar tissue and reconditioning of the muscle, but I don't know for sure.

 

[brianb76]

Im sure getting sick of this injury. 3rd time this year Ive had to take time off. One medium level strain last winter and two minor recurrences since then. Strained this time while serving. (go figure) This strain is actually on the lower part of my calf muscle not the top where was injured before.

Gonna try a neoprene calf sleve(McDavid) to keep it compressed and warm from now on, espically when its cool. I always stretch so i really don't know what else to do to prevent.

Any other ideas? Will weight training/strengthing exercises help prevent this from happening again?

 

[Posture Guy]

Just some basic things....

- when injured, do NOT stretch or work it in any way until the pain's gone

- the pain being gone does NOT mean the injury is healed. It means it's better enough that you can begin doing some PT on it.

- getting assessed by a physical therapist is a great idea. See what might be causing that spot to get undue pressure. Could be muscle activation issues, postural issues, functional problems, etc.....

- as you begin working it, getting deep tissue massage regularly to break up scar tissue and keep the new fibers oriented properly is a key, in my opinion.

- once you feel like you're all the way back, you gotta do some explosive movements. This, in my opinion, is where a lot of people don't take their training far enough. You have to re-teach the brain how to properly 'run' that muscle in a way to permit you to do what you want it to do. Tennis is very different than jogging, much more explosive movements, many 'unexpected'. If all your training is slow and steady stuff, the brain can literally 'forget' how to activate that chain of muscles fast enough to get sound and functional engagement. So something like plyometric work is a GREAT idea. Start easy, then build up.

When I injured my calf, once I got to the point where this was safe, I started by standing one step up from a stairwell landing, then jumping down onto the platform and landing evenly and softly with both feet. Would do that maybe 10 times, then move up a step, then another step, then another step until I was jumping down about 4-5 steps, trying to land like a cat, letting the knees and hips flex upon landing, trying to make as little noise as possible.

Then I did it again landing on one foot and alternating between the two. Only worked up about 2-3 steps that way.

Once I could do that, then I started jumping UP onto a box, or doing one legged hops over a small pillow, just slowly getting more aggressive with the movement.

Gotta retrain both the muscle tissue and the brain to accommodate the explosive movements tennis requires.

It's a crappy injury, good luck to all dealing with it.

 

[lostinamerica]

Well tonight I joined the club. Geez, this thing hurts. I once ruptured my other let's Achilles' tendon and I feared it was the same but higher up. It sure hurts to walk. Wish I didn't have to work tomorrow.

 

[Morgan]

Sorry to hear. It took me about a week to even be able to fully put weight on the leg without eliciting the stabbing pain. Thankfully no injury for awhile - but I know it can hit me at any time.

Good luck w/ the recovery. This thread has been very resourceful in what to do to treat calf strain injuries.

 

[lostinamerica]

Sorry to hear. It took me about a week to even be able to fully put weight on the leg without eliciting the stabbing pain. Thankfully no injury for awhile - but I know it can hit me at any time.

Good luck w/ the recovery. This thread has been very resourceful in what to do to treat calf strain injuries.

After a week and a day, I am able to,walk without a noticeable limp. I still have a contentious relationship,with stairs but it is worlds better. I can't run but starting the stationery bike. I am hoping to be back on the court in 4 weeks.

 

[Mike Hodge]

Calf strain

Sorry to hear. It took me about a week to even be able to fully put weight on the leg without eliciting the stabbing pain. Thankfully no injury for awhile - but I know it can hit me at any time.

Good luck w/ the recovery. This thread has been very resourceful in what to do to treat calf strain injuries.

Morgan: I had this injury a few years ago. Worked out like a demon -- hit the weights, ran sprints, ladder drills and played tennis. Got in great shape. Also got injured a lot. At first it was little nagging stuff, plantar F, soreness, stiffness. Didn't think much of it until one New Year's eve day I was playing and suffered a severe/moderate tear of the gastroc in the calf. It was a month before I could even play mini tennis and several months before I could go full out. For a while, I thought it might be career ending. It was that bad.
The big thing for me, as far as a long-term solution, was stretching. My PT told me this when I got hurt --- that I was too inflexible for the amount of power my speed I could generate. Something had to give. And it was my calf.
Now I double the amount of stretching and I'm smarter about working out off the court. My recovery time is much better. My recommendation: Get a good stretching program and stick with it. I stretch twice a day, sometimes more -- and it's not just for five minutes like I did before when I half-assed it.
Figure out what your weaknesses are and attack them. It will pay off.

 

[RogueFLIP]

Haven't read through the whole thread, but I'll quickly give my $.02:

Stretching is important yes. So is strength/conditioning.

Equal of importance is breaking up muscle spasms/knots and loosening up any restrictions of the soft tissue. Massage, myofascial release, other manual therapies either self administered or paying someone to do it can significantly decrease your injury "timeout".

You can be strong/flexible/conditioned, but if you don't loosen up those restrictions, it'll only be a matter of time before you're hit again.

And not just in the symptomatic areas. Everything's all connected.

Chronic strainers might need a good postural assessment/correction. Something "off" up and down the chain can easily cause compensations which may lead to strains/sprains/injury.

 

[Posture Guy]

What RogueFlip wrote is on the money.

In my experience, most chronic strainers have a fundamental postural imbalance causing the leg muscles to work in a dysfunctional way, and over time this has also led to myofascial distortions. Restoring postural integrity and normal function, combined with myofascial release, will then allow conventional stretching and strengthening techniques to create benefit.

Strengthening a body that is mispositioned will often make the problem worse. Just increases the body's ability to apply dysfunctional load. Most Crossfit folks are a great example of this. From a body composition and traditional training perspective, these people are wonderfully fit. But most of them are functional and postural train wrecks.

 

[Greg G]

Gotta look into this, my right calf (the one I strained), seems to always be sore now after treadmill work/tennis. I do know that my left hamstrings are tighter than the right for some reason (working on correcting this).

 

[lostinamerica]

I am two weeks out of my calf pull. I can not run but walking with no discomfort. I can push on the injury and feel mild discomfort. It feels like it still has bruising.

I did go to the courts with my kids and hit a few serves. I could serve fine without discomfort. Until I can play again, doctor originally said 8 weeks and I negotiated down to 6 weeks. It is looking a lot like 6 weeks and maybe 8. I am probably out for our city playoffs so my men's 18 team will probably end their season there.

Our 40+ sectionals is in September and I am really hoping to be 100% then.

 

[Morgan]

Has been a couple years now since my last injury. No problems since. Have been running, swimming along w/ twice a week hitting. Knock on wood - this is a miserable injury when it happens.

 

[TroutSc]

Anyone using a support? (sorry I have not read this entire thread yet).
I found a New Balance Ti22 Adjustable Shin/Calf Support, wondering if this might help avoid re-injury once im healed.

http://www.newbalance.com/Adjustabl...?dwvar_11110_color=Black&start=10&cgid=114500

 

[Morgan]

I used a similar neoprene sleeve for awhile just to remind me NOT TO push off on the affected led. But after awhile no longer used it. It has been awhile since the injury, but I know that it can return anytime. Probably should always have it on.

Also bought some K-tape, but never really used that.

 

[AlwaysImproving]

Calf strain injury prevention

I wanted to update this thread with some injury prevention tips.

From what I've read, the key to injury prevention is keeping the muscle strong but flexible, doing proper dynamic warmups, proper cooldown, and getting rest to avoid repetitive stress injuries.

Here is some good info from ACSM on injury prevention concepts:
http://www.acsm.org/access-public-information/articles/2012/01/10/basic-injury-prevention-concepts

Here the ACSM lists specific ways to rehab and prevent injury depending on type (strain, tendonitis, etc).
http://www.acsm.org/docs/current-comments/exercis-inducedlegpain.pdf

 

[Posture Guy]

I agree with all of that but after dealing with my balky calves a couple of years ago, and now having had no issues for a long time, I'm convinced that a big part of this is training the brain to work with the muscle at the proper speed.

Muscle engagement is not just strictly physiological, it's neuro-physiological. The brain needs to be trained how to properly fire the calf for what you're asking it to do. And a lot of people try to train the calf by jogging, which is a VERY different demand than tennis. With me, I think I had to get my brain and calf used to working at a faster speed, more burst-type of activity. So the last time I recovered, before I went back on the court I went through a series of plyometric kind of movements, starting gentle (like going up one step from a landing on a flight of stairs and then jumping down onto the landing and coiling. Doing that like 10-20 times, then a couple of days later doing the first step, then going up another step, etc..., until after a week or two I was going up 5-6 steps and making a pretty good jump down. Then I started doing jump ups. Then one legged hops, etc...

Haven't had a problem since. Calves feel great.

 

[BHBeguile]

Thanks for revivingbthe thread. Tore my plantaris tendon last week and have been tring to follow this regimen for stage 2 injuries:

http://www.sportsinjuryclinic.net/s...n-pain/calf-strain/calf-strain-rehabilitation

 

[Chas Tennis]

Are Most Tennis Calf Injuries to the Gastrocnemius or Soleus?

This issue will likely bear on conditioning for prevention.

I read somewhere that the calf muscle most often injured was the Gastrocnemius. Can't recall now if that information was in general or for tennis. ?

The Gastronemius of cats was observed to have a higher proportion of fast-twitch muscle cells than the Soleus.

The Gastrocnemius is less effective than the Soleus in producing force when the knee is bent.

Tennis seems to be played with a bent knee a significant part of the time. When do most injuries occur?

Does anyone have any reference regarding whether the Gastrocnemius or Soleus is most often the location of calf injuries. Of tennis calf injuries?

Reference -From Breakpoint to Advantage, B. Pluim, Marc Safran - Says that "tennis leg" is an incomplete rupture of the inner part (medial head) of the Gastrocnemius. Common injury of players 35-50 years old. Area between between muscle and tendon affected. Pushing off or landing.......

Reference also says usually the Gastrocnemius is injured, page 626.
http://www.med.nyu.edu/pmr/residenc...s NA_sports med/MSK injuries tennis.pdf#bib69

If you were injured, was it the Gastrocnemius or Soleus?

 

[Devil_dog]

I've had grade 2 injuries on both calves and it was horrendous. First injury was from jogging and felt like a someone jabbed a knife into my calf. Second injury to my other leg was during tennis but less severe pain but like someone hit me with a tennis ball. Both times I was out probably 3-4 weeks and then started self-managed PT to strengthen my calves. I no longer start any tennis until I warm up my calves with stretching. I haven't had another recurrence of the injury (knock on wood!) for at least two years. And for Chas Tennis, I believe my injuries were to the gastrocnemius muscles.