Ripped Calf Muscle recovery final stages...

[JackF]

Hi... thanks very much for making this forum open to patients. Very generous of you. And very much appreciated. Now some background...

About a year ago, I started running every other day. Took it easy and ran in good shoes. No problems. About two months ago, I added steps. Lingering calf soreness but I thought little of it. About 3.5 weeks ago, I felt a *pop* in my calf muscle while running to catch a plane in an airport. I iced, elevated, compressed.

A week later, still much in pain, I went to an osteopath/sports medicine doctor. He showed me where I could feel a tear in the muscle and taped it up in a way that really seemed to accelerate the healing process. He recommended I suspend running for three weeks. This week is the end of the third week.

In the mornings, I need to warm the leg up a bit before it feels 100%. But it's moderate to nothing now compared to first days of the injury. I have mild tenderness in the calf to the touch, but can walk on it fine with no pain at all. Usually. The other calf has some very slight soreness too, so I'm worried that was also strained a bit.

Anyway, I'm anxious to get back "on the road" but of course don't want to injure it again, which is something I've seen reported on many running forums.

So yesterday I took a walk on my running route and got only about 10-15 minutes into it before I felt an odd sensation, not in the calf which didn't hurt at all, but in the inside ankle just above the inside heel. It was stiff, as if tight. And very mildly tingling at points. I was afraid that if I kept going, I'd injure it somehow and be out even longer, so I turned around.

But is some kind of stiffness normal after this kind of injury? What's the best way to get back to running without causing a new injury? That is, are their specific exercises to do first? Or stretches? I'm happy to take it easy as long as I can get back out there again.

Thanks again and thanks in advance for your reply.

JF

[physiofixme]

Hi

I'm just wondering if you have done ANY stretches or strengthening exercises at all yet?? Also where exactly in your calf did you feel the initial pain??

Your most recent pain down near your ankle is most likely from your achilles tendon which is basically an extension of your calf muscles. You have two main calf muscles...the gastrocnemius (which is in two parts) and the soleus. It will Depend on which one you have torn as to which exercises you should do. However: if you do a combination of:
1. Soleus stretches (hold 2 x 30 seconds)
2. Gastrocnemius stretches (hold 2 x 30 seconds)
3. Calf raises. Standing flat foot and raise up on to your toes on both feet, and lower. Repeat 3x15 repetitions 2 times daily. Once this is free of discomfort then..
4. Single leg calf raises. 3x15 2 times daily (as above but on one leg). Once you can do this with no discomfort, do....
5. Eccentric lowering off a step. Stand with the ball of your feet on a step and your heels over the back. (make sure you are holding a rail or the wall) Raise on your toes on two feet and slowly lower, dropping your heels below the level of the step. Return to start position. Repeat 3x15 2 times daily. Once you can do this comfortably ....
6. As above but raise up on two feet and then slowly lower just on one.
THEN you can start running. This may take a few weeks. Do this 4-5 times a week.

Remember this is a GUIDELINE only and you should check with a physio or sports Dr who has actually examined you.

THEN...check your running shoes to ensure you have the right ones for your feet and running style.

Start out slowly when you do start running and no hills for the first few weeks.

Hope this has helped.

[JackF]

Thanks... this is exactly what I was looking for. Very few sites online that mention the steps taken for recovery at this stage.

To answer your question, the pain in my calf was on my inner left leg/rear from where the bottom of the calf muscle just bulges out to the center. Both I and the doctor could feel the tear, a sideways "T" shape running longer on the vertical.

I have gently tried the first three of the exercises/stretches you list and already if feels less tight than before. It was slightly painful, but I was careful not to overdo it. I'm also going to try some light massage of the area.

I'll continue with these steps you suggest. Again, I'd rather have this healed right the first time then risk a repeat injury and even longer recovery.

Another question: I've been doing an exercise bike with no ill-effect on the calf. I have a rowing machine avail. but worry that would be too much stress. Someone has also suggested using an elliptical machine as another possible alternative.

A good idea or no? This, with the understanding that anything that causes sudden or major discomfort in the recovering muscle, I'll avoid.

[physiofixme]

The exercise bike is fine. DON'T use the eliptical trainer. I'm not a big fan of these as the motion of it causes you to lift your heel earlier than you would with normal walking (or running) which actually engages your calf muscle earlier and causes it to do more work! I have seen people actually cause themselves calf and achilles tendon injuries from using these machines.

The rowing machine may put a little too much stress on your calf too so maybe stick to the exercise bike for now.

[JackF]

Hey,

Just a few days later, and I'm logging on to say a big thank you. I know one of the frustrating things for medical professionals is when a patient doesn't take the advice and then complains of a lack of results.

But I've done the stretches as you suggested here, and I'm really impressed with how quickly they've made a difference. I have less pain, more mobility, and for the first time in 4-5 weeks, feel confident this annoying injury won't plague me forever.

I checked this with a friend who is an osteopath, too, and he seconds everything you said in your list. On your recommendation, I left out the elliptical trainer. We're traveling (visiting family), so the exercise bike isn't available to me this week. So I'm making due with resistance exercises.

Might start incorporating some walking today. I think I'll be able to start up a very light (interval) running schedule next week, careful to pay attention to how it's feeling, etc.

Anyway, I just want to reiterate that this is working. Anybody who seeks this out in the same way I have out to bookmark this page. Thanks again!

[JackF]

Sorry... forgot to add...

* Stupid as it may seem, I have never done the soleus stretch before. Didn't even know about it. I'm a beginning runner, in relative terms (been at it, this time around, about 10 months). Even though I'm pretty sure it's the other calf muscle that I injured, this is a great stretch. Definitely to become part of the regimen from now on.

* I did note that you mentioned it might take a few weeks. So I'll move ahead with that in mind. At the time of my first exam, about a week after the injury, the doctor I went to in Paris said to do no running for at least three weeks. At the end of that period, it was pretty clear that was still too soon.

* I did find one other page that ran through what was happening in recovery for this in particular. Don't know the URL now, unfortunately. But threes seem to be the number here. Three grades of injury (mild to severe, with 2-3 weeks recovery for mild; 4-5 weeks for moderate; as much as 3-4 months with possible surgery for severe). Three phases of recovery, with the rip in the first stage, requiring rest, ice, compression, elevation; collagen etc. helping to close the rip in the second, with more rest and toward the end possible passive stretching; and scar tissue forming in the third, with active stretching (I might have some of that wrong, and please feel free to correct... but somehow knowing the phases also seemed to help reinforce what to do in each stage).

This is an awful lot of commentary from me, I know. Apologies.

Just that I was pretty glad to have re-discovered some level of post-40 fitness. And dismayed to get sidelined like this. I'm certain I'm not alone -- in fact, I imagine you've got some pretty busy times ahead with the all those Boomers out there, taking up rock climbing, etc. at an age when grandparents used to happily collapse into their Barca loungers.

[physiofixme]

Glad to hear it is feeling better. Progress slowly however. These things have a way of resurfacing if you do too much too soon!! Good luck.