Please Help-Calf injuries & heel raisers

Yep, I've had minor calf problems off and on over the last year.

I do use heel lifts (allbeit small ones), and have had some success. Maybe try getting smaller lifts (1/4 or 1/8 inch). Also, keep in mind the heel height of the shoes you are wearing. Not all shoes have the same heel height; you may need a larger/smaller lift to compensate for a lower/higher heel.

I also recently puchased "The Stick." So far, I really like it. It is effective for quickly massaging my calves after long runs and workouts.

One last thing I do is calf-raises. Start on you tip-toes (do one foot at a time) with your heel hanging off a step. Then, slowly lower you heel below the height of the step. Do 2 sets of 15 about 3 times a week. This has also helped me in the past.

I only run about 50-60 miles a week, but have done so religiously for the last year and a half. My calf problems seem to occur when I get lazy about stretching and doing calf-raises.

Good luck.

I'm 47 and had those exact same problems for years.

I switched to an Asics DS Trainer from the bulkier Nike shoes I was wearing and also started doing all speed or tempo work in racing flats.

More important I started walking barefoot several times a week

outdoors and always around the house.

From empirical observation and also from what I seem to read a lot about on these boards I think the calf needs LESS elevation not more.

But thats just me.

if you have the ability, get outta your dress shoes at the office. being lifted all day can't help! i walk around in white socks at my office all the time. at first the co-workers were telling me to put my shoes on, but now it's strange to see me wearing shoes -- obvious exceptions are the restroom, if i go to another floor or have a big meeting.

next, get some $10 flip flops at the GAP or whatever. wear 'em everywhere. again, staying outta shoes where your heel's up in the air.

stretch, stretch, stretch, strengthen, stretch, stretch, strengthen ... and did i mention stretch?

There is a strong movement to move the opposite direction to lower-heeled shoes (especially with a small or negligible heel-to-forefoot ratio). The idea is that higher-heeled shoes cause the calf muscles and tendons and the achilles to shorten and weaken. We therefore become conditioned to high heeled shoes. I have sold running shoes for 16 years and have generally accepted the better shoes in the marketplace. However, there is a great deal of supported research/evidence that lowering the heel height is the long term solution to many running injuries. To address your question specificially, the heel insert might give you some relief, but it is not solving the problem. I recommend reviewing this site for the barefoot info and gradually moving to lower profile shoes. The caveat is that you must be committed to doing so and cannot be lazy about the conversion. The process will probably take you months, but will result in stronger muscles and tendons and fewer injuries. Good Luck.

This worked very well for me:

Do not run and wear inserts in your shoes only when in pain.

If pain disappears only run slow.

If there is no pain in the morning do eccentric calf excercises and walk barefoot as much as possible.

When slow miles don't cause pain the next day very slowly increase speed in tempo's and/or intervals.

I had some calf problems last year and was able to take care of them with stretching. The important thing to know is that you have 2 seperate muscles that make up the calf. You have to stretch both of them. The larger gastroc is stretched when your leg is kept straight. The smaller soleus is stretched when your knee is bent.

Another option is to cut back the miles and run with a little more intensity. An extra day off each week will allow the muscles to heal better.

What shoes do you train in? I agree with some of your other posters, work your way back to your bodies natural bio mechanics. Lower heel shoes with minimal cushioning. This will allow your muscles to work properly and hopefully with time your pains will go away.

Hey, thanks everyone for your helpful advice.

Unfortunately, there are 2 camps; lower heel placement (and even barefoot) with the idea of strengthening the calf muscles in order to prevent injury. In addition, doing calf strengthening exercises.

The other camp being to take pressure off of the calf muscles with the use of heel inserts. Both ideas seem to have pros & cons. Obviously with both camps its always good to do a lot of stretching, massage, and icing after a hard workout.

In my particular case I feel that I have to give my calf muscles a significant rest or they will break-down too much and get injured. In between one of my recent injuries, I was religious about doing calf exercises daily. (100-200 per day on the stairs) This didn’t seem to help as I got injured after 2 ½ months, just about the same time it took me to get injured when I didn’t do the exercises. In addition, in high school & college I used to run 80-100 MPW, will very little rest, and I NEVER had this particular calf injury. Also, I always stretch 20-30 mins. before each run. With this in mind, I’m leaning toward the age-factor and the breaking down of the muscles with little rest theory but, at the same time, I feel that it is also important to keep those calf muscles strong.

On a run this morning, without using the heel lifts for the first time in 3 runs, I really felt the workload placed on my “rested” calf muscles. I came to a conclusion that I think will work as it takes both “camps” into account. I will run 3-4 days a week without the heel lifts (these will be my harder runs) and 2-3 days a week WITH the heel lifts, for my recovery runs. I will treat the recovery runs (with the heel lifts) as a kind of “cross-training” designed to give my calf muscles a total break but at the same time I will be doing an exercise that most closely simulates my regular running. I think this will work, or at least it’s the best strategy I have at the moment!

By the way, I’ve been running in Asics Gel tempos & Asics Gel Vigorous. I have a new pair of Asics Cumulus and New Balance M 717 GT’s that I haven’t worn yet.

Thanks again for everyone’s input. I will try to update this thread as the times goes by.

OldSchooler

You are most likely experiencing what I've heard referred to as a deep calf heart muscle tear. It is not a cramp. At the first sign of this, a twinge or tightness stop and walk. Sometimes you can start running again after a few steps sometimes not. If not, bag the day and go home. Don't stretch until the tear has healed, and then mildly. The wall stretch is good. You may want to consider foregoing stretching the calf before running. In any event do about 50 thumb glides, upward only, on each calf to warm up the muscle before you run. Alternatively you can use the stick to warm the muscle up. Several years ago John Parker wote an excellent article on this issue for "Running Times".

Good Luck

Rick

You should also try racing flats when you run on the grass. I do this all the time and it really seems to help.

RB

From:

http://www.thestick.net/Calf%20Heart%20Attack.htm

It’s possible to diddle around with micro-tears for months. One miscalculation and you might be back to square one.

About ten years ago, I started having a lower-leg problem that I assumed was a pulled calf muscle. The calf would get tender, sometimes knotty, after hard training (usually intervals); then a few days later, while out on a run, I’d feel a sharp pain very deep in the gastroc, and bingo, I’d be out of business.

The injury would respond to massage and rest, and after a few days, it would seem to be fine. Here’s the tricky part, when I’d start back running after a few days off, things would go well for a mile or so, and then, yikes! The sharp pain would be back!

So I’d take a few more days off, more massage, and then start back. Deja vu all over again. And I found I could repeat the cycle as many times as I wanted, and the injury would just keep popping back up. It was the most frustrating injury I had ever dealt with.

I finally mentioned it to my old mentor, Roy Benson, and he set me straight.

"It’s probably not a calf pull at all", he said. "More likely, it’s a microtear deep in the muscle. A spasm forms around the torn muscle, that's the knot you feel in there. It starts to heal; that’s when you think you’re OK. But the process takes longer than we usually think – several weeks at least. When you start back too soon, you’re simply re-injuring yourself".

Roy was right. I found that I had to say off the injury for several weeks, and even then, I had to take it easy when I started back. One miscalculation, and I was back to square one. It was possible, I soon discovered, to diddle around with this injury, literally, for months. (Ironically, I did pull my calf muscle in a skiing accident a couple of years ago, and though it seemed to be a fairly serious injury at the time, I was back to running much sooner afterward than with this pseudo-pull).

Since that initial injury, I’ve had this problem, in both legs, many times. It was always extremely frustrating because it always seemed to happen just as I was getting into halfway decent shape. But each time it happened, I learned a little more and cut my downtime by a few days. I now consider myself one of the world’s experts on this injury, which my buddy Tom Raynor calls a "calf heart attack", and I’ve managed to avoid it altogether for several years now.

The root cause of this injury, according to my orthopedic friends, is compartment syndrome, which means that the sheath around the calf muscle isn’t flexible enough, and when the muscle swells up during exercise, it can’t expand enough to accommodate the necessary blood flow. The muscle becomes constricted, and eventually some fibers tear. Even after it heals, scar tissue often remains, which makes the site a prime candidate for reinjury, thus the cyclical nature of this problem.

If you’re prone to this injury, you’d do well to focus on it right from the beginning. Otherwise believe me, it will frustrate you for years.

Here’s a program for dealing with calf heart attack syndrome, including both short-term treatment and long-term prevention and maintenance:

Step 1.

Stay off it for as long as it takes to heal completely. I recommend at least a week. Do some wet vesting or cycling, but don’t run just because it feels better after a day or so.

Step 2.

Get as much massage – including self-massage – as you can, TheStick massage tool has been invaluable to me in this regard (because this injury is in deep, icing has not been as helpful as it has for most injuries). Definitely don’t stretch your calf yet. Let it heal first.

Step 3.

This step is the real "secret" to recovering quickly from this injury. I’ve found that it can cut recovery time from weeks or months to days. After a week of no running, start back with a "medicinal workout" on a track or another flat, controlled surface. Start by walking a mile, then jog very easily for a few hundred yards, and then walk again. Alternate between walking and jogging for three or four miles or until your calf begins to feel numb or sore. Then stop immediately. Your goal is to get as much circulation to it as possible without re-injuring it.

Step 4.

If you get through the whole session and your calf still feels good, you’re still probably not healed, but you’re on your way. Take a day off and then repeat the procedure. Do this every other day for a week; increasing the jog portion of the workout as your calf improves.

Step 5.

After a week of the medicinal workouts, try a short, very gentle run of three to four miles, on as flat a surface as possible. As always, if your calf gets numb or the sharp pain reappears, stop immediately and walk back. Remember the cyclical nature of this injury. Keep adding to your mileage and intensity day-by-day, but be ready to retreat at the first sign of trouble. After a few such runs, if you haven’t overdone it, you’ll be back to your normal routine.

Step 6.

The long-term key to prevent a recurrence is just to stretch the hell out of your calves and Achilles tendons. I use a homemade, 45-degree stretching board in my office, which I try to get on several times a day, standing on the high end and lowering my heels as far as I can.

Again, make sure the injury is completely healed, and then make serious calf stretching an integral part of your routine. Continued use of TheStick is also highly recommended, both to mitigate any scar tissue and to keep the muscle and sheath as flexible as possible.

So take it from a long-time sufferer, the next time you "pull" your calf and it doesn’t seem to heal, consider changing the diagnosis to "calf heart attack", and get yourself back on the road to good health.

RT

John L. Parker Jr. is the associate publisher and editorial director of Running Times

To Calfed up once......That article hit the nail on the head!

It describes what I am going through EXACTLY...Numerous recurrent calf injuries-both left & right...the sharp pain after a few miles..as well as the recovery process. I have learned that it takes me a minimum of a week to 10 days off. I've also learned a similar recovery process of every other day running while slowly increasing the miles-similar to the steps in the article. Sometimes it works the first few times running and other times I learn that its not fully healed.

THe new info is the stretching throughout the day, as well as "the stick". I will definetely incorporate these into my routine. Everything helps!

THanks again. It's nice to see that I am not alone in this injury!

OldSchooler

After turning 40, tight calves became one of my most consistent problems. I found that if my calves got knotted up, I could count on several weeks for it to clear up. I make sure that I stretch them out consistently. The best preventative measure I have found (courtesy of Keith Brantley several years ago) is to do calf raises on a stair. I do each leg separately. With my toes on the edge of the stair, I stretch the heel down, bend the knee slightly and do 10 calf raises on each leg. I try to do this a couple of times a day, including before each run. When I'm consistent with this, I have no problems with achilles or calf stiffness, but when I go awhile without doing this, I have problems with my calves. I can't promise anything, but it does work for me. Oh, to be young again! Back then, things cleared up by just backing off for a day or two, but now, everything/anything takes a month to heal! Good luck!

It sounds like you're getting the necessary input, but I am curious if anyone else thinks that 100-200 calf raises per day might be a bit excessive? Perhaps this is contributing to the problem rather than alleviating it?

Yes calf raises contribute to the problem.

My calves kept getting tighter to the point of keeping me from running.

I started doing 10 minutes of astanga (power) yoga sun salutations each morning before running, and the problems disappeared.

This book/method is endorsed by the New York Road Runners Club.

The point is that you stretch where the tightness is "not", rather than where it is.

By stretching and lengthening the other muscles that are loose, this relieves the pressure on the tight ones.

100 Calf raisers only took about 3-4 minutes. I did them fairly quicky on the stairs twice a day. Since I got injured with the same regularity as before I figured they were not helping. Also...I was doing some reading about "Compartment Syndrome" and thought that this is what I had at the time and figured that calf-raisers would not help solve the problem but worsen it.

I do see the value of calf raisers but I think I should do them much slower, from what I am reading here. SLower seems that it could function as both stretching & strengthening ?

Ruth.....Nice to hear from you. Hope all is well with you and Tom!.

OldSchooler

OldSchooler,

We are fine. I am teaching/coaching at a private school. Tom is a real estate broker managing an office and training new agents. We have 2 boys. Michael is 14 and we adopted a Russian boy a year and a half ago. He is 10. My running is now recreational for the most part. As I got older, I found I was training harder to run slower.

I feel silly agreeing with Ruth. Not like she needs my endorsement. I've had calf strains for about 5 years, starting in my 30s. In 2003, I had 6 of these bastards, including during leg 1 of the Hood to Coast relay. That sucked. This year, one real strain with more mileage than last year. Stretching is key.

Best solutions for me:

-Serious stretching, especially eccentric stretching like on a stair. Has to be more than just pushing on the wall. You need to increase range of motion. Also, during recovery, gentle eccentric stretching (lift up with the good calf, lower yourself off the end of a stair with the recovering calf) helps muscle fibers regrow straight and flexible.

-Full stride evaluation from physical therapist -- my orthotics were not well matched to my stride motion.

I've had this same injury. THanks for sharing. I am going to try what you have. How it is working?

Jonny B