- Don’t neglect to strengthen the soleus muscle
- Don’t train the calf muscles daily
- Use different types of exercises to rehab, not just the generic calf raise.
- Cross-train to keep as much of your aerobic fitness as possible
- Keep training the muscles higher in your leg e.g. quads and glutes
We see a lot of calf injuries, many of the tips for calf injuries are also helpful advice when rehabbing from an Achilles injury, shin splints, or an ankle injury. Of course, there are subtle differences. We’ve stated our main tips for calf injuries above if you want to learn why we’ve advised these then read on a bit further.
What is the soleus muscle?
For those of you that don’t know the soleus muscle is one of the two main muscles of the calf. The calf is made up of the gastrocnemius and the soleus. The gastrocnemius is the big muscle that clearly defined when you see somebody tense their calves. It looks different in everybody but it is the “mirror” muscle of the calf so to speak. Soleus is the deeper more central muscle of the calf and they both join at the base to form the Achilles tendon.
Why should you focus on soleus?
Soleus is the bigger of the calf muscles and generates three times the force of the gastrocnemius. It is responsible for the work of the calf when the knee is bent and is often overlooked by many in their training.
The gastrocnemius is mainly made up of type 1 muscle fibres which are mainly for speed. This means the gastrocnemius is a more powerful and explosive muscle whereas the soleus is an aerobic muscle and is used more in longer runs and walking.
The soleus is also highly active when you are cutting and turning during field sports. Strengthening the soleus will help reduce chances of reinjury, and improve performance if you are playing GAA, football or rugby.
Too often field sport players ignore the soleus as it’s seen as a muscle for distance runners. The soleus is important for distance runners as much as it is important for people playing GAA, rugby, or football. Just to be clear when I was distance runners I don’t just mean marathoners, I’m talking everyone out there trying out park run (https://www.parkrun.ie/) or couch to 5km or just jogging themselves for fitness. Any running of a steady pace is going to need some soleus strengthening.
How much strengthening should you do for the calves after an injury?
When it comes to how many sets and reps have to be determined based on your capacity post-injury. Here, at the pain and performance clinic, we advocate for loading and strengthening muscles as soon after an injury as pain will allow. Too many physios avoid pain totally.
One thing I can say for definite is you should not be doing calf exercises every day. Some mobility work or big multi joint exercises like squats and lunges can be done daily.
But, when it comes to isolated calf work, doing calf exercises every day is going to make your calf sore from not giving it rest. That goes for hamstrings and biceps too.
The calves need some good strengthening after an injury but also a day to recover after strengthening work. When it comes to strength training often the recovery is as important as the training itself. Not allowing for adequate recovery and over training is often why we see people in our clinic.
What kind of exercises should I use to strengthen my calves?
There are four kinds of exercise that we generally recommend for calf injuries and calf rehab.
- Isometric
- Concentric
- Eccentric
- Plyometric
Isometrics are exercises where you hold in one position. You aren’t moving but the muscle is tensing and working. Concentric is the “pushing” portion of the exercise. In a calf raise this would be coming up onto your toes. Eccentric exercise on the other hand is the opposite of concentric. So in a calf raise this would be the lowering portion of the exercise. Finally plyometric exercises are stuff like hopping and bounding.
So which of these is best for calf rehab? Well, it’s all of them a rounded plan should use all to improve your calf strength and get you back walking, running or playing sports pain free.
Of course on top of these strengthening exercises your rehab should also include sport specific exercises too. Depending what you play and even what position you play this will change your rehab. GAA players need to be able to turn and pivot, rugby players need to be able to tackle, props need to scrummage, basketball players need to be able to pivot and rebound and so on…. A good plan should not just include strength or mobility work it should also address the demands of whatever sport you are playing even if it is only recreational. If you enjoy your five-a-side then you need to rehab for it appropriately, even if it isn’t the champions league level.
What is cross training?
No we don’t mean using the “cross trainer” machine in the gym will specifically help for the calves. Instead we mean you should do some training for your aerobic system that doesn’t aggravate your calf and isn’t your usual type of exercise.
For example if you’re a runner with calf injury. You will be doing your calf rehab every second day. The reasons for every second day are outline above. On every other day then it may be a good idea to do some cycling or use an arm-cycling ergometer to train your aerobic system so that you don’t lose your general fitness while you are rehabbing your calf.
Using your injured calf to get out of cardio is a handy excuse. If you’re dedicated you can minimise your loss of fitness elsewhere. Google Sonny-Bill Williams using a rowing machine with only one leg. Some ingenuity there. Where there’s a will there’s a way! When you go back running/playing sports after your calf injury if your aerobic fitness is still good it’s one less area that you are worried about.
Cross training is actually a good idea even when you aren’t carrying an injury. As a runner, adding a light cycling day can help keep fitness up, aid recovery and reduce the amount of mileage you need to run. Or if you’re playing a field sport swimming may be good for you once a week. Swimming is a great aerobic exercise and by not being on your feet will take some pressure off your legs.
Why should I keep training my other leg muscles when my calf is injured?
Too often when we injure one area we start neglect training as a whole. Just because you’re injured doesn’t mean you should let the rest of your body get weaker. Of course with a calf injury it is obvious that you can still train your upper body.
But, you can still train your lower body even if your left calf is out of commission for a while. Firstly you can start by training the opposite side. There’s a phenomenon called the cross over affect when single leg exercises or single arm exercises maintain strength on the opposite side too.
It’s believed to be because of a neural effect within the nervous system. But, even if it all turns out to be fake no harm bullet proofing your other calf so it doesn’t happen to the opposite leg another time.
On top of training the opposite calf you can use this time to work on exercises like single leg glute bridges or single leg squats. And it is definitely safe to work on the hips and quads of the injured side. Hamstrings I’d avoid just because some hamstring exercises can have calf involvement too. But, you can definitely do some seated or lying exercises to keep the quads and hips strong on the injured side.
How long should I keep doing my rehab after I’m back from my injury?
When it comes to continued rehab once you’re back playing sports or back pain-free you need to keep strength training up once if not twice a week for at least 6 months. The biggest risk factor for injury is a previous injury in the same place. It’s not that you are always going to have a “bad” calf because you injure your calf once. This is most likely because rehab is not thorough and fully followed through the way it should be. After you have completed your initial rehab and have returned to sport here at the pain and performance clinic we will always leave you with what we call an “exit plan”. This is in the hopes of reducing your chances of re-injury.
When it comes to calves this exit plan will include five minutes of strength work you can do before training/matches as an addition to your warm-up plus one strength session to be done a week. If you are on a week off from football/hurling/rugby you will generally do two calf-specific sessions to maintain the strength in your calf and prevent the chances of re-injury.
If you were a patient of ours you would have a specific plan to follow but our general rule of thumb advice is;
One dedicated calf strengthening session a week plus calf work in match/training warm ups for 6 months minimum post return to play.
OR
Two dedicated calf strengthening sessions a week for minimum 6 months if you have no sport to play (i.e. never played sport, or an athlete with no training/matches in a given week.)
These are the time frames for calf injuries specifically. This advice will change depending on the location of your injury. E.g. shoulder issues, especially a shoulder dislocation, require consistent shoulder strengthening for far more than 6 months. But, an overuse knee injury from running may need less specific intervention once return to running has occurred pain free but we would still advise runners to strength train in general to improve performance and reduce chances of injury in the lower limbs.
If you have any questions about your calf injury or any injury for that matter feel free to contact us via email, by phone or through our social media channels.
