The calf is the area at the back of the leg that is situated between the back of the knee and the ankle. While calf injuries may seem relatively insignificant to knee or ankle injuries, calf injuries can be a significant source of lower extremity pain and immobility.
Anatomy Of The Calf
The strong muscles and tendons in the calf are used during everyday walking, running, sprinting, jumping, and lunging movements. Basically, any movement that requires a push off from the toes or the heel being raised involves the calf muscles. Without the calves, plantarflexion wouldn’t be possible.
The three superficial muscles of the calf are the soleus, gastrocnemius, and plantaris. These are called the plantarflexors. The gastrocnemius muscle is the most superficial. It actually has two heads, one originating from the lateral condyle of the femur (thighbone) and one originating from the medial condyle of the femur. The soleus muscle is slightly deeper and located just underneath the gastrocnemius. The distal end of the gastrocnemius and soleus muscles unite to form the Achilles/calcaneal tendon, thereby connecting the heel to the calf. The plantaris is a much smaller muscle that runs between the gastrocnemius and soleus.
The deep muscles of the calf and their tendons also assist with plantarflexion, but have additional roles in foot and toe movements. These muscles are the tibialis, flexor hallicus longus, flexor digitorm longus, and polpliteus.
What Causes A Calf Injury?
Calf injuries are commonplace in sports, especially contact sports and those requiring pushing off from the toes. Direct trauma to the calf may occur when the calf is compressed or struck during a fall or car accident. However, if the calf muscles are tight, fatigued, overexerted, or overused, even the most routine daily activities can result in a calf injury. Muscular imbalances that involve the quadriceps being stronger than the calf muscles can also place one at risk for a calf injury.
What Are The Most Common Calf Injuries?
Most injuries to the calf involve the muscles and tendons.
Calf Strains / Pulled Muscles
A calf strain is an injury to one or more of the muscles and/or tendons in the calf. Strains occur when the fibers of the muscle and/or tendon are forcibly stretched beyond their normal elasticity or torn. The Achilles tendon is the most injured tendon in the entire body. Muscular strains of the calf most commonly occur in the medial aspect of the gastrocnemius muscle. This particular muscular strain is a common injury seen in tennis and is sometimes called tennis leg.
Calf strains are graded one through three based on the amount of damage to tendon or muscle fibers. A first degree strain involves stretching or microscopic tearing of the fibers, but doesn’t limit the function of the calf muscles. A second degree strain involves a moderate amount of fibers being torn and some loss of function. A third degree strain is the most severe and involves extensive to complete tearing of the muscle fibers that severely limits function.
Calf Muscle Contusions
A muscle contusion is a bruise that reaches the muscular level. It is the result of an impact, trauma, or compression that crushes the calf muscles against the underlying bone. The capillaries near the muscle are damaged during the injury, which results in blood seeping into the interstitial tissues and muscle tissue.
Like strains, muscle contusions are graded based on the severity of damage to the muscle. A first degree muscle contusion results in mild bruising and tenderness with little, if any, swelling. The calf retains normal function. A second degree muscle contusion impacts deeper muscle tissue and produces moderate bruising, swelling, and tenderness. The calf may feel stiff. A third degree muscle contusion produces severe bruising, swelling, pain, and immobility. A force strong enough to produce a third degree muscle contusion may also result in a strain, bone contusion, and possibly bone fracture.
Calf Cramps
A calf cramp is a sudden, forceful, and involuntary contraction of the calf muscles. Calf cramps often accompany traumatic injuries to the muscles and bones of the lower leg. This is possibly a natural response to stabilize the injured area and prevent movement. That said, it’s still unclear what exactly causes cramps in general to occur, but the following factors are commonly associated with muscle cramping:
* episodes of vigorous exercise
* overuse, prolonged use, or repetitive use of the calf muscles
* prolonged periods of standing or sitting
* nutritional deficiencies
* dehydration
Strengthening Exercises
These Calf Exercises are ideal to build strength and flexibility.
Massage Treatment
These Calf Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments and soaks.
ACUTE STAGE SYMPTOMS AND TREATMENT
When there is swelling and inflammation in your calf.
ACUTE STAGE SYMPTOMS:
The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the calf because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured calf, causing pain, inflammation, lumps and swelling.
The sensation of heat is due to the warming action of the blood and fluids overheating in the injured calf as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
During the acute stage it is very important to restore normal circulation to the calf, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the calf, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the calf can strengthen and regain it's mobility.
ACUTE STAGE TREATMENT:
1. Apply the Sinew Herbal Ice on your calf to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the calf. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.
Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that don’t heal well.
2. Massage your calf with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
CHRONIC STAGE SYMPTOMS AND TREATMENT
When there is NO swelling and inflammation in your calf.
CHRONIC STAGE SYMPTOMS:
The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in your calf that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.
Your calf may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your calf you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.
Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.
During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the calf, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.
CHRONIC STAGE TREATMENT:
1. Massage your calf with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. The Sinew Relaxing Soak can be used in-between applications.
2. Soak your calf with the Sinew Relaxing Soak to relax muscles and tendons that are in spasm, ease joint pain and stiffness, and improve range of motion. The Sinew Relaxing Soak is particularly useful if you feel restricted mobility in your calf. The soak can be used by saturating a towel in the liquid and applying it to your calf. Chronic Sinew Liniment can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
