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Jogging & Running/Strained calf - - questions re recovery/training

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Hi Nick,

You helped me in the past (we had a number of post exchanges) regarding my torn TFL last November.  Thanks so much for your help!  The great news is that the TFL has not flared up at all.  I worked my mileage back up to 11.5 miles (my normal mileage on long runs is 13 miles).  The bad news is that the weekend following the 11.5 mile run, I did a 7 mile trail run (this past Saturday), which included 5 hill repeats in the middle, and got a mild calf strain.  ] :  

How it happened - - I ran a 3.5-mile trail run, then stopped for hill repeats - - during the second hill repeat, I felt a cramp in my calf, so I stopped and stretched it and it felt fine, so I went on to do three more.  My calf felt fine as I went on to finish the 7 mile run.  I have been getting deep tissue massages monthly and had an appointment that afternoon.  I didn't realize I was injured, my calf was a little sore, but didn't think much of it.  Probably should have left the calf out of the equation.  So anyway, coming home from the massage, I was thinking, the therapist didn't work my calf good, because it was sore and a little stiff.  The next morning though my calf wasn't tight or sore, so I didn't think anything of it.  I went to the gym and spent 25 minutes on the StairMaster, 25 minutes on the spinner, did some squats with 10 pounds and did some leg extensions on the resistance machine.  Still felt fine.  The next day (Monday#, I tried to do a short lunch run at work and when I got to mile 2, my calf cramped up and was slightly painful.  So, I stopped and walked back to work and saw the doc the next day.  He says the strain is very mild.  I am now at day 6 and it is still slightly tender and there is a very mild pain if I press on it.  I am wearing KT tape on it. I of course would love to get back out there running as soon as possible, but will likely take this weekend off and hit the bike at the gym.

I am so disappointed.  Not sure where to go from here to remain injury free. The sports injury doc says I should never incorporate more than a 5 mile run with hill repeats. These two injuries, beginning with the TFL, are my first ever and I have been running for years.

I began forefoot running the beginning of last year and was fine all last year until the TFL just before Thanksgiving last year.  The TFL tear happened I think not too long after I was making efforts to improve my speed, adding more speed runs into my training.  I ended up with a faster general speed overall with every run.  

Well anyway, I'm aware that the calves take a lot of the impact when you forefoot run and will be working to adjust that a bit when I get back out there -- trying to land with a little more of the thought of letting my heel kiss the ground slightly when I land on my forefoot - - rather than coming down with a pointed foot.  I'm hoping this will protect my calf enough from becoming reinjured - - coupled with not doing hill repeats until I feel strong and to not incorporate them with longer runs. #;

The doc says he thinks I strained the calf because of the way my knee turned or something when running up the hill.  Not sure that's the case.  He just tested the strength in my foot and my knee and came to that conclusion (my knee on the left side didn't perform as well as the knee on the right in resistance testing - - which was a cursive kind of manual test).  I think it happened because I was just building up my miles and my calves were probably just getting used to that after my three weeks off from running and the hills just pushed them over the top.  

Is there any information you can provide me with that will support fast healing and strengthening of my calf, as well as any training suggestions when I do get back out there?  I really appreciate your advice.  Thanks.

Answer
I'm sorry to hear about your new pain/injury Cecilia.  Calves can be tough, but I believe you'll end up being alright.

1) I think your changing your foot strike a little is a great remedy. I always say that if running isn't feeling good then change something slightly.

2) Right now let your calf heal and don't push through the pain. Gradually build up to where you want to be.

3) I'm not a strong believer in stretching for many parts of the body, but I am for the calves. Stretch often, but not an intense stretch.

4) Further, do some calf raises on a raised surface. This will enhance your body's ability to work in a lengthened position. Don't do too many. Just use body weight and maybe 3 sets of 8 repetitions.

5) Do the Total Motion Release techniques (we discussed previously) before every run.


If you don't have alleviation of the problem soon then I suggest finding a physical therapist that has SCS or OCS credentials after their name.

Please let me know if you have any questions about these suggestions or further questions. I hope you're back in full action quickly!

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Nick Rainey

Expertise

I can answer questions about pain and training program. If there is a question about running that I don't know then I'll do some research and make sure I provide you with an answer.

Experience

I'm a Doctor of Physical Therapy. I'm a track and cross country coach. I train clients throughout the year. I've helped prepare athletes for their NFL Pro Days. I've written articles on running. Finally, those that I work with have less pain and run faster.

Organizations
American Physical Therapy Association- Sports Section

Publications
The 6 Week Workout Program- I'm the author of this book Research Made Simple for Physical Therapists- I'm the author of this Kindle book

Education/Credentials
Board Certified Clinical Specialist in Orthopaedic Physical Therapy Doctor of Physical Therapy BS in Exercise Science NSCA- CSCS and CPT USA Weightlifting Level I NPI- Certified Posture Specialist Total Motion Release Level II Certified Dry Needling

Awards and Honors
National Posture Institute's International Perfect Posture of the Year Award 2011 Clinical Excellence Award- Rocky Mountain University of Health Professions Aegis Therapies Scholarship recipient

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