Monday, December 24, 2012

How to prevent calf muscle pulls and strains

During the last 4 years of running one of my occasional problems has been getting a calf "pull" (or "cramp" or "strain"). I tried to remember all the strains I've had and I think it totals up to at least 8.

Only one of them (Long Beach Marathon) occurred *during* a race, thank god, and I have never missed the start of a marathon due to one (although I did have to bail on a Ragnar Relay I was signed up for)

Along the way I have figured out how to deal with Achillies Tendonitis (perhaps another post on that sometime) as well as dealing with a leg length discrepancy that was beating the crap out of one leg more than the other.

But the strain problem is now my next focus. So let me share what I have found out so far.

What is a calf pull, strain or tear?

Firstly, it's NOT a cramp. A cramp is the sudden onsen of a knot in the muscle due to low electrolytes or dehydration. They can happen in your sleep! I have had them hit me in the foot after a tough day. Not often though. 

Lesson #0: Sadly, a pull/strain/tear is just what the last one says: some of the muscle fibers have torn. Walking or running usually becomes impossible without pain and that pain is there because the involved muscles are trying to keep you from doing further damage. You may have swelling and tenderness in short order. 

As usual with these kinds of things RICE (Rest, Ice, Compression, Elevation) right after the event will save you a lot of time on recovery. (Tip: Use your calf compression sleeves to hold a cold-pack against the injury area and provide compression for the first half day after.)

Treatment Lesson #1: Be CAREFUL after a tear. If you pull up lame in a race, you need to use your best judgement before you proceed. In my Long Beach race, I managed to massage the pull and get it to relax. Then I was able to limp-a-thon my way to the finish. My recovery time did not seem to be worsened by this but it probably was some (i.e. I probably did a bit more tearing getting to the finish) This pull was pretty minor by comparison to some others and was a actually a "re-pull"...the story:

3 weeks before the race I had torn my calf with an too agressive stretch (The kind where you grab your toes with your leg extended......I don't do those any more!). 3 weeks is not really enough time to fully heal..you really need 4 or even 6 weeks to heal before a big stressor like a marathon.

Treatment Lesson #2: Give it time to fully heal. I also was an idiot for insisting on running this race at my goal sub-4 pace....wrongo. I did better with my pull before Berlin....I waited a full three weeks before I did any running, and then only base pace. I made it to Berlin and I also ran a slow (for me ) pace there and so had no problems.

Treatment Lesson #2a: when you start running again, take it easy. No fast paces, speedwork or steep hills. Plain old base pace running is the fastest you should go.

How to prevent calf pulls?

Prevention Lesson #1: Compression sleeves help.  They are not a panacea but  in my humble experience they do give you a little bit of margin for error. All but a couple of my pulls happened when NOT wearing calf sleeves. Why don't I wear them all the time? Sigh.       Good question! I have bought myself 4 pairs of them now so I always have a clean pair.

Prevention Lesson #2: Tight calfs are BAD..stretch!.  The calfs need to be kept loose so that the tension loading during your running is not high..you need the tension loading to be as low as possible during ordinary running, else when you sprint,, head up that big hill, or hit mile 20 in your marathon... here comes a tear!

This is the lesson I forgot during my time off after Berlin. I did a lot of hiking and walking but my muscles were also pretty tight from just sitting a lot of the time too. I was doing NO stretching or squats that would loosen me up and keep me ready to resume running safely.

Prevention Lesson #3: Trigger points are RED FLAG WARNING signs. Do you know what a trigger point is? It's when you get a little knot in your muscle..visualize a rubber band with a little snarly knot it in. This is VERY bad for your calfs because that knot will not stretch. Hence you have shortened the effective length of the muscle. That means more of the range of motion has to come from less fiber ...therefore more tension loading..and rriip!

So a cramp can be a bad sign, because it's a knot...a trigger that is so bad it is in spasm and forcing you to stop. If you don't work it out you may get a tear and be in for some down-time!

When I resumed running after my time off post Berlin  I could feel some funky trigger points and soreness, but it was way around on the left side of my left calf near the top of the outside, right next to the bone. 

Stupidly I did nothing about it, figuring it would go away by itself, and it also seemed to be in an area I wasn't really using in my running. WRONG.

Getting rid of trigger points has several methods:

1) foam rolling
2) the 'stick'
3) jacknobbers and other 'point' tools
4) massage 
5) self massage

We all know we should do more of these things and I did some  of 1 and 2, but my problem was the triggers I had were quite deep and also close to the bone..an unusual place. So neither of these really worked...rolling showed I had soreness but they couldn't get pressure on them to iron out the knots.

Eventually I realized this ..they were the same level of knottyness after two weeks of rollering..and so I got the message and got a massage. YOW! When he found the knots and pressed his fingers in..MAN DID IT HURT!  Gradually after 10-15 seconds I could feel the knots relax and lengthen out. 

I came out of that massage realizing that I had re-pulled because of my own stupidity at not stretching and getting those post-marathon triggers out of there ASAP, rather than letting them sit and adhere to the surrounding muscle for the last month. That just makes it harder to iron them out.

I got two more massages and each time the triggers were less, and relaxed quicker. I complained that my self massage was very difficult: a) it's hard to inflict huge pain on yourself, and b) my fingers just were not strong enough to hold the tension well.

 My massage guy suggested I get a couple of 'jackknobbers'  so I could really do a proper job after every run.

I have been using them for about a week now and they get really the job done! I use a little lotion on the spot where I am applying them and then press in the larger ball shape and work it around..gradually the muscle relaxes and then I shift to the smaller balls to get more pressure..gradually sliding it around to hunt for any more knots.

(NOTE: I paid for my jacknobbers, I am not reviewing them and there are many similar devices that would work just as well, IMHO. )

How to prevent tight calfs and trigger points?

So, now we ask ourselves "Why am I getting these tight calfs and trigger points?"  What is the Uber Prevention Lesson?

We promise to stretch, keep our legs clean of triggers and wear our sleeves, but can't we prevent them in the first place?!?

Yes, I think we can. I'm not sure, but as I mentioned in my previous post I think a 'chi-style' stride will help. The key light bulb moment was when reading the book, Danny (mr Chi) tells us that our lower legs should be relaxed and loose, even floppy if you will. 

We should be getting power from our glutes and hamstrings, NOT the lower legs. 

Say what? My lower legs are NOT FLOPPY. I have decent form (got rid of my AT with it) but I do use my lower legs far too much in my running. So, they get tired. And when I run hard or long, they can get trigger points.

As I recover from my previous errors, I'm trying to keep my calfs uber relaxed. I'm not perfect at it yet but give me another month or two.

All this is just in time for Tacoma training..it's  "only" 19 weeks out so gotta get cleaned up and ready for some mileage building!

Happy Holidays! 

7 comments:

  1. A valuable source of solid information - thanks, Paul! I also had my PT do dry needling in my calves to help get those knots out much faster. I wish I had the strength to do some dry needling on myself, but, haha, no way! I don't have any of the calf knots anymore, but those torn ligaments in my foot this summer are causing me grief on lateral knee joint. BLeh.

    A very Merry Christmas to you and your family! :)

    ReplyDelete
  2. Great post Paul and thanks for the advice!

    ReplyDelete
  3. Thanks Paul,

    I had numerous calf issues in the past before I changed to the chi stride. I also ditched the motion control shoes I was wearing for neutral shoes. I've had no problems with them in nearly a year. I disagree with the stretching part. I do very little stretching and that's helped also. I do a warmup that involves almost no stretching. Stretching the wrong way will damage the calves more, in my experience at least. I do stretch on off days--properly.

    Thanks and I hope you stay healthy.

    ReplyDelete
    Replies
    1. Hi Trent,

      Thanks for that advice about no stretching. I have tried that a couple of times over the last 2 years and I find I do need to do some active stretching (e.g. pushing against a pole with muscles working.. not just passive stretching) or things get really really bad. I do the this after .5 miles of easy running.

      I have always worn a neutral shoe (Brookes Launch)

      Delete
  4. Very informative, especially helpful to me as my calves are my issue too. I've never heard of jackknobbers, I'll check that out. I use the stick a lot, as well as massage. I'll have to see about using my lower legs too much too, never thought about that before.

    ReplyDelete
  5. Thanks for all this interesting information Paul! I hope you are enjoying your holidays...Happy Holidays to you and your family :)

    ReplyDelete
  6. Thank you, Paul, for referring me to this post on my site. I do run Chi - I do however need to open my stride more from behind. I'll be practicing that more once I get over this strain.

    It all makes sense from a rehab POV!
    -Celia

    ReplyDelete

What do you think about all this? Please leave me a comment! 8)