Calf tears

One of the problems that I've had to deal with constantly are tears in the muscles of my calf. I have found a system that seems to work for me in getting back on the roads as quickly as possible and reducing the chance of a re injury. I put this hear because I'm tired of answering this question all the time. Easier to just point to this link.

Often these seem to happen around mile 20 of a marathon. They start as a cramp, and as I continue to run on it the muscle fibers tear in the area around the cramp. This leads to even more muscle damage. The day after the marathon, the calf is very painful to the touch and I can hardly walk on it. The pain can last for a while and the site of the injury becomes a locus for future injuries to the muscle.

When you injure the muscle tissue the body attempts to heal it. There is an inflammatory reaction around the site of injury and sometimes even bruising. As the body heals the damage, scar tissue can be laid down. You can feel this scar tissue with your fingers in the weeks after the injury as a painful knot deep in the muscle. In can sometimes feel like a hard marble imbedded in your calf. This is a knot of scar tissue and the remains of the inflammatory material. Even after there is no pain and you can run, if this knot is present it will be a site that re injures again. The idea is to get rid of this knot so the muscle can function more normally.

What to do

If you feel your calf cramp up and it becomes painful try these steps.

• Stop running! If you continue to run you can either create tears in the muscle or simply make the injury worse. Unless you are in the waning miles of an important race, pull up and call it quits.
• Ice. As soon as you can, ice the calf well. This is often tough to do since the injury is deep in the muscle. I use an ice wrap around the calf. Others have recommend using the frozen Dixie cup trick for use as an ice massage. At least 15 minutes.
• Don't stretch. One of the temptations is to try and stretch the muscle. If it is damaged, stretching can simply exacerbate the injury. You want it to heal up first, worry about increasing flexibility later.
• Time off. One of the hardest things to do is to take enough time off for the calf to heal. You should do anything that makes the calf hurt. If you can walk without much pain, fine. But if it hurts when you run, don't even think about running. Depending on the extent of the injury, this can take from 1 to 4 weeks.
• Massage. Besides not making it worse, this is the most important thing you can do. You need to massage that painful knot in the calf muscle 2-3 times a day until it is no longer painful and until you can no longer feel it with your fingers. The best solution is to see a massage therapist have them do it for you. I'm too busy and broke so I do it myself. This is a great application for The Stick. Roll across that knot, or massage it with your fingers or thumbs. The point is that you have to do it hard. What you are trying to do is gradually break down the adhesions between the muscle fibers so they can slide smoothly again. If not, as the muscle works this scar tissue will just create new micro-tears in the muscle tissue. The massage hurts, a lot. Follow every massage with ice to keep the inflammation down and take some NSAIDs if your Doc has OK'ed it. Again, keep this up until the site is no longer painful and you can't feel that knot anymore.
• Stretch. Once the calf doesn't hurt (except when you are massaging it, you can start to stretch. The idea is to increase flexibility to help avoid the same problem in the future. The stretching isn't going to help cure the existing injury but is to just prevent it again. Stretch gently!
• Comming back. This is when I actually am glad that my wife has a treadmill. With this type of injury, you can feel fine for a few miles, then suddenly you can feel the pain return. Not good if you are miles from home, it is cold and dark and you are dressed for running, not hobbling. As soon as you feel any pain in the area of the injury STOP. If you keep running you will just slow down your eventual recovery. If I'm on a treadmill I can just stop and ice if this happens.

As always, this is what works for me. The best thing to do is to go see a physical therapist so they can give real professional help.

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