GUEST POST: HOW TO PREVENT LOWER LIMB INJURIES BY RAMNIK SAANDAL
How to prevent lower limb injuries:
This week one of my friends was complaining of pain behind the right leg and the ankle. I told him to pop down into my clinic so I could examine his condition further. He’s in this early 30’s and usually commutes to work by public transport within the city. So, you can imagine he’s always on his feet. He has had this pain for around 6-8 month.
I automatically suspected it to be a calf muscle injury just as he walked in. He said his G.P did an X-ray but found nothing. However, an x-ray will only show bone. An MRI or ultrasound scan is required to view soft tissue.
As he sat down on the plinth as he took his shoes and socks off. Before I tested the joints and muscles I asked him to tip toe.
He could not tip toe as this was very painful for him. I then tested his joint on this foot and told him that this was definitely a calf injury and most likely a micro tear on Achilles tendon, known as achilleas tendinopathy. He replied ‘how do you’, ‘you haven’t even done any scans’. I told him that just from the fact he could not tip toe and the weakness in his ankle joint points out that his calf muscle is injured.
So today I am going to be talking about stretching exercises you can be doing which will help you prevent lower limb injury, particularly to the calf muscles. Our lower legs are one of the most used parts of our body. Therefore, regular sports and use of the calf muscles can cause micro tears through repetitive trauma sustain. Even when we exercise we use these muscles.
What is the calf muscle?
The calf muscle connects to the Achilles tendon. The Achilles tendon connected to the heels bone behind the ankle which is known as the calcaneus. The calf muscle consists of two muscles, a) the gastrocnemius and b) the soleus. They help flex the ankle joint which is known a plantar flexion, such as tip toeing. It acts as a massive shock absorber
The gastrocnemius originated from behind the knee where else the soleus is much deeper and originates from behind lower leg.
The gastrocnemius is the bigger part of the muscle and has two bellies forming a diamond shape. The soleus is much small is underneath the gastrocnemius.
We need the calf muscle in order to walk, run and stand. And therefore, it is important we stretch these muscles before any workout in order to prevent injury from occurring.
Common injury associated with the calf muscles:
Calf muscles injuries are usually the result of overuse. Before we delve into show you some stretches you can do we, here is a list of the most common injuries associated with the calf muscles:
- Calf muscle strain: this is when the muscle is overstretched or pulled and is commonly caused by overuse of the muscle or fatigue. The muscle becomes inflamed and is quite painful. The muscle can feel stiff and there will be a limited range of motion. Tip toeing will be very difficult and painful.
- Calf muscle tear: once a muscle is strained it can lead to micro tears within the tendon of the muscle. The micro tears cause damage to the blood vessels and cause inflammation, bruising and pain. The muscle is weak and you may not be able to use the muscle with no to very minimal range of motion of the ankle joint. You will not be able to tip toe. This is known as Achilles tendinopathy.
- Calf muscle rupture: This is when the tendon has completely torn off or snapped of. This can lead to excruciating pain and in ability to use the calf muscle. This is known as an Achilles tendon rupture and is very well known in the sports arena. One of the most famous cases was when David Beckham sustained this injury and had to has his foot/leg casted and had to undergo surgery.
What to do if you think you have any calf muscle related injuries?
It is important to always seek medical care from your physician where they can take your full medical history and carry out a few tests to determine if it is a strain, tear or rupture. However always stop your activity as continuation can make your condition worse. Particular if you see blood, can’t walk and the pain does not go away.
Now I will show you some stretches you can do to focus on the prevention of calf muscle injuries. Before you start your work out you should always stretch your muscles and take some time to warm up. Heat helps the connective tissue to elongate and become looser. Thus, reducing tension and less chance of causing tears and damage.
Here are some stretches you can do:
- Gastrocnemius: Bend one knee and keep the other straight and slanted as you push against a wall.
- Soleus: Bend both knees while pushing against the wall.
You should feel a stretch at the calf muscle area. Hold for 30 seconds and then swap sides. If this feels too pain full then decrease the angle by pushing back with your arms to ease the tension.
- Wall calf stretch: Both knees straight, place one foot onto the wall. Hold for 20 seconds and switch. This targets the gastrocnemius
- Wall calf stretch: With both knees bent place one foot onto the wall. Hold for 20 seconds and stretch. This targets the soleus.
After stretching your calf muscles, you are now good to warm u and engage these muscles. I like to warm up first on a treadmill for 5-7 minutes, jogging at a moderate pace. Be careful not to make the warm up phase too vigorous as the aim is to all engage all the muscle groups. If you don’t have a treadmill you can jog on a stop which is just as effective. Make sure to jog gently as you do not want to place too much strain on the calf.
Another good warm up exercise is to do light squats, around 10-15. Again, we just need to do enough to engage the calf muscles so they are ready to be used within your activity.
Remember these are light warm ups and you should not exert too much force into the calf muscles.
I hope this advice helps and educated you about stretching and warming up the calf muscles in order to prevent injury. I always stretch my calf muscles and warm them up before working out and have always felt the difference. Prevention is the key but if you suspect you may have calf muscle injury which has not gone over a period of time then it’s a good idea to seek medical help from your doctor or podiatrist.
This article is aimed to educate you on lower limb injury and should not be treated as advice of. The stretches and exercises outlined here are to be done at your own risk. You must not rely on the medical information provided here and by no means should this replace the advice provided from your doctor or other healthcare professional. If you suspect you have any lower limb conditions you should always seek medical advice from your physician.
For immediate medical attention you should never delay seeking medical advice or medical treatment because if information provided here. There are no warrantied for the information here.
Nothing in this medical disclaimer limits any of our liabilities in any ways that are not permitted under applicable law, nor does it exclude any of our liabilities that may not be excluded under applicable law.
Author: Ramnik Saandal is a HCPC board certified practising podiatrist from London who is a specialist on the lower limb, particularly the foot & ankle. His aim is to help people with their lower limb problems. @podiatrist.ram