Over the last few weeks I've had several patients come in to Team Chiropractic and Rehab of Ames with calf strains.  These people have hurt themselves running, golfing and kickboxing.  All of these activities demand a lot of strength and explosive power from the lower body (yes golf is a lower body sport).  It makes sense that an increased demand on the two muscles of the calf (gastrocnemius and soleus) would lead to a possible overuse and injury.  Typically, a calf strain consists of a small portion of the muscle fibers tearing, resulting in a painful inflammatory reaction.  At Team Chiro, we don’t just aid our patients in healing faster, we try to educate our patients on why their injury occurred and what they can do to prevent it from happening again.  Functionally, I believe calf strains occur when there is a loss of motion in the ankle and/or a loss of functional gluteus strength.

There are several reasons why modern man’s ankles become tight.  First, most of us end up sitting in a desk /car all day, or we stand all day on flat hard surfaces.  In both of these situations, the ankle is not challenged in all three plains of motion like it would be if we lived and worked all day on a primitive farm.  As the old saying goes, “you use it, or you lose it”, well most us lose it when it relates to ankle mobility.  Another common cause of lost ankle mobility is improper healing fallowing an ankle sprain.  It is very common for the injured tissues of an ankle sprain to heal in a manner that restricts motion in the ankle if it is not properly rehabbed. (Hint: don’t just brace up a sprained ankle for a few weeks and call it good, get it checked out by a sports medicine professional.)

When an ankle stops moving effectively, the muscles of the calf suffer.  Say you lose 25% of your ankle range of motion, now physiologically the calf muscles begin to adapt to their new demands.  The fibbers that help the muscle open up to it normal range of motion begin to contract over time.  I use the analogy of some glue being spilled inside your muscle and hardening around the fibers that are no longer stretched due to the restricted ankle motion.  Now, when this individual with the restricted ankle and compromised calf muscle tries to do something explosive like run up a hill, hit a golf ball out of the heavy ruff, or burnout on roundhouse kicks, their calf is setup to fail.  The injury will occur when the muscle fibers of the calf that are doing all the work fatigue, or when the person puts the foot in a position where that lost 25% range of motion is needed and the weak contracted (glued) muscle are challenged.

Another interesting theory on why people strain their calf muscles is that the calf is compensating for weak glutes (your butt muscles). The human glutei muscles are the largest muscles in our bodies, yet many of us don’t use them effectively.  Functionally, our glute muscles extend and rotate the hip/pelvis, propelling our bodies forward.  Technically, our calf muscles can mimic the forward propulsion that the glutes perform, only from the ground up.  But, that’s a lot of extra work placed on the calf, leading to overstrain and injury.  It’s easy to visualize the mechanism of calf muscle compensation when you think of someone running up a hill without the ability to powerfully extend their hips. It’s harder to visualize the weak glutes and an overstrained calf in a golf swing or a roundhouse kick.  The calf that typically gets overstrained is the rear leg in the golf swing and the calf in the kicking leg; it is actually compensating for the opposite side glute muscle weakness.  Yes the opposite glute, if you are kicking with the right foot, the left hip/glute is where you start to generate all of the power for the right leg.  When the left glute contracts it helps pull the pelvis and torso around, initiating a powerful impact with the bag.  The calf injury will occur when the calf on the kicking leg pushes off the ground, trying to compensate for the weak pull of the opposite hip.

In golf, both glutes are important to a powerful efficient swing. On a right handed swing, the left glute will extend the pelvis, while the right will help with pelvic rotation on an explosive follow-through. If the glutes don’t activate the golfer will have a difficult time staying down on the ball (early extension); part of that problem starts in the calf musculature trying to excessively push the body off the ground to force the needed extension and rotation to swinging club.

The moral of this blog post is stretch your ankles and calf muscles, and don’t ignore your glute muscles when it comes to preventing future calf strains. If the glutes don’t contract, a person can compensate and try to generate all of the needed force from the calf to try to push the body into rotation and extension.  Of course you can only do this so long before something breaks down!

Believe it or not, when you were 10 months old, you probably had better push-up form/technique then you do now!  How can that be?  It’s actually quite simple, a healthy infant trains their stabilizing muscles all day long.  They do this by the simple act of crawling.  When you think about it, spending all day on your hands and knees does wonders for developing the muscles that run from your back and ribs to your shoulder blades (scapula), these muscles are what we in the rehab community call scapular stabilizers.  Specifically, the scapular stabilizing muscles are: lower trapezius, serratus anterior, and rhomboids.  Unfortunately these muscles are often underdeveloped and neglected.

As we get older, we tend to stop using the scapular stabilizing group of muscles in our modern lives.  We spend hours sitting or standing with sometimes not so great posture.  Even people that “go to the gym”, may not have an adequate ability to control their scapula because many of the exercises they preform are pushing exercises (there is a difference between a bench press and a push-up functionally).  It is not coincidence that many of my patients that have shoulder pain and or neck pain/mid back, have tight chest muscles (Pec and Pec minor) and tight muscle that run from the neck to the shoulder (upper trapezius and levator scapula).  Typically these muscles tighten because the scapular stabilizing muscles are under developed and under-utilized, leading to a rounding of the shoulders and an observable “winging” or elevation of the shoulder blades.

Back to the baby push-ups  to crawl effectively an infant must be able to keep their shoulder blades “glued” to their rib cage.  This allows them to shift their body weight from one arm to the other as they pivot and crawl forward.  Without this ability to stabilize their scapula, they would not be able to move from one arm to another while holding up their body. This concept of scapula hugging the rib cage is the big difference between a proper push-up and an exercise like a bench press.  Bench pressing is grasping a weight and moving your hands up and down, actually the opposite motion of a push-up functionally. Preforming a proper push-up is really about using your shoulder blades to lift your torso up and down, much like the infant uses the shoulder blade to control the body while crawling.  The concept may seem simple, but most people focus on their arms and hands too much when preforming push-ups and actually put their shoulders in a compromised position leading to increased strain on the shoulder and eventually impairment.  Instead, focus on the tips below to help you revert back to your perfect baby style push-ups:

·         Start on the ground perfectly flat, lift the hands up of the ground and squeeze the shoulders blades down and back. (Keep the shoulder blades glued to the rib cages during the whole push-up movement)

·         Place the hands on the ground using a narrow hand position

·         Keep the hands below the plane of your shoulders

·         Direct the crease of your elbows forward (toward the direction of your head) as you push up

·         Shift the weight in your hands off the index finger and thumb to a more balanced palm pressure

·         Keep your pelvis and lower back in a neutral position

·         Keep your chin tucked in and your head retracted back.