Lower Leg Injuries
The rate of injuries to the lower leg is high. The knee has the highest incidence of injury in runners. After that, the lower leg is the most vulnerable area. This is partly because of the wide variety of injuries that can occur between the ankle and the knee. We look at some of the most common including calf strain, Achilles tendonitis, and shin splints.
Anatomy of the calf muscles
The calf consists of two main muscles. Gastrocnemius forms the belly of the calf. And the soleus muscle sits beneath it. The calf is attached to the heel by the Achilles tendon. This is a long fibrous tendon with notoriously poor blood supply.
Calf Strain (pulled calf muscle)
Symptoms: A feeling of sharp pain, tightness or weakness in the calf. Often accompanied by mild swelling. Occasional spasms, and more pronounced pain when standing or walking.
Cause: Overstretching or tearing of either of the two muscles of the calf. Often caused by accelerating during running or changes in direction
Prevention: Making sure that you thoroughly warm up and cool-down as per the earlier instructions. Also, ensure that increases in training load are progressive and incremental.
Treatment: Rest, and only return to running once the calf is completely free from pain and swelling. Ice/Cold compression. Wrap in a soft cloth and apply to the calf for about 8-10 minutes. Repeat about every 2 hours until the swelling goes down. Elevating the calf above the heart (when possible) will also help reduce swelling.
Symptoms: Dull ache or sharp pain on the tendon when pushing off from the foot. Tenderness/stiffness in the tendon that lessens as you warm up. The creaking sound when you touch or move your Achilles tendon.
Cause: This is a chronic injury that builds over time. Often caused by increasing mileage or running speed too quickly. Can also be brought on by hill running or hill repeats
Prevention: As for calf strain (see above). In addition, it is important to include bent knee calf stretches as part of your post-stretch routine.
Treatment: The Achilles needs more rest than many other injuries. Usually a minimum of two weeks, but longer for more serious cases. To help restore it properly it is advisable to do specific strengthening exercises prior to recommencing running. Standing or seated calf lowering is very beneficial. We recommend consulting a physiotherapist to ensure full rehabilitation.
Symptoms: Pain felt over the inside of the tibia (shin bone), often dull and aching. Worsens during running. Often accompanied by tenderness and swelling around the area.
Cause: Although causes can vary, the main cause in runners is the repetitive stress on the anterior tibialis muscle. This stress leads to an inflammation on the bone attachment site of the tibia.
Prevention: Ensure you have the right footwear. Vary the types of surface you run on (hard surfaces exacerbate shin splints), and allow adequate rest for tired and sore muscles.
Treatment: Rest (normally for up to two weeks), ice compression and massage. It is often possible to cross-train during recovery with activities such as swimming, yoga or Pilates.