Q+A: Calf strains: Why they occur and how to treat

Q I’m 44 years old and have been running for 20 years. I stretch my calves and hamstrings before I run but have recently suffered a calf strain after a few miles. How can I avoid this and how should these injuries be treated when they occur?

A From our 30s both the muscle tissue and tendon part of the calf muscle are subject to age-related changes. The changes in the connective tissue, which is the non-contracting part of the muscle, probably cause most of the problems.

Your injury suggests you are probably sustaining small muscle fibre stretch injuries. It is quite likely there is no actual tearing going on but the overstretching or overloading to groups of muscle fibres is enough to cause discomfort. Age-related change makes us more susceptible to these and some people are more susceptible than others. Try applying ice over the painful area for 20 minutes after the strain occurs.

The jury is still out as to whether it is helpful to stretch before you run. In your case, it doesn’t appear to be helping. Try power walking for five minutes at the beginning and the end of your run instead. Adopt a good heel to toe movement, rolling off the toes properly with each long stride, and use your arms to gain momentum and retain balance.

Power walking will enable blood flow to the muscle tendon to increase more steadily than if you were to go straight into a run. It also stretches the calf-muscle tendon dynamically over a greater range than running would, which helps the connective tissue in the muscle to loosen up effectively. Try this in preference to static stretching.

There are a few other factors that might contribute to this injury. Have you changed your running shoes recently? Are you properly hydrated before and after you run? Running dehydrated will make you more prone to muscle injury. Consuming low-GI carbohydrates soon after exercise will help recovery – foods such as fruit, oats, rye bread and some nuts fall into this category.

Judith Pitt-Brooke, East Midlands Physiotherapy Clinic, Loughborough