Do calf raises prevent calf injuries in running?

Old man calf injuries are a scourge amongst middle-aged runners everywhere. And for one reason or another they do seem to be more common amongst men. Perhaps it’s the inability of the male of the species to accept that we’re not as fit and strong as we once were? I was able to run 4 minute kilometer pace, so I’ll just do that regardless of how long it’s been since my last run. Years – no problem. Oops I think I just pulled my calf – again!

Perhaps I’m overstating the case, calf strains and tears may well be equal opportunity injuries amongst all runners. According to running specialist and physiotherapist Blaise Dubois they are the most common muscle strain injury suffered by runners and joggers.

Calf raises to prevent calf injuries?

Standing-barbell-calf-raise-2

Image via WikiMedia Commons

One consistent curiosity I have encountered working with runners on improving running technique is the large number who have been prescribed a regime of calf raises to strengthen the Gastrocnemius (the big calf muscles just below the knee). The rationale seems to be that having stronger calves will prevent future calf injury.

It sounds good in theory and I’ve even come across elite runners who are convinced that doing heavy straight leg calf raises will make them immune to calf injury. One runner was surprised that despite all his hard work doing calf raises with a heavy barbell that he continued to injure his calves. I must admit I wasn’t because the calf raise dose not closely model how the calves work in running.

What the calves do in running?

I’ve often read or been told that the calves are contracted concentrically (like they do in a traditional straight leg calf raise) to assist toe off. I’ve even been involved with discussions where aspiring Australian Rules Football players were working feverishly on strengthening their calves in the expectation that this would improve their vertical leap.

Both propositions, in my opinion, misunderstand the role of the calves in running and jumping. Remember Jonathan Edwards? He’s the world record holder in the triple jump. If anyone can spot him doing a calf raise like movement during his world record leap I’d like to know about it. He also doesn’t have very big calves!

If the calves needed to work in the same way as the traditional straight leg calf raise in running I speculate that we’d see very different angles developing at the ankle during ground contact and at toe-off. In the example below we see the foot and ankle angle not progressing much beyond a maximum of 90 degrees at toe-off. In a calf raise it might get above 150 degrees or more?

Contact-Stance-Posture-Gregson

If the calf was used in running as it is during the calf raise you’d get bigger angles developing and these elite runners would end up launching themselves forward and likely land flat on their faces – probably with a calf strain to add insult to injury. What we can see is the calf and Achilles tendon loading and unloading, not the calf actively engaged to propel the runner forwards.

Toe-off-Gregson

James Dunne over at Kinetic Revolution was kind enough to comment on this article on Facebook and he added these thoughts on the role of the calf in running, which make a lot of sense to me.

A big role of bi-articular muscles (muscles that cross two joints) such as the Gastrocnemius is to transfer mechanical power between proximal and distal joints, imparting the power from Glute Max initiated hip extension into the ground to propel ourselves forwards, rather than the calf concentrically working to push off.

So what might cause calf injury?

Knee-posture-at-extension

You won’t find this theory in the next edition of the British Journal of Sports Medicine, so you have to take it as a reasoned opinion rather than empirical evidence.

However, I have observed that a number of runners with chronic calf problems tend to have something in common. These frequent calf pulls and tears appear to be related to over-stretch and/or overuse of this muscle. This seems mainly a coordination rather than absolute strength issue – although these concepts are inextricably linked.

In other words, the hip extension chain (pictured right) breaks down in one or more elements, leading to the premature straightening of the supporting or contact leg. This places the calf in a weak, fully stretched position during running.

When stronger runners run at an easy pace they don’t generally fully extend their leg before toe-off (the foot losing contact with the ground).

Lazy bums, under developed hamstrings and floppy feet tend to lead to excessive straightening of the leg during slow running and/or overuse of the calf to make up for the other muscles not doing their jobs.

Another way of thinking this through is to imagine momentarily resisting the straightening of the leg in contact with the ground. Not as easy as it sounds, something that takes reasonable strength and good coordination.

Premature leg straightening

The middle stick man above has relaxed his glutes and hamstrings allowing his leg to straighten. He will tend to bob up and down on the spot and could be at risk of injury. With a straighter knee the calf (gastrocnemius) supports relatively more weight and is more fully stretched than if the knee had remained more flexed.

Meanwhile his counterpart to the right will drive forwards much further with each stride. The exact knee angles that are optimal during the weight bearing phase of running I don’t know, but this recent tweet provides some insight.

With the knee flexed at 90 degrees the soleus (lower & deeper calf muscle) does all the work, so perhaps somewhere in between would help the gastrocnemius and soleus share the load more equally.

Science and injury management

Blaise Dubious says that there is little scientific evidence pointing to isolated strengthening of the calf muscle per se as having any preventative benefit against future calf injuries.

With no science supporting this strengthening approach he recommends working the muscle gradually and in a functional way to prevent muscle injuries – not stretching and not calf raises in full range of motion (which is not needed in running). In other words, we stretch beyond our needs, which is unnecessary and potentially harmful.

However, Blaise also says that there is benefit in rehabilitating an existing injury using repeated concentric contractions. In this way the non-functional aspect of calf raises is not as important. Maybe this is where the confusion begins for runners, they keep going with an exercise prescribed to rehabilitate not prevent future injury?

Strength training – coordinating the extension chain

One way to practice these concepts is to use resistance training exercises. Calves are there to be loaded and unloaded each and every-time your foot touches the ground, but this can only occur if the bigger muscles at the hips (glutes and hamstrings) are playing their part. This is where the strength training comes in.

The hamstrings and calves help the knee stay flexed, when I look up my anatomy text I see the gastrocnemius is also described as a knee flexor in addition to its foot/ankle plantaflexor role. They could be alternatively described as knee stay-flexors.

I most notice my calves working in the gym when performing exercises where the knee is slightly bent (flexed) and pressure is applied downwards with the glutes while the hamstrings are also engaged. One of my favorite exercises is this single leg body-snap pictured below (not a beginner move). Another is walking lunges (a challenging entry level exercise) which also gives my calves and hamstrings a good workout in addition to quads and glutes – because of the isometric knee stay-flexor aspect. The Romanian dead-lift is another good exercise to consider.

A session of these exercises works the glutes, hamstrings, calves, and feet. Much of the work done by the hamstrings, calves and feet in this exercise seems more isometric (static resistance) than concentric (where the muscle shortens with repeated contractions).

To run well you need to be able to maintain some level of joint stiffness as you contact the ground. This allows the tendons and other structures to load and unload. The faster you run the stiffer the joints and more force applied. In jogging and easy running a relaxed strength or control is what you want to think about rather than being too stiff and robotic.

Practice loading and unloading the calves and feet with drills

My running form drills guide isn’t too far away from being released and one area that I cover is avoiding popping off the calves or doing an concentric calf raise at the end of key moments doing drills.

This is perhaps the easiest way to explain what this article is about. I filmed myself doing an A drill wrong i.e. popping off the calves and very nearly pulled a calf muscle – this wasn’t faked and for a moment I was a bit worried!

The A and B drills in particular are a great way to practice what it feels like to contact and move over the ground with the full extension chain active i.e. glutes,  hamstrings, calves and feet.

Conclusion

While calf raises might be a useful tool to help runners rehabilitate damaged muscles you shouldn’t assume that just because you have strengthened your calves that this will protect your from future injury.

In my opinion the key lies in practicing using and strengthening the muscles that help the runner maintain a strong chain between the lower back, hips, hamstrings, calves and feet.

Lose control of or have a weak link in any part of this chain and you risk over-stretching and/or overusing the calf in running – a potential contributor to repeated and painful injury.

Caution: before you decide to practice and implement anything discussed in this article remember that any change in technique will stress your body in ways it is not used to. Technical changes are best implemented in the off season when your training volume and intensity is significantly reduced (i.e. by more than 50%). If possible work with a coach and qualified running injury specialist – especially important if you’ve had chronic injury problems.

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11 Responses to Do calf raises prevent calf injuries in running?

  1. gary moller December 23, 2013 at 3:21 pm #

    Excellent article Brian! I have written a few observations here about calf injuries and running form and linked to your article as essential reading. Here is the link:
    http://blog.garymoller.com/2013/12/do-calf-raises-prevent-calf-injuries-in.html

    Keep up the good work!

    • Brian December 23, 2013 at 5:57 pm #

      Thanks Gary!

  2. Dave Coombs October 23, 2013 at 2:06 pm #

    Hi Brian,
    An interesting post. I have read your book and enjoyed what you had to say so please keep up the good work!
    You mention in the above post about the action of the gastroc and its action on the running stride but make no mention of the soleus. What are your thoughts on performing strengthening exercises for the soleus given its important role during running.
    Cheers
    Dave Coombs

    • Brian October 23, 2013 at 6:15 pm #

      Hi Dave, thanks for the encouragement and support! Functional stuff like the lunges, Romanian dead-lifts and the body snap pictured will all work the soleus as will most exercises where the foot is in contact with the ground. As noted in the embedded tweet the soleus does most of the work if the knee is flexed to 90 degrees so reasonable to assume exercises involving a decent flex at the knee will work the soleus more. Personally I wouldn’t try and do isolation exercises unless it was under guidance of an injury rehab specialist or there was another good reason to go there (which sometimes there is). A lot of runners go for the bent knee calf raise, which if you made me choose, I’d pick over the straight leg calf raise discussed in the article.

  3. Jenny October 23, 2013 at 2:01 pm #

    Excellent article thank you Brian. I am a personal trainer with some weekend warrior runners who are just happy that they can run. A couple of them though have had calf issues and one in particular recurrent achilles issues. They go to the physio and get the usual exercise prescription along with massage and trigger point therapy release for the calves. But have been scratching my head as to why it continues to happen. So this is brilliant. I have them doing fairly comprehensive strength work to try and wake their glutes up and their hamstrings….. what are your thoughts as far as the achilles in regard to this idea you have presented? i have just read the first comment so I will go and look at the referenced article too….

    p.s. Steve yes great tip!

    • Brian October 23, 2013 at 6:05 pm #

      Hi Jenny, thanks for the feedback! In terms of the specific achilles injury you mentioned I’d rather not speculate. If it’s not resolving try and have your client seek out someone who is an expert in tendon injury/rehab and running – there are a few about.

  4. Andrew Cowell October 23, 2013 at 11:08 am #

    Hi Brian, this is really good information. I’m that old man you talk about at the top of the article! After employing your techniques in your book, my calves are the only area still giving me trouble. I’ve obviously still got some work to do!
    I find the concentric/eccentric calf exercises a little confusing. This article http://www.beginnertriathlete.com/mobile/Article.html?articleId=1694 seems to be suggesting the opposite to Blaise Dubious? More than likely my interpret ion is off.
    Cheers, Andrew

    • Brian October 23, 2013 at 12:55 pm #

      Hi Andrew, you’ll get there, persistence and a bit of patience is always rewarded – keep doing those basics well! I think that article is referring more specifically to Achilles tendon injuries rather than calf injuries. One of the Sports Docs or Physios might be able jump in and confirm the different approaches to rehabbing each injury.

  5. Steven October 23, 2013 at 10:48 am #

    Hi Brian

    Fantastic article!

    After getting back into running a few years back I found I was suffering recurrent calf injuries (like every 4-6 weeks!). So I bit the bullet and booked myself into your gait analysis.

    I’m happy to report that your program has virtually eliminated my calf injuries (touch wood!).

    I was one of your typical “pop off the calves” runners and found your glute and hamstring strengthening program largely eliminated that problem. Occasionally I still slip back into old habits when fatigued, but have found a quick and easy way to diagnose the calf pop is to keep the horizon as still as possible when running. If it’s bobbing up and down when I run, I’m invariably popping off the calves too much.

    Cheers
    Steven

    • Brian October 23, 2013 at 12:56 pm #

      Thanks Steven, I appreciate the feedback. That’s a good tip re keeping the horizon from bobbing up and down too much – I might use that one!

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