Calf injury healing - or the rehab of any injury - is about far more than simply following the RICE protocol. Understanding that everything in the human body is connected is the key.
If your sport involves running, no doubt you've had some sort of calf strain or at the very least, you've had tight calf muscles. What's more, despite spending a little bit of time trying to push a wall over somewhere near the end of your run, those pesky calf muscles never seem to get any less tight (and the wall is still standing).
Frustratingly, injuries in this area are common and calf injury healing takes ages!
So is there a piece of the puzzle you're missing? I think so.
Learning About Fascial Lines
A little while ago I attended a workshop with the brilliant Dr Perry Nickelston of Stop Chasing Pain. The thrust of the workshop was that every muscle in our body is part of one or more systems, connected to each other by something called fascia. These systems can be referred to as fascial lines and it's those fascial lines that allow us to move. Contrary to the old way of looking at the body, muscles do not work in isolation.
More often than not, the site of pain isn't the problem at all. There's nothing wrong with your calf muscles, they're working just fine and therefore they're also working way too hard, because somewhere else in your kinetic chain there is a muscle or muscles that aren't doing their job properly.
Perry's system for dealing with this is called the RAIL Reset system. More on that later.
Forced to Try It
A few weeks ago I was out running, All had been going well, but despite the runs being short I had started to develop a stiffness in my left calf. I had done the usual stretching thing with the usual results. On this particular day I was running at a comfortable recovery pace when my calf went from zero to total cramp in the space of one stride. I thought I'd torn something & it took ages to limp home.
For the rest of the day, the calf was very sore despite the RICE protocol. This is all I would have done for calf injury healing in the past. It's never worked as well as I'd have liked: nobody wants to have to take 2 weeks off training to heal.
Then I remembered Perry's workshop and decided to try to work out what muscle was inhibited and causing my calf to be facilitated (fancy word for tight). It was all a bit "trial & error", but here's what I did.
Implementing the RAIL System
Trying the system
The first part of Perry's system is to release the facilitated muscle. I did this by finding the sore spot in the muscle & applying pressure to it until the pain subsided. This is the sort of thing a massage therapist or physio would do for you, but most would stop there. Unfortunately, if you simply stand up and walk away at this point, your poor old calf muscles still have to do the work of the lazy muscle elsewhere and will simply tighten up again.
Enter the next step: Activate the inhibited muscle. I really didn't know what was being lazy, so I went after a common culprit. I did did some glute bridging exercises before moving to the next step and these seemed to help.
Step 3 is to integrate this now activated muscle into your movement pattern. I did this using some bilateral crawling.
Finally I needed to use this improved patterning in locomotion - in other words I needed to walk. And so I walked up and down the house a few times. This in itself was pretty miraculous in that I hadn't been able to walk without a very pronounced limp and the accompanying wince before I'd sat down on the floor to start the process.
A massive improvement, but I wasn't quite "fixed" yet.
Input from the Expert
After a quick Facebook chat with Perry where he suggested that the pain experienced when walking downstairs might indicate issues with my hip flexors or hamstrings, I repeated the RAIL reset, this time using exercises to activate my hamstrings and deep hip flexors as well as my Vastus Medialis quad muscle.
The results were amazing. Where I would historically have spent at least a week hobbling around, icing my calf & being very annoyed at myself for getting hurt, I was walking normally (including down stairs) within a day. I was able to do my weight training as normal.
Sometimes, you just need input from someone with significant experience and Perry is certainly one such person.
I gave running a miss for a little while to let the bruising from the cramp heal up. There are obviously some issues with muscle firing patterns when I am running, which I am addressing (using the RAIL Reset System) and I have returned to running.
The reason for this blog post is simply to get you to think differently about injuries or tightness in muscles. Our bodies are a group of interlinked systems, the muscular system is no different. Be good to that system and before you get injured, try to figure out who in the team is not pulling their weight, re-educate them and take the pressure off those who are currently working too hard.