Monday, February 20, 2017

Persistent Calf Pain

If you've logged a few high-mileage weeks in your days, you've likely dealt with minor, or even major, calf strains. It's an extremely common problem among runners, and I'm no exception. I'd like to outline some of the things that I've found to help me deal with nagging calf pain. I've tried to list these tips for overcoming a calf strain in the order of most helpful to least helpful, though a combination of many, if not all, of them will likely get you back on the trail the quickest. Last but not least, I'm a runner, not a doctor, so please consult a medically trained professional if you are unsure of the severity of your injury.

Rest

I know it's the last thing you want to hear as a runner, but you might need to take a break. If you act at the early signs of an injury, you could be talking about a few days recovery versus weeks or months. Calf strains are almost always a sign of overuse, so one of the best methods for recovering from nagging calf pain is to give your calves some time to relax. I try to take at least one or two days off whenever a significant pain pops up on a run, and then I test the waters with a short slow run to ease back into things.


Stretching

When you are experiencing calf pain on a run, the first natural reaction is to stop and try to stretch it out. This is probably a natural reaction because it usually works pretty well. A calf strain is generally caused by overusing your calf muscle, and if it's addressed early it's simply a matter of stretching out a tight muscle.

One thing that I've realized as a runner, is you don't always feel pain at its source. You may be experiencing pain in your calves because other muscles in your leg may be tight, and exerting more strain on your calf muscles. So, don't just stretch your calves when they're in pain, make sure to stretch your quads, ex-tensor tendons (the muscles that run along your shin and connect to the top of your foot), hamstrings, glutes, and hips. That might sound like overkill for a calf strain, but one key concept to understand is that all of your muscles live in opposition to other muscles. That's what allows you to move a body part in different directions. For instance, flexing your calves allows you to point your toe downward, or raise up on to your tiptoes. Your extensor tendon flexes to allow you to raise your toes upward toward your knee. If you over-stress one of those muscles, it will tighten causing more stress on the opposing muscle. You may end up feeling pain in either one of the muscles. You can read about how switching to barefoot running, and over-stressing my calves, put me in a battle with extensor tendinitis here. To make a long story short, if you're experiencing pain in your calves while running, make sure to loosen up all of the muscles in your legs, not just your calves.

Compression Socks/Calf Sleeves

This is a debatable product that I don't feel qualified to discuss the science behind, but I absolutely swear by compression socks and calf sleeves as a runner. I've gotten a few pair from Pro Compression, and they work great! The idea behind compression socks is that they provide graduated pressure (more pressure near the foot, and less pressure near the knee), in order to increase blood flow through the legs. From my research on compression socks, most of the debate on their effectiveness relates to whether or not they're actually effective while running, not whether they're effective after a run while recovering.

I like to wear compression socks or calf sleeves while running, but I think I gain the most benefit by continuing to wear them for several hours after a run. I've even worn them to bed before, when my calves are really screaming. Again, I'm not a medical professional, and I don't really know if there is science to support why this seems to help me so much, but compression socks and calf sleeves have become like my runner's security blanket. I absolutely recommend giving them a try if you regularly experience calf pain from running. I've also heard many people use them for shin splints, but, believe it or not, I've never had shin splints, so I couldn't speak to their effectiveness for that. In my opinion, $50-60 for a pair of high quality compression socks is well worth the price.

Hydration

This might seem like a no-brainer, but sometimes it's as simple as drinking more water. When you get dehydrated it can cause cramping in your muscles, and in runners, your calves will be likely be the first to go. Not drinking enough water can sometimes become a problem for me, even though I've been a regular runner for years. One of the ways dehydration sneaks up on me is in the winter when it's cold. It's hard to pound water when it's 30-40 degrees, but it's just as necessary as it is in the middle of summer. When you throw on a warming layer to go for a run, you may be causing yourself to sweat just as much, if not more, than when running in the summer.

Massage

When your muscles are sore massage can feel amazing, but beyond simply feeling good, it will actually help to clear lactic acid from your muscles and improve circulation to speed up recovery. Getting a quality massage can get pretty expensive, especially if you're regularly dealing with sore muscles from running. One great do-it-yourself product that I've found to be insanely helpful is the Stick. This product is so simple, but SO effective, and it has gained a cult-like following from runners over the years. If you don't want to spend $30-$50 on a stick, you can use a rolling pin or a broom handle, but nothing quite works as well as the actual Stick. Basically, you just use it in various positions and roll it back and forth over sore muscles. The only muscles I've ever used it on are my calves, and it works wonders. I wouldn't say that it's anywhere near as good as getting an actual massage from a trained professional, but using the Stick for 10 minutes before and after a run may be enough to loosen up your muscles and get you back to 100%.

Electrolytes

In order to function properly your muscles need the right balance of sodium, potassium, calcium, and magnesium, but the first two are the most important. Given that most Americans likely get far more sodium in their natural diet, that leaves you with making sure that you're getting enough potassium. Some common sources from food are bananas, potatoes, sweet potatoes, watermelon, black beans, and beets. There are a ton more if none of those appeal to you. Another option that I generally use on any run longer than an hour is Salt Sticks. I've only used the classic version in pill form. It may be mostly mental, but when I take them during a long run it makes my muscles feel like when I drip oil on a dry bicycle chain. Tightness and tension seem to drift away, and everything just feels smooth. I take 1 capsule per hour while running.

Running Form

This is something that's probably not necessary if you're an experienced runner. If you're just getting into running, and you're experiencing calf pain even after trying everything else I've mentioned, it may be worth analyzing your running stride to see if you're placing unnecessary stress on your calves. Generally this would be that you are exaggerating landing on your forefoot, near your toe, and your heel is well off the ground when you first make contact with the ground. Ideally, your mid-foot should hit the ground first, and your heel should be as low as possible, without causing it to strike first.

Some of the ways in which you can identify problems with your stride, are by looking at the treads on your shoes. You should notice significantly more wear on the treads between the mid-foot and fore-foot where your foot naturally strikes the ground. If that spot looks to be very far forward (toward your toes), then try adjusting your stride while running to land more toward your mid-foot. When you look at the heel of your shoe, you should see some wear on the heel. It shouldn't be nearly as pronounced as the wear on the mid-foot, but there should be some wear present. This shows that your heel is in fact coming down and making full contact with the ground with each footfall. If there isn't much wear on the heels of your shoes relative to the wear on the mid-foot, you may be putting unnecessary stress on your calves by not giving them a brief rest between each step you take.

NSAID's

I decided to put this on here as a method for dealing with calf strain, but I really don't recommend taking ibuprofen or any other anti-inflammatory drug to enable you to continue running. I try to take medicine as sparingly as possible, but there are times when taking an Advil can really help to alleviate pain and reduce inflammation. In my opinion, if you're at the point where you need to take pain medicine in order to make it through a run, you probably shouldn't be running. Focus your efforts on rest, and some of the other methods I laid out in this post before you get out running again.

Taking an NSAID after a run to deal with particularly sore muscles can really help. I generally do this after a marathon or an intense trail run. The one thing I would caution against is making taking an NSAID a regular part of your running routine. it should be something used on occasion, not everyday. If you're constantly in so much pain that you need to take something to deal with it, you're running too much, too fast, incorrectly, or some combination of all three.

I hope that some of these methods help you along in your recovery, and get you back on the trail soon.

Happy Running!

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