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Calf Strain and RICE
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I just strained my calf on a run. Limped home. Is Rest, Ice,Compression and Elevation (RICE) still the best first aid? Any other suggestions?

Pat
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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I'm an Exercise Physiologist. RICE is still the best start. Always start with RICE. Reason being is nothing can go wrong with RICE. Maybe add some IB Porfin or something. LIGHT stretching, and I do emphasize light may help. Think a passive type of stretch. For the calf just point your toes up as high as you can (dorsifelxion) and that will do for now. Foam rolling is also pretty low risk. If it still persist there is something a little more serious and you'll need to get it checked out.

I still lapped everyone on the couch!
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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Yep, that is a smart first step. Next, figure out why it happened. If you are over 40, search 'calf heart attack' on this forum- there are a few extremely helpful threads on this issue.
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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Don't run on it as soon as it feels good.
Give it a week of pain free walking prior to beginning again. And then, slowly return

"Good genes are not a requirement, just the obsession to beat ones brains out daily"...the Griz
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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Go out to Loews/Home Depot and buy a 5 gallon bucket. 2-3 times a day for 15-20 minutes, fill the bucket up with 10lbs of ice and add water. Soak the injury in this mixture, it's much more effective than an ice bag or a pack of frozen vegetable. I've suffered the same injury and this works miracles.
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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Yorlik wrote:
I just strained my calf on a run. Limped home. Is Rest, Ice,Compression and Elevation (RICE) still the best first aid? Any other suggestions?

Thats a bummer, I'm sorry. But it'll heal up, just be patient. The below info is just my routine process with my patients, not specific medical advice to you. You should go get checked out before you start anything.

First, I'm sorry to say but ice won't actually do much. Well, I should say that its effects are minimal and you aren't missing anything or setting healing back by not icing. Compression and elevation are far more effective for addressing swelling, but you may not even have any swelling.

Usually I would stay away from ibuprofen or any anti-inflammatories as well, with an acute muscle strain you want to promote healing and NSAIDs may actually hinder that. You want to promote the formation of immature muscle tissue, its the natural healing process. I never start stretching too soon. I tell my patients to wait 3-5 days, or until the pain and soreness is gone. When they can walk on it pain free for a day, then I begin passive stretching in small doses.

Then we start with cycling or pool work, anything that limits weight-bearing. Then into progressive strength work and plyometrics/running last.

FYI I tore my calf in 3 places back in October. Confirmed with MRI because we couldn't isolate the structure based on the complexity of it. I didn't ice a single bit. Was patient with it, kept it loosely wrapped with a pressure gradient to promote better circulation and started with manual work and progressive loading. Minimal stretching. I was back to running and sprinting (soccer) in 5 weeks. And this was a grade II strain in 3 muscles.

Keep it simple, go get it checked out. Don't just take blind advice on the forum. Good luck!
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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Yorlik wrote:
I just strained my calf on a run. Limped home. Is Rest, Ice,Compression and Elevation (RICE) still the best first aid? Any other suggestions?



Don't forget massaging of the calf muscle. No one knows the exact reason for the development of calf strains but it could be secondary to weak and/or tight muscles. As others have stated, be very careful about stretching this as a strain is a tear in the muscle. Initially, ice will help to decrease the swelling but it is not actually doing anything to promote healing. If you are going to ice, I would consider it for the first day or so, and then stop. Rub the same area of both calves. If you still have any pain or discomfort, in the damaged calf (as compared to the other one) then do NOT run. This is a good way to figure out when the two feel equal. Even when they feel equal, do not immediately jump back in to running. Go for a walk and make sure there are no aggravations. Massage your calves real good before you run.....I keep The STick with me to roll out my muscles before every run
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Re: Calf Strain and RICE [Felt_Rider] [ In reply to ]
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Felt_Rider wrote:
Jloewe wrote:
I'm an Exercise Physiologist. RICE is still the best start. Always start with RICE. Reason being is nothing can go wrong with RICE. Maybe add some IB Porfin or something. LIGHT stretching, and I do emphasize light may help. Think a passive type of stretch. For the calf just point your toes up as high as you can (dorsifelxion) and that will do for now. Foam rolling is also pretty low risk. If it still persist there is something a little more serious and you'll need to get it checked out.


I am curious to this. I have strained or micro tears six times in my past during strength training. I am not sure the grade of strain in each, but none needed surgery for reattachment and yet all had severe bruising. It seemed intuitively that stretching tissue that was a micro tear could potentially tear it worse at the initial treatment. I don't know the true answer so I am asking to learn the truth. I know you are saying and emphasizing light. I always played it extra cautiously and waited about 3 weeks to start very light stretching. In each case I started movement with zero resistance spinning on the bike to keep motion in my legs.

It is odd because there seemed to be a major desire to stretch during the first days as if that would relieve the discomfort, but I was too scared thinking that it would tear more.


Actually, stretching would be the LAST thing to be doing right now. Even lightly.

CB
Physical Therapist/Endurance Coach
http://www.cadencept.net
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Re: Calf Strain and RICE [PTinAZ] [ In reply to ]
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PTinAZ wrote:
Actually, stretching would be the LAST thing to be doing right now. Even lightly.

Thanks
That's kind of what I thought and did not stretch until I felt like the tissue was healed. I said earlier that I waited 3 weeks, but I believe that I actually waited until I had already started back training before I started stretching and even then it would be light.
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Re: Calf Strain and RICE [Jloewe] [ In reply to ]
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Uhh, people living under the bridge--

Ice has soundly been discredited as a healing aid and probably compression and elevation are bad too.

http://www.drmirkin.com/...delays-recovery.html
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Re: Calf Strain and RICE [Zissou] [ In reply to ]
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Zissou wrote:
Yep, that is a smart first step. Next, figure out why it happened. If you are over 40, search 'calf heart attack' on this forum- there are a few extremely helpful threads on this issue.



Dan Empfield
aka Slowman
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Re: Calf Strain and RICE [Jloewe] [ In reply to ]
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Quote:
I'm an Exercise Physiologist. RICE is still the best start. Always start with RICE. Reason being is nothing can go wrong with RICE

Icing has largely been discredited these days as a number of studies seem to believe that it might hinder the body's natural inflammatory response. However, some still believe otherwise.

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IB Porfin
????

I'm guessing you mean ibuprofen. Again NSAIDs are generally not being recommended nowadays as they 'encourage' people to push harder than they should and actually hinder recovery.

Over here calf strains are generally classified as Type 1, 2, or 3. With Type 3 being a rupture and needing surgery, Type 2 possibly crutches for a few days, and Type 1 just a little discomfort/slight pain.

For me recovery from a calf strain is about doing as much as you can without pain. I had a Type 2 some years back that put me on crutches for a few days. After some work with a physiologist (Thanks Tony Snell :-)) I threw the crutches away and began walking. As the walking became easier I began jogging, a bit of massage, then some gentle stretching and so on.

I would suggest in the first instance you get it checked out to find out the severity of it. Then work form there.

Trust me I’m a doctor!
Well, I have a PhD :-)
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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I have had a couple of calf sprains over the years and both times I believe it was causes by my ankle being jammed up and not moving
correctly, this put stain on my calf, as soon as the ankle had full range of motion the calf strain went away in short order.
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Re: Calf Strain and RICE [Yorlik] [ In reply to ]
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My struggles with calf strains led to the following compilation of advice.

YMMV,

Scott

********
Calf

Bump 12/12/15
Bump 8/2/15

Self-diagnosis: Grade 1 strain
Grade 1 calf strain is a minor tear with up to 10% of the muscle fibers effected. The athlete will feel a twinge of pain in the back of the lower leg. They may be able to carry on playing or competing in mild discomfort. There is likely to be tightness and aching in the calf muscles two to five days after injury.
http://www.sportsinjuryclinic.net/...hin-pain/calf-strain

Rehab:
Avoid hills and jumping until 6 weeks post-injury. Discontinue taking any NSAIDs.

Continue strengthening and postpone return to running until 1-leg heel raise matches uninjured side.

Resistance bands can be used initially, followed by calf raises and then eventually single leg calf raises. Remember not to do any exercises if they are painful. Once you can acheive 3 sets of 20 single leg calf raises, pain-free gradually incorporate running into the rehab program. Eventually plyometrics or hopping exercises should be done to return to full match fitness and prevent the injury recurring.

Running:
-- warmup 15 min on the bike
-- walk 5 min to further warm up
-- run 10 min (not run walk interchange as this is worse for the muscle) at 80 pct of long run pace, stop if tight or painful. Track or treadmill
-- run with compression calf sleeves
-- stretch well afterwards but not before

Do that every other day for a couple of days, then run 15 min instead of 10, then 20 then 30

No speed work or hills for another 3 weeks but okay to ramp up duration as per above to about 40 min over those 3 weeks

http://forum.slowtwitch.com/...on%20sleeve;#4930105

**********

Step 1. Stay off it for as long as it takes to heal completely. I recommend at least a week. Do some wet vesting or cycling, but don't run just because it feels better after a day or so.

Step 2. Get as much massage – including self-massage – as you can, TheStick massage tool has been invaluable to me in this regard (because this injury is in deep, icing has not been as helpful as it has for most injuries). Definitely don't stretch your calf yet. Let it heal first.

Step 3. This step is the real "secret" to recovering quickly from this injury. I've found that it can cut recovery time from weeks or months to days. After a week of no running, start back with a "medicinal workout" on a track or another flat, controlled surface. Start by walking a mile, then jog very easily for a few hundred yards, and then walk again. Alternate between walking and jogging for three or four miles or until your calf begins to feel numb or sore. Then stop immediately. Your goal is to get as much circulation to it as possible without re-injuring it.

Step 4. If you get through the whole session and your calf still feels good, you're still probably not healed, but you're on your way. Take a day off and then repeat the procedure. Do this every other day for a week; increasing the jog portion of the workout as your calf improves.

Step 5. After a week of the medicinal workouts, try a short, very gentle run of three to four miles, on as flat a surface as possible. As always, if your calf gets numb or the sharp pain reappears, stop immediately and walk back. Remember the cyclical nature of this injury. Keep adding to your mileage and intensity day-by-day, but be ready to retreat at the first sign of trouble. After a few such runs, if you haven't overdone it, you'll be back to your normal routine.

Step 6. The long-term key to prevent a recurrence is just to stretch the hell out of your calves and Achilles tendons. I use a homemade, 45-degree stretching board in my office, which I try to get on several times a day, standing on the high end and lowering my heels as far as I can.

Again, make sure the injury is completely healed, and then make serious calf stretching an integral part of your routine. Continued use of TheStick is also highly recommended, both to mitigate any scar tissue and to keep the muscle and sheath as flexible as possible.

http://www.runnersworld.com/...-attacks?page=single
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