Last week, I had the perfect day for my first backcountry ski adventure in four days. I saw it line-up beautifully: home alone while family on trip, legs recovered, great weather, and plenty of snow on a late March day. I loaded up my gear and headed out.

For someone looking for what to do about a torn calf muscle, here is the best link I found for information on torn calf muscle and how to treat. Others interested in reading a story and the road to recovery, keep reading.

calf muscle tearphoto from physioworks

My first run was awesome. Such sweet turns on a mountainside of fresh snow. Popping in and out of the trees. Linking my turns and hitting a few high-speed spots. A couple of months on the lift-served side while kids went to lessons had really improved my skiing.

If you don’t know, backcountry skiing provides a great triathlon cross-training opportunity because you have to hike back up the hill. You don’t get a ride up the lift. For a dad with two young boys, it is also much cheaper than buying a lift ticket!

My second run started great, too. I decided to hit an area that is more open and a bit steeper than the previous run. The snow here had a some soft spots that my tips dug into but I recovered nicely…until I didn’t.  At a point that the pitch steepened, my ski tip dug, and I endo’d, breaking out of my bindings straight-forward and tumbling down the hill. I gathered myself and brushed off the snow. Quick check: neck? good. arms? good. knees? good. Legs? good. Wait…calf muscle has significant pain. Better get moving back up the hill RIGHT NOW! because I have to hike out of here and ski back down the lift-side with what feels like a very bad torn calf muscle.

I got up the hill ok but with some pain. Skiing down was a different story for the top half of the hill, as it was icy and I couldn’t turn well. Further down, I had more room and didn’t have to turn so it was easier. Sitting in my car for the 30 minute drive home, my leg as SCREAMING at me.  I wanted to cry from the pain but was too happy that my knees were intact and I got out of that mess by myself.

At home and with my leg RICE’d as much as possible and self-medicating the pain of a possibly ruined summer, I began my research. Of the many websites I checked, Pysioworks  was the best for me.

I figured I had a Grade 2 tear, based on the description, but I had no bruising (yet).  The Physioworks site has a great treatment plan listed, and I started that immediately:

How to Treat a Calf Muscle Tear

Calf muscle tears are one of the most common problems that we see at PhysioWorks and it is unfortunately an injury that often recurs if you return to sport too quickly – especially if a thorough rehabilitation program is not completed.

Researchers have concluded that there are essentially 6 stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence – these are:

Phase 1 – Early Injury Protection: Pain Reduction & Anti-inflammatory Phase

As with most soft tissue injuries the initial treatment is RICE – Rest, Ice, Compression and Elevation.

Your calf muscle is a large powerful group of muscles that can produce sufficient force to run, jump and hop. In the early phase you’ll be unable to walk without a limp, so your calf needs some rest from weight-bearing loads. You may need to be non or partial-weight-bearing, when crutches or a wedged achilles walking boot may be the best treatment.

Ice is a simple and effective modality to reduce your pain and swelling. Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot.

Anti-inflammatory medication (if tolerated) and natural substances eg arnica may help reduce your pain and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain reducing medication.

As you improve a compressive bandage, supportive taping or an elastic calf support will help to both support the injured soft tissue and keep the blood from pooling in your foot.

Keep your foot elevated above your heart (where possible) to allow for gravity to help drain your calf and lower leg swelling.

I stayed off my foot and kept it raised as much as possible the rest of the day and Sunday. I went to work and hobbled around as little as possible on Monday (I have a desk job). I was liberal with Biofreeze the entire time. I really LOVE THAT STUFF!  As I wondered how my “it’s going to be the best ever” season was going to pan out, I remained happy that my knees are healthy and tried to figure out how to get healthy in a way that would keep me there. God was teaching me patience..AGAIN.

On Tuesday, I went swimming to see how that would feel. It was good. Not great. But good. I could certainly do pulls and some light kicks.  I could still turn and push with my good leg. Looks like a swim-focus week!

Wednesday, Thursday, and Friday were big swim days. Kicks and pulls mostly, until Friday when I decided to hit a final personal-best-ever distance of 4,000 yards. I accomplished that, so I turned this disaster in a personal best.

So, the swim kicks are really helping me recover without pushing it too far. Saturday morning, there are the first visible signs of real damage with some discoloration of skin in my leg. I can’t say they are “real” bruises but I suppose they meet the definition . Also, I am walking ok but can’t put a lot of pressure on a calf – raise exercise.

image

Phase 2: Regain Full Range of Motion

If you protect your injured calf appropriately the torn muscle will successfully reattach. Mature scar formation takes at least six weeks. During this time period you should be aiming to optimally remould your scar tissue to prevent a scar that will re-tear in the future.

It is important to lengthen and orientate your healing scar tissue via massage, muscle stretches and neurodynamic mobilisations. Signs that your have full soft tissue extensibility includes being able to walk without a limp and able to perform calf stretches with a similar end of range stretch feeling.

Phase 3: Restore Concentric Muscle Strength

Calf strength and power should be gradually progressed from non-weight bear to partial and then full weight bear and resistance loaded exercises. You may also require strengthening for other leg, gluteal and lower core muscles depending on your assessment findings.

I am in Phase 3 now, and I can walk with only a minor limp. I hope to try a bike workout on Sunday morning, but I will NOT push it into a pain. I am following the “let heal all the way” principle before I try to restore strength. The swim-focus week proved that I can maintain some fitness during this injury (the multiple exercise option is what I love about triathlon!), so I’m not worried about losing too much fitness. I am a bit depressed because the weather is awesome right now, and I could be skiing again today with 55 degrees and sunny and very little wind — PERFECT! — but I will be at the park with the boys, which is probably better for me overall anyway!

I certainly won’t be running until two weeks from now. I’ve had a slight calf strain previously, and that was “nag-nag-nag” all year long until I finally just stayed off it for three weeks.

A week later, I have a slight discoloration but not a dark bruise. As much as this hurt, it was probably only a solid grade 1 tear, maybe a light Grade 2. What would a Grade 3 feel like?!?!?! Again, I’m just happy I have my knees and was able to get off the mountain by myself.

Below are the rest of the steps from physioworks. I figure I have until mid-May to be at 100% on this.

Phase 4: Restore Eccentric Muscle Strength

Calf muscles work in two directions. They push you up (concentric) and control you down (eccentric). Most calf muscle tears occur during the controlled lengthening phase. Your physiotherapist will guide you on an eccentric calf strengthening program when your injury healing allows.

Phase 5: Restore High Speed, Power, Proprioception & Agility

Most calf injuries occur during high speed activities, which place enormous forces on your body (contractile and non-contractile). In order to prevent a recurrence as you return to sport, your physiotherapist will guide you with exercises to address these important components of rehabilitation to both prevent a recurrence and improve your sporting performance.

Depending on what your sport or lifestyle entails, a speed, agility, proprioception and power program will be customised to prepares you for light sport-specific training.

Phase 6: Return to Sport

Depending on the demands of your chosen sport, you will require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to your chosen sport.

Your PhysioWorks physiotherapist will discuss your goals, time frames and training schedules with you to optimise you for a complete return to sport. The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a through rehabilitation program has minimised your chance of future injury.

 

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