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I Ve Been An Avid Runner For A Good Number

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Posted on Wed, 13 Nov 2019
Question: I've been an avid runner for a good number of years....even ran 4 marathons back in the 90's and early 00's -- last marathon was 2002. But the past 3 or 4 years, I've had to cut back my mileage due to my schedule...and various minor injuries as I've aged. The past several months, I will get into a decent groove running, trying to build my mileage back up to 30 miles per week, and each time I start to feel good about how I'm progressing, I get a calf injury. It will just "ball up" in one spot, and I have to sit out 4 to 6 weeks before I can start running again. Same thing happened about a week ago.....2 miles into a 4 mile run, my calf "knotted up" in one spot, and I had to limp back home. Waited a week, then got on a treadmill, but 5 minutes into an easy pace, I could feel strain in the same spot. Can you help me determine what's causing this consistent problem? It's not the same calf....over the past several months (couple years or so) it's happened to each calf.
doctor
Answered by Dr. Dr. Antoneta Zotaj (4 hours later)
Brief Answer:
Calf muscle injuries tend to recur due to scaring and are worse with age- some advice below

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

I carefully read your query and understand your concern.

You are experiencing calf muscle strain and this tends to become chronic in runners. This means that once a patient has a calf muscle strain he will be more prone to future strains because previous strains cause injury and scar tissue which predisposes to future episodes.
Also, this is more common with age as young runners get these less often than older runners.
A very likely cause is also increasing the work out too quickly (the intensity or the distance). In your case, you are trying to increase the distance you are running in a week so very likely you are increasing it too fast.

Being regularly checked with a sports doctor probably would help you to do the proper adjustments to prevent or reduce similar episodes in the future.

As general rules:
- you should not increase the running distance more than 10% in a week. In your case, I would even recommend less than that, as you do get calf pains more frequent recently.
- running up heel may trigger calf pain so you may need to avoid this when you recently had calf pain.
- regular stretching exercises are important to prevent strains.
- regularly warm-up before running
- calf massage if you have pain and also foam roller to relax hardened calf muscles.
- medical compresses for the calf- these can be used while running to improve the blood flow in the calf muscles
- make sure you do drink well and also take salts and minerals to help the muscles function better
- strengthening exercises such as heel-lifting done regularly may help the calf muscles to be stronger and prevent strain
- make sure you use proper shoes for running. Flat shoes predispose to calf pain.
- pay attention to your body- if you have pain, do not continue to run. Start to run again when walking feels comfortable and make sure you do not increase the workout too fast
- you may benefit from a visit with a physiotherapist who would check if there is any weak muscle that needs to be strengthened with specific exercises. Hip muscles may need to be strengthened as well as they play a major role when running, together with the calf muscles.
- finally, as mentioned previously, a sports medical professional would be of great help as he can examine you and determine problems with muscles and if certain muscles need exercises to be strengthened. He will also be able to give you proper advice on the running technique and how to safely increase the running distance.

I hope this answers your query.
I remain at your disposal for further medical assistance.

Regards,
Dr. Antoneta Zotaj
General and Family Physician



Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 4435 Questions

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I Ve Been An Avid Runner For A Good Number

Brief Answer: Calf muscle injuries tend to recur due to scaring and are worse with age- some advice below Detailed Answer: Hello and welcome to "Ask a Doctor" service, I carefully read your query and understand your concern. You are experiencing calf muscle strain and this tends to become chronic in runners. This means that once a patient has a calf muscle strain he will be more prone to future strains because previous strains cause injury and scar tissue which predisposes to future episodes. Also, this is more common with age as young runners get these less often than older runners. A very likely cause is also increasing the work out too quickly (the intensity or the distance). In your case, you are trying to increase the distance you are running in a week so very likely you are increasing it too fast. Being regularly checked with a sports doctor probably would help you to do the proper adjustments to prevent or reduce similar episodes in the future. As general rules: - you should not increase the running distance more than 10% in a week. In your case, I would even recommend less than that, as you do get calf pains more frequent recently. - running up heel may trigger calf pain so you may need to avoid this when you recently had calf pain. - regular stretching exercises are important to prevent strains. - regularly warm-up before running - calf massage if you have pain and also foam roller to relax hardened calf muscles. - medical compresses for the calf- these can be used while running to improve the blood flow in the calf muscles - make sure you do drink well and also take salts and minerals to help the muscles function better - strengthening exercises such as heel-lifting done regularly may help the calf muscles to be stronger and prevent strain - make sure you use proper shoes for running. Flat shoes predispose to calf pain. - pay attention to your body- if you have pain, do not continue to run. Start to run again when walking feels comfortable and make sure you do not increase the workout too fast - you may benefit from a visit with a physiotherapist who would check if there is any weak muscle that needs to be strengthened with specific exercises. Hip muscles may need to be strengthened as well as they play a major role when running, together with the calf muscles. - finally, as mentioned previously, a sports medical professional would be of great help as he can examine you and determine problems with muscles and if certain muscles need exercises to be strengthened. He will also be able to give you proper advice on the running technique and how to safely increase the running distance. I hope this answers your query. I remain at your disposal for further medical assistance. Regards, Dr. Antoneta Zotaj General and Family Physician