Torn a calf muscle

[vander]

I would see Paul.
http://www.physiosports.com.au/Paul_Visentini.html" onclick="window.open(this.href);return false;

[CKinnard]

Sure will do.

But how bad is it to have damaged that muscle? Is that muscle likely to be permanently damaged or can it become stronger than before after being healed?

you don't want to fall into stinking thinking like the problem is only one muscle.

if you've overloaded and torn one muscle, you've usually got issues with multiple. i.e. a torn medial gastro or soleus is regularly associated with tibialis posterior pathology (tenosynovitis or tendinitis).

It's not rocket science to realize overloading a functional muscle group is unlikely to adversely effect only one muscle in that group.
I'll bet my hat if you get your tib post origin assessed it's tight, hard, and painful++, especially at the bony origin.

And that opens the door to seeing a podiatrist with a special interest in cycling to get cycling orthotics.

[zill]

A strain is a tear in a muscle or tendon FYI.

Yes, was confirmed by the physio as well.

Neil is quite correct here. Little chance of doing it cycling although (very small chance) of doing it sprinting.

The physio said that this was still possible from "over" cycling and it doesn't have to be from a big sprint, can be just overuse of the muscle possibly over a few days prior as well. Looking back, I shouldn't have done an extra 60 minute climb (while interval training on the climb) after time trailing up it prior.

I have had a shop bike fit and it feels comfortable enough.

[zill]

I'll bet my hat if you get your tib post origin assessed it's tight, hard, and painful++, especially at the bony origin.

The only pain I can feel is from the lower and slightly inner calf. No pain elsewhere. The foot and ankle feels fine.

[NeillS]

Read my previous posts. It's almost certainly not damage in the sense of it taking time to "heal", although synovitis is a possibility it sounds like a simple overuse trigger point. Let us know how you go with waiting for it to heal, I'll be curious how you are going 6 weeks from now.

[zill]

Read my previous posts. It's almost certainly not damage in the sense of it taking time to "heal", although synovitis is a possibility it sounds like a simple overuse trigger point. Let us know how you go with waiting for it to heal, I'll be curious how you are going 6 weeks from now.

I've read your posts. This injury occurred one month ago and it still hasn't healed. One leg is still much weaker than the other. Surely that is a tear?

Do you work in this area of sports science?

[vander]

While it is impossible to diagnose over the internet it really doesnt sound like a tear.
A lot of things can cause a weaker leg.
I hope you get it sorted quickly.
FYI a complete achillies rupture surgically repaired and going well can be back on an exercise bike 4 weeks post (in a boot still). How quick does that make you think a grade 1 medial gastroc strain should take.

[zill]

While it is impossible to diagnose over the internet it really doesnt sound like a tear.
A lot of things can cause a weaker leg.

The injured leg felt pain in the calf area in the first two weeks when riding and now just feeling weak after riding for 30 min or so.

The calf obviously is more serious than just being sore since that is usually healed in a couple of days at most. You think it is not a tear then what other possible calf injuries can there be that takes more than one month to heal?

FYI a complete achillies rupture surgically repaired and going well can be back on an exercise bike 4 weeks post (in a boot still). How quick does that make you think a grade 1 medial gastroc strain should take.

My physio said a small muscle tear should take about a month to heal.

[JdM]

I've had a calf tear take up to 3 months to get anywhere near back to 100% - it can take time.

[zill]

I've had a calf tear take up to 3 months to get anywhere near back to 100% - it can take time.

Was it a significant tear?

You said earlier in this thread that you tore it twice. Was it the same area? If so was it because you tried to get back to full training too early?

[JdM]

No I did the left and then the right in close succession.

It was a very bad grade one tear according to the physio. I ended up with a lot of scar tissue which then needed to be worked out by a massage therapist as well.

The injury was due to overload without the proper sort of maintenance, I've since addressed a lot of the underlying strength issues as well as the structure of my training.

As I said in my earlier posts, you need to trust your physio and if it isn't healing in the time frame they have advised, go back to them and have it reassessed.

[zill]

Did both legs take 3 months to heal each or 3 months combined time (1.5 months for each leg)?

It was a very bad grade one tear according to the physio. I ended up with a lot of scar tissue which then needed to be worked out by a massage therapist as well.

Were the scar tissue visible? If not how did the physio know about it?

The injury was due to overload without the proper sort of maintenance

Was it basically that you tried too much and too hard (compared to what you are use to doing) on one day?

[JdM]

Did both legs take 3 months to heal each or 3 months combined time (1.5 months for each leg)?

The first one was nowhere near as bad, but it was still slow. I can't remember exactly, but it would have been 6 weeks or thereabouts from memory.

Were the scar tissue visible? If not how did the physio know about it?

Firstly - I'm not a physio or any sort of sports medicine professional. However my understanding from what I have read and the advice I have received is that as the muscle repairs itself the scar tissue is generated as part of this process. You can't see it, but a sports medicine professional such as a massage therapist or physio will be able to feel it while doing deep tissue work.

The scar tissue doesn't have the same 'elastic' type properties that your muscle fibers do, so it can lead to reduced range of motion and strength. What happened to me was I went back to sport (I was against the clock to be ready for something) and when I took off into a sprint late in a match I felt a pop in the same spot of the calf - It felt exactly like I'd done the calf again however it settled after about two days. Both my physio and massage therapist agreed that I had 'snapped' some of the scar tissue, at which point we got stuck into trying to work it out of the muscle as much as possible.

I can't stress enough though, this was my experience, which doesn't necessarily translate to your situation.

Was it basically that you tried too much and too hard (compared to what you are use to doing) on one day?

Kind of. It was a combination of things. Lack of conditioning, progressing too fast without building up volume and some bio mechanical issues which were being caused by lack of strength in certain areas - I injured myself running, but these things also apply to cycling, or any other sport for that matter.

But as I said, you need to go and speak to someone who is qualified to deal with this sort of thing in the flesh. If you can't get this sort of information and advice from your current physio, find a new one.

[zill]

That's very informative JDM, thanks. Hopefully my injury will be good in 2 or at most 3 more weeks (7 weeks in total). My physio doesn't tell me a lot other than that he thinks its a small tear. He will answer my questions when I ask him and to be honest all my questions seem to arise from this thread! Should I get a new physio who takes more of an initiative or are most physios like this (since they also just have 30 min with you)?

He does give me a message and recommend exercises to do during the week.

[CKinnard]

I can vouch for JdM's experience. That's very very common and he's done a good job of describing the repair process.
I saw a guy 2 years ago from our CC who did a Grade 1 calf tear. I worked it over 6 weeks, then strapped him to start grading his strength and conditioning, and return to sport...12 weeks after RTS, he goes in his first race and feels a twinge. (incidentally, I wanted him strapped but he didn't show up). That took him back to where he was 3 months earlier.

He kind of lost faith in me after that, and went off and saw a host of other physios. Eventually he came back and I said he should see a sports physician and get a MRI. Personally I felt he had poor recovery capacity possibly related to gluten intolerance and ongoing intestinal inflammation. Anyway, he was not impressed with the sports physician who didn't add much to what he'd already been told. I didn't see him riding for about a year after that...had a chat to him recently at the training track, and he'd just had 10 months off the bike altogether to get over the calf issue and gut problems.

The lesson in the story is not everyone tears muscles when they ride hard...so it pays to look for other reasons why you might be prone to tears. Nutrition, sleep, hydration, lumbar and sciatic nerve issues, are all reasons why muscles may be vulnerable. Those who casually dismiss this just don't have much of a clue on the human body.

[zill]

I can vouch for JdM's experience. That's very very common and he's done a good job of describing the repair process.
I saw a guy 2 years ago from our CC who did a Grade 1 calf tear. I worked it over 6 weeks, then strapped him to start grading his strength and conditioning, and return to sport...12 weeks after RTS, he goes in his first race and feels a twinge. (incidentally, I wanted him strapped but he didn't show up). That took him back to where he was 3 months earlier.

He kind of lost faith in me after that, and went off and saw a host of other physios. Eventually he came back and I said he should see a sports physician and get a MRI. Personally I felt he had poor recovery capacity possibly related to gluten intolerance and ongoing intestinal inflammation. Anyway, he was not impressed with the sports physician who didn't add much to what he'd already been told. I didn't see him riding for about a year after that...had a chat to him recently at the training track, and he'd just had 10 months off the bike altogether to get over the calf issue and gut problems.

The lesson in the story is not everyone tears muscles when they ride hard...so it pays to look for other reasons why you might be prone to tears. Nutrition, sleep, hydration, lumbar and sciatic nerve issues, are all reasons why muscles may be vulnerable. Those who casually dismiss this just don't have much of a clue on the human body.

Thanks for sharing. Looks like I may be out of it for a long, long time but hopefully not. Definitely torn the muscle from an extremely hard ride, one which I obviously wasn't prepared for. Other issues are obviously on the table like nutrition and sleep.

[kb]

I'd caution against an all or nothing mentality too. You won't go from being injured to cured and will probably need to exercise restraint when you get back into it even if you feel fine. On the other hand, starting gently could also mean starting sooner.

[vander]

Thanks for sharing. Looks like I may be out of it for a long, long time but hopefully not. Definitely torn the muscle from an extremely hard ride, one which I obviously wasn't prepared for. Other issues are obviously on the table like nutrition and sleep.

I am just going to reiterate here, a minor calf tear should not keep you of the bike for long treated properly.

[zill]

Yes, have been riding recently but very gently. Not even puffing and not too distant a ride either. Nothing competitive. Feels bad riding like this. Makes you really think how much you take for granted on the days when you had normal legs. Normal legs feel like a world away at the moment.

[CKinnard]

I am just going to reiterate here, a minor calf tear should not keep you of the bike for long treated properly.

define properly, as in a full rehab protocol that applies equally to all minor calf tears.
if you strap, explain your strapping technique/s.
if you ice, when you stop icing.
what criteria do you use to progress exercise? pain? palpation? if strength, how do you quantify? time? please explain.

[AUbicycles]

CKinnard and vander, lets keep in mind that the discussion will never replace qualified medical advice and because of intrinsic differences, what works for one person may not work for another.

The point is that while it may be possible to delve right down into this, it will be difficult to quantify to that satisfaction of all. It may however be beneficial however when discussing this to include in a 'please' when requesting feedback or information as a courtesy.

[vander]

CKinnard and vander, lets keep in mind that the discussion will never replace qualified medical advice and because of intrinsic differences, what works for one person may not work for another.

This is perfectly correct and why I wont go into what exactly I would do for this patient.

[Xplora]

The fit was mentioned earlier as comfortable... I suspect this I as the moment that you have to look past that initial feeling of comfort because it has led to an injury. You shouldn't be getting injuries when the bike is fit right. Seeing a coach might be helpful as well to act as a counter to your more intense desires to train hard. I ask one question... Is the lost month of the bike worth more than the extra climb?

Good luck. Injury sucks

[zill]

You shouldn't be getting injuries when the bike is fit right.

Even if the load is really unbalanced? For example, for training mainly doing short intervals on the trainer (burning less than 6000 kj each session) than ride all day outside burning more than 16,000 kj including a TT effort plus intervals?

What I've learned is to do base training as well as interval training at the same time. Hence to average about 500km a week.

Slowly improving with the injury. Probably will be light pedaling for another 3 weeks. Treating this period as an off season.

[Xplora]

Answer remains the same. You should not be getting injuries from training. EVER. If you are getting them from overuse in training, how the hell do you expect to lift 10% in competition? I cannot ride super hard when training alone. Put a wheel in front of me, booyah.

Look at your training, and take the injury as a learning experience. Most of the value in the PMC is figuring out what is good for YOU. I get away with limited Z2 riding for a while but just racing (Z3 with a ton of Z6 and Z7 efforts) eventually destroys me.