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The Relationship Between Age and Calf Injuries

We examine the research on why older runners are at a higher risk of calf injuries and steps they can take to prevent them from occurringIn our article about Common Running Injuries in Men, we found that particular injuries that are common among male runners—knee osteoarthritis, meniscus tears and calf strains—are also conspicuously more frequent as runners get older.

Calf strains (or tears) in particular are a very common problem among masters athletes, so today we’ll be looking into why this injury occurs more often as you get older.

Did you check out our latest podcast with Masters World Record Holder Kathy Martin? Kathy is a great example of getting stronger (and faster) as you get older!

Examining calf injuries and age

Calf injuries appear to be unique among muscular sports injuries in that they appear more frequently as you get older.

A study of professional soccer players by Jan Ekstrand, Martin Hägglund, and Markus Waldén at Linköping University in Sweden found:

Hamstring and adductor injuries were more common than calf injuries, the incidence of calf strain increased with age, while the risk of injury to the other muscles of the leg remained unchanged.

The calf actually consists of two muscles: the gastrocnemius and the soleus.  The gastrocnemius has two “heads” which make up the meatier upper part of the calf, while the soleus is the more slender lower part of the muscle.

Both the gastrocnemius and soleus can be strained, but the medial head of the gastrocnemius is the most common location for injuries.

Though calf injuries are a problem for runners, they also occur quite frequently in ball sports like tennis, soccer, basketball, and cricket, so many scientific studies, including the ones we’ll be looking at, involve competitors from these sports.

Research-backed theories

The first step in answering the question of why calf injuries become more common with age is understanding the mechanics at play when a calf strain occurs.

One creative study, published in 2002 by sports injury clinicians at the Australian Cricket Board, examined the exact moment of a calf strain, caught close-up by multiple TV broadcast cameras during an Australia vs. England cricket match.

  • The authors of the study noted that the calf strain— clearly visible in the video, when the athlete’s calf appears to slacken on the lateral side—occurred just as the player’s opposite foot left the ground, as the calf transitioned from an eccentric contraction to an isometric “stance phase.” 
  • The authors also cite other work which indicates that calf injury occurs not as you push off  the ground (a concentric contraction), but just as you transition from landing to supporting and beginning to drive off the ground (eccentric and isometric muscle contractions).  This is significant because it can help us predict strategies for prevention.
  • Eccentric loads are also known to be more damaging to muscles, though the body is capable of supporting significantly more weight in an eccentric contraction than a concentric one.  Knowing this, we can predict that aging would increase the risk of muscular injury, as muscular strength gradually decreases as you get older.
  • Not only that, but aging selectively weakens the “fast twitch” muscle fibers that are tailored to handle high-power contractions and rapid loading.
  • Less muscle strength overall will also lead to increased fatigue, which has been implicated in muscle strains—at least in one study at Duke University using rabbits.

Unfortunately, this still leaves open the question of why the calf in particular becomes more susceptible to injury with aging, and not the hamstrings, quads, or adductors.

I found no research that could directly explain this phenomenon.

It could simply be that the calf has less muscle mass overall when compared to the other prime movers of the lower leg, like the hamstrings and the quads.

A consistent rate of muscle fiber decline with age would therefore affect it to a greater extent than these other muscles.

On the other hand, there could be something biologically unique about the calf or its function during sport that makes it more susceptible to injury with age—either differences in the muscle itself, or differences in the relative amount of force that it must handle.

Final thoughts

Older runners, especially men, need to be aware that their calves get more vulnerable to injury as they age.
Our understanding of the injury process can also help predict some preventative measures; since we know that calf strains occur during the eccentric and isometric phases of the running gait, it is likely that calf strengthening routines that focus on these aspects will be more successful at preventing injury than simply doing traditional calf raises, a primarily concentric exercise.

Eccentric heel drops,  often used to treat Achilles tendonitis, are a highly effective eccentric strengthening exercise, while “toe walks”—walking forwards or especially backwards keeping your heels off the ground—are a good isometric exercise that even strong runners will find challenging after a few sets of 15 or 20 meters.

These are explained in our Instagram video, which you can check out HERE.
Staying healthy is an integral part to success as a masters athlete, so being aware of the causes and possible ways to prevent calf strains will help your training and racing greatly.

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  • Treating the source of injuries rather than the symptoms
  • How bad running form causes cramping in the marathon
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1. Ekstrand, J.; Hägglund, M.; Waldén, M., Epidemiology of muscle injuries in professional football (soccer). American Journal of Sports Medicine 2011, 39 (6), 1226-1232.
2. Dixon, J. B., Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries. Current Reviews in Musculoskeletal Medicine 2009, 2 (2), 74-77.
3. Orchard, J. W.; Alcott, E.; James, T.; Farhart, P.; Portus, M.; Waugh, S., Exact moment of a gastrocnemius muscle strain captured on video. British Journal of Sports Medicine 2002, 36, 222-223.
4. Lindle, R.; Metter, E.; Lynch, N.; Fleg, J.; Fozard, J.; Tobin, J.; Roy, T.; Hurley, B., Age and gender comparisons of muscle strength in 654 women and men aged 20–93 yr. Journal of Applied Physiology 1997, 83 (5), 1581-1587.
5. Larsson, L.; Grimby, G.; Karlsson, J., Muscle strength and speed of movement in relation to age and muscle morphology. Journal of Applied Physiology 1979, 46 (3), 451-456.
6. Mair, S. D.; Seaber, A. V.; Glisson, R. R.; Garrett, W. E., The Role of Fatigue in Susceptibility to Acute Muscle Strain Injury. American Journal of Sports Medicine 1996, 24 (2), 137-143.

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8 Responses on “The Relationship Between Age and Calf Injuries

  1. Cured!

    Here’s my story…

    I went through calf injuries on and off (more on than off) for 6 years until slowly I couldn’t run more than 3kms, and then only slowly and never 2 days in a row.

    I’m a 47 year old male runner (best marathon 2h52 back in the day..!) and it was heartbreaking to battle this for years – but I refused to give up.

    For 6 years I tried everything: physiotherapy, foam roller, “the stick”, rest, ice, shoes, orthotics, ART, shock
    therapy, Pilates, vascular tests for compartment syndrome etc. Everthing. I had MRIs of both calves – they never showed any scar tissue.

    It started with Achilles problems and maybe at the time I had been over-doing it. That developed into chronic calf tears in both legs.

    Except finally, after 6 years, I found out that it never was.

    I finally mentioned to my sports physician that my back was always stiff – never sore – just stiff. He sent me for an MRI and found a slipped disc L5/S1. My calf pain had been neural referred pain all along.

    A single epidural cortisone injection resolved the problem literally overnight and 9 months later I’m still 100% injury free and back to my best.

    • Thanks Ralph, I think you just gave me the answer that I’ve been looking for for 2 years: I was diagnosed about 5 years ago with a prolapsed disc in L5/S1- I am a 42 year-old runner and have had almost identical calf strains for the last 2 years. Every 3 months or so I get the same calf pain that is so bad it sidelines me for 1 month, and so I make no progress … I used to post great half marathon times – now I wonder if I can last 30 mins without something going ping..and I’d never thought the 2 problems were related. Thanks again, it totally makes sense now…

      • Glad you were able to find some answers from Ralph! Hopefully his suggestions, in combination with our post, will give you a better idea of what to do. Check out our posts and podcasts over the next few weeks. We have a lot of helpful advice coming for older runners. I am sure you will both find it very helpful!

  2. Thanks for writing what you wrote. I’m 54 and enjoy running but every so often my right calf blows out while training. I run SLOW, never race, but enjoy distances. When my calf goes out it starts as a slight twinge that feels as though I could work it out but then quickly balloons into what feels like a burning knife in there. It’s only there when I run or extend my calf. I can still ride a bike with not much pain but running is out of the questions for weeks.

    This only happens once a year or so but wow, it hurts and is heartbreaking. Any thoughts? I have had spine surgeries but I’m wondering if my calf pain is different than what you suffered. I love hearing how you recovered, congrats.

  3. Hi Siro,
    My story is similar to yours, although I’m 47. Unfortunately I don’t have a solution to the calf problem, however I am still extremely fit, and not just for my age. The trick is to find what you can do to maintain your fitness while the calf gets better.
    I find dynamic squats (lifting off the ground off the heals, not the ball of the foot) pain free even after a week of the injury, and of course your upper body is free to work as normal. Try TRX for instance; you get as much support from the apparatus as you need to keep working hard. When I’m injured, I use it as an excuse to get creative with my workouts. Most importantly, don’t stop working!

    • Great advice Ian. I am sure Siro will find your suggestions very helpful, and using TRX is definitely worth a try to see if it works. That is great you are able to stay in shape, and have found what works for you. You are right when you say that as long as you are creative, there really are few excuses, as you can always find a way to do what works for you based on your limitations. Thank you for your contribution Ian, very inspiring to the result of the running community!

  4. Just had this injury occur. Been a runner for years and never this kind of problem. I did try using Creatine when this happened. So not sure if this is what contributed to it happening??

    • Could be, it would impossible for us to tell Joe. Best thing to do is just to rest up, and stay away from the creatine, even if there is just a chance they were related. Feel better!

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