The calf: anatomy, role and injuries

What is the calf? Definition

“In the anatomy of the human body, the calf is the soft posterior part of the leg. It goes from the knee to the Achilles tendon. It includes muscles; the leg bone, on the other hand, does not. part,” explains Dr. Noamane Moudden, sports doctor. “The posterior compartment of the calf comprises 3 muscle heads, which constitute the triceps sural. Two of them are superficial muscle heads, the lateral gastrocnemius and the medial gastrocnemius. These two muscles were formerly named the twin muscles of the triceps sural. The third is a deep muscle, the soleus.The deep compartment of the calf includes the flexor muscles of the toes, and in particular of the big toe, as well as another very important muscle, the tibialis posterior.The tibialis posterior is the muscle which supports the arch of the foot and prevents the foot from collapsing”.

What are the functions of our calves?

“The calf muscles are muscles allowing propulsion during movement and effort. It is thanks to them that the person can stand on tiptoe, can walk or jump. They are very powerful muscles” describes the specialist. The triceps surae allows the foot to bend forward (plantar flexion) and the knee to bend (knee flexion). It is in particular thanks to the calf muscles that we can flex the big toe. It is also impossible to walk properly when this function fails. In this case, people walk with their feet flat. On the other hand, the calf is neither involved in standing stature nor in maintaining balance.

What is a tennis leg? What are the symptoms ?

“Tennis-leg is a very common calf injury, especially in people who play tennis, hence its name. Tennis requires the player to make very frequent changes of direction with rapid accelerations. The tear often occurs at the same place: there is a detachment between the aponeurosis and the muscles of the internal gastrocnemius” explains the doctor. A painful hematoma may form.

This injury occurs especially in people who do not exercise regularly enough. It can also happen in top athletes but it is much rarer, he adds. “The tennis leg is very painful; the person has the impression of having received a bullet in the calf. In the hours and days that follow, the area remains painful when you press on it. But the pain disappears after rest, in a seated position for example” finishes the doctor.

What is the support for a tennis-leg?

“Faced with the violence of the pain of a tennis-leg, the patient’s reflex is often to immobilize immediately. He walks on a demi-pointe to avoid stretching the calf. It’s a mistake! Even if it’s “is counter-intuitive, you must not immobilize the torn muscle. You must walk again immediately and stretch the muscle to recover an extension” explains the sports doctor.

• To relieve the pain of a tennis-leg, ice is an effective treatment in the first days;
• If necessary, the patient can take paracetamol, or even non-steroidal anti-inflammatory drugs if the pain is very intense”;
• Rehabilitation with a physiotherapist should also be considered in the treatment of tennis leg. “After confirming the diagnosis of a tennis leg by a doctor, physiotherapy sessions must be started as soon as possible to mobilize the muscle, put it back to exercise, and gently recover an extension” complements the doctor;
• In rare cases of very large hematomas, it is possible to practice a slight intervention and to puncture the tennis-leg from the 2nd or 3rd day, under ultrasound control.

What other possible calf injuries are there?

“The calf can also tear up on the hooks, but that’s infrequent. This muscle injury occurs more in runners. The lesion(s) require physiotherapy sessions as soon as possible” details Doctor Noamane Moudden.

“Rupture of the Achilles tendon can occur in any context, in anyone. The rupture takes place at the moment of an acceleration. Management is either orthopedic (immobilization for at least 3 months), or open-air surgery or micro-invasive approach. he completes.

“Following a sprained ankle, you have to be wary of the possibility of rupture of the posterior tibialis. This can go unnoticed and have significant consequences for the patient. In fact, the person feels pain in the ankle and not in the tendon, which delays the diagnosis. Following the rupture, the foot collapses and ends up giving a flat foot: the internal vault is lost”.

To avoid calf injuries in sport, the key word is regular training. “The ideal is to exercise very often and gradually, after a good warm-up. At the end of the session, you have to stretch. Dedicated stretching sessions are very beneficial” says Dr. Noamane Moudden.

In addition, the risk of calf injuries (rupture of the Achilles tendon in particular) often occurs in the context of overuse, such as excess weight. “If you are overweight, you should ideally lose weight and, in the meantime, adapt your physical activity“says the sports doctor.

Finally, the calves suffer when the technical gesture is not good during the effort. “For example, walking without slowing down the step, having a heavy step, attacking the movement of walking with the heel can cause pain and muscle damage… Do not hesitate to educate children to walk correctly from an early age and not to walk with the heel but with the forefoot”.

To avoid any risk, a good walking sequence is done in 3 stages.

• At first, you have to put the heel flat with cushioning to protect the joints.
• In a second step, it is necessary to completely unroll the foot to the toes.
• Finally, in a third step, the toes allow propulsion, in particular the big toe. It is by not neglecting this third step that we can increase the amplitude of the walk.

“It is possible to rehabilitate walking with a physiotherapist!” however, reminds the doctor.