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Epidemiology of Calf injuries
• 4th most common injury • 4% of all injuries• 14%-16% of all muscle injuries (FC Barcelona 2009)
• 14.7 days lost – 13% are >28days• 13% re-injure• Older players more frequently injured• Last 15 minutes of game key period
Older players more frequently injured
Age
Soleus contributes 50% of total vertical support
force
Soleus 52%Med Gas 32%Lat Gas 16%
Albracht et al 2008
@seth0neill [email protected]
MTJ RTP earlier than MTC
Which muscle?
• 66% are solitary muscles• Isolated tears = Gastroc : Soleus
49% : 46% • 34% are combination injuries• Soleus not normally reported• Plantaris and Deep muscles occasionally
involved@seth0neill [email protected]
What else can Soleus do?
• Control knee flexion• Control tibial translation
Therefore may link with ACL and Meniscal injuries and be important pre/post injury
• Control Achilles loads and is implicated in tendinopathySherbody et al 2003, Mokhtarzadeh 2013, Fleming 2001
@seth0neill [email protected]
What we can learn from other muscles
• Strength seems important• Monitoring of strength may be predictive• Strength may inform RTP• Fascicle length and pennation angle may be
key• Injured players may respond differently to
strength changing
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Preliminary data (caution N=9 in each group)
96%
206%
P .00001Rehab needs to be heavy
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Rehab, RTP and prevention
• Identify which muscle and which location• Strength >BW
• Endurance• Rate of force development• Velocity
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Summary
• Calf injuries are frequent, produce loss of play, and may link to other pathologies – e.g. ACL and AT
• Consider intramuscular tendon injuries specifically Soleus.
• Beware older (senior+expensive) player • Late game situations
• Rehab heavy@seth0neill [email protected]
@seth0neill [email protected]
