FOCUS ON: Calf pain in skiers and boarders Do your calf muscles get tight and sore after a few days on the slopes?  You’re not alone. Although skiing and boarding have very different physical demands on the body, the calf complex can notoriously be a problematic area in both sports. This newsletter is going to focus on aches and pains from overuse and DOMS (delayed onset muscle soreness), rather than a tear in a muscle from direct injury (contact iOsteopath if you want more information about calf muscles tears and acute injuries).   You have two major muscles in your calf complex.  The more superficial of these is called the gastrocnemius and the deeper one is the soleus. Generally people are more aware of gastrocs muscles and how to stretch it however, the soleus is particularly key in skiers and boarders because it is a stabiliser when the knee is bent.   The role of both of these muscles is plantar flexion, in other words they point the foot towards the ground. Any pressure through the ball of your foot is generated by the calf complex. When we are skiing and boarding we are constantly using pressure through our forefoot to control our equipment, speed and direction. Therefore the calf complex is constantly being stretched and contracted, placing the muscles under significant tension. There are many factors that increase the risk of calf strains and pains when you are skiing / boarding.  These include but are not limited to:

• poor flexibility in both the gastrocs and soleus muscles
• weakness
• ankle joint stiffness
• inadequate recovery periods
• poor foot position and / or boot set up
• inadequate warm up and cool down There are many factors that increase the risk of calf strains and pains when you are skiing / boarding.  These include but are not limited to:
• poor flexibility in both the gastrocs and soleus muscles
• weakness
• ankle joint stiffness
• inadequate recovery periods
• poor foot position and / or boot set up
• poor balance
• inadequate rehabiliation following a previous calf injury
• Ankle Mobility Skiers in particular are required to have good ankle flexibility to facilitate ankle flex in a rigid boot.  If you don’t have good flexibility in your ankle joint and calf complex you will struggle to achieve a sufficient ankle flex pattern which will not only affect your performance but put you at increased risk of injury.  Stiff or over flexed boots will also put more strain on the calf complex, as can boots that are fastened incorrectly.  To ensure optimum set up, speak to a professional boot fitter and take your time to get a ski boot tailored to your individual needs and level of skiing. How to increase the flexibility of the calf complex Try the gastrocs and soleus stretches pictured below everyday for at least six weeks prior to your skiing / boarding holiday. Make sure that you are warm before you stretch and hold each of these positions for thirty seconds. Repeat three times on each leg.  You can stand in these stretch positions while you are brushing your teeth – that way it becomes part of your daily routine.  If you do not feel that your flexibility is improving after a few weeks of doing these stretches daily, you may need to see an osteopath to make sure that it is not a structural / bony restriction.   Signs and Symptoms of a Calf Strain DOMS in the calf complex is most frequently felt when you begin a new exercise program, change your exercise routine, or dramatically increase the duration or intensity of your exercise routine, such as when you are on a skiing or boarding holiday.  Symptoms include:

• tightness and muscle spasm
• pain and stiffness may occur when resting, or after standing up having sat for a while.
• sudden pain or a pulling sensation in the calf area, which increases with activity such as walking, stairs and standing on tip toe
• Pain and stiffness can be significant in the morning.  This may improve as you get going.
• Calf Muscle Strengthening To strengthen the calf complex place the balls of your feet on the edge of a low step. You may wish to hold on to a bannister for balance.  Slowly sink your heels down and pause, then rise up onto your tip toes.  Aim to repeat this 20 times. Ideally aim to practice this 5 times a week (although start with as few as 5 repetitions if you find this hard and gradually build up). This exercise targets the gastrocnemius muscle. To focus on strengthening the soleus muscle, stand in the same position. This time bend your knees into a small squat position.  Again, sink your heels, pause and then rise onto your tip toes,  Maintain the bent knee position while you do this – it is a difficult one to master.  Repeat as above. If you do have aches and pains in your calf muscles when you are on your skiing holiday in Val d’Isere or Tignes, call us for free telephone advice.  We are likely to advice a deep tissue massage or a osteopathy session to accelerate the healing process and get you back on the slopes pain free. Osteopathy may involve:

• soft tissue and myofascial release
• strapping and taping techniques
• use of a heel wedge

• ice or heat treatment

• stretches and joint mobilisation
• ultrasound therapy
• exercises and rehabilitation
• biomechanical correction
• compression garments
• anti-inflammatory advice
• Please be aware that there are other reasons that aches and pains may occur in the calf.  It is always recommended that you seek professional advice rather than trying to diagnose injuries yourself.