Address These Lower Leg Issues To Avoid Injury and Improve Running Performance

eccentric calf raises

Hello Runners,

In the last three posts I have discussed strengthening the glutes and outer hips muscles, as well as proper activation of these muscles, to significantly improve running performance and minimize the risk of injury.

Another factor that can adversely affect running performance and increase your risk of injury is muscle tightness. I had planned to address muscle tightness issues in this post. However, I recently had the opportunity to have a conversation with massage therapist and ultra endurance runner, Aaron Lange. Aaron practices massage on athletes, include Olympic athletes, in Boulder, CO. In our conversation I asked Aaron about some of the most common issues that occur in runners and how to address these issues. The main issues Aaron encounters in runners are poor running mechanics, overtraining, improper function of the ankles, and lack of glute strength.

In a previous post I discussed proper running mechanics, and in another post I included cues that you can use for proper running mechanics. In addition, Aaron mentioned that running drills and performing strides, in which you are running faster, can help. To run faster you have to run more efficiently, so that is why performing strides and sprints are beneficial. I have discussed these previously, but will revisit these in a future post. I will also discuss overtraining and signs that you are overtraining in a future post. As far as glute strength, Aaron shared this is important to keep your feet from landing close to, or even crossing the midline of the body, because this promotes a turning outwards for the foot. When the foot turns inward or outward this can lead to the most common injuries that runners encounter including: IT band syndrome, plantar fasciitis, knee pain, Achilles tendon issues (tendonitis or tendinosis). Proper engagement of the glutes can minimize this outward movement of the foot.

In the rest of this post, I will talk about what Aaron shared with me regarding issues with the ankle and how to address these. Having proper control at the ankle without the foot turning outward or inward can significantly minimize the risk of injury and results in a more efficient stride, which means you can run faster. As with the muscles at the hip (glutes, outer hips, hip external rotators, etc.), muscle weakness and tightness of the muscles that control the ankle can result in the inward and outward movement of the foot upon landing and then push off of the ground.

Muscle Weakness Issues

The muscles that control the movement of the ankle include the gastrocnemius (outer calf muscle), soleus (deeper or inner calf muscle), peroneals (outside of lower leg), posterior tibialis (inside of lower leg), and flexor halluces longus. The best exercise to address weaknesses in any of these muscles is eccentric calf raises.

To perform eccentric calf raises:

  • Use a step with a hand railing, so that you can balance yourself as needed as you lower your foot so that it drops below the level of the step.
  • Position each foot so that approximately half the foot hangs over the edge of the step
  • Have your legs straight and engage the core so you are as tall as possible
  • While using the hand railing for support as needed, raise up on both feet
  • Then slower lower on one foot so that foot drops to below the level of the step
  • Raise back up on both feet
  • Perform 15 repetitions for each foot
  • Make sure to keeping breath throughout this exercise, ideally exhaling as you slower lower
  • Make sure the foot is pointed straight forward when lower and not turned to the side

I recommend starting with one set of 15 repetitions for each leg with a straight leg. Once you are comfortable with this then increase your frequency to 2-3 times per day. Then increase the number of sets to 2-3. Aaron also performs this exercise with a bent knee, which can better target the soleus muscle.

Muscle Tightness Issues

Most runners statically stretch the calf muscles, at least the outer, or gastrocnemius.  You should also be stretching the inner or deeper soleus muscle by bending the back leg (the one being stretched). Bending the knee will also stretch the Achilles tendon.

Although many runners are good about stretching the gastrocnemius and sometimes soleus, they ignore addressing tightness in the other muscles important for proper ankle function. Some of these muscles are referred at as the “stirrup muscles” and are found on the outside (peroneals) and inside (posterior tibialis) of the lower leg. These muscles can become tight, especially if a runner does not properly control at the ankle and has their foot turn inward or outward.

The best ways to address tightness in these muscles is through foam rolling (for the peroneals) and self-massage while flexing the ankle (for the posterior tibialis).

To reduce muscle tightness in the peroneals:

  • While lying on your side, place a foam roller directly underneath the outside of your lower leg between the knee and ankle
  • Support your upper body using your forearm and free hand. Adjust pressure into the roller with your free hand and foot.
  • Slowly roll up and down the length of the peroneals (outside of the lower leg between the knee and ankle) while slightly rotating the leg periodically for 20-30 seconds.
  • Repeat on the other side.
  • Be sure to keep breathing while rolling
  • You may also want to apply pressure on the most tender area of the peroneals and hold for 20-30 seconds while you continue breathing

To reduce tightness in the posterior tibialis:

  • While seated cross one leg over the opposite knee.
  • Apply pressure with your thumbs on the muscle just on the inside of the ridge of the shin
  • Slowly flex and extend the ankle
  • Start for 30 seconds and gradually build up to 1-3 minutes daily
  • Repeat on the other leg

 

Please let me know if you have any questions, or if I can be of help in any way.

Also, please feel free to share this with anyone you feel might benefit

Your friend and coach,

Brian

 

References

Jay Dicharry. Anatomy for Runners. Skyhorse Publishing: New York, NY, 2012.

National Academy of Sports Medicine Essentials of Corrective Exercise. Ed. Michael Clark & Scott Lucent. Lippincott, Williams, & Wilkins: Baltimore, MD, 2011.

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