In this edition of Ask the Practitioner, we again connect with Mark Fadil, Clinic Director at the Sports Medicine Institute (SMI) of Palo Alto.  SMI is one of Northern California's leading orthopedic and deep tissue massage resources, assisting both world class and recreational athletes since 1996.  

RC: Tight and/or sore calves are one of the most common ailments for new and experienced runners alike.  What exactly is happening when one feels like his or her calves are tight and they have become sore to run on? 

MF: Sore/tight calves are a very common problem with runners.  Generally someone may experience sore calves when running for the first time, coming back from time off, during a period of increased speed work or during a period of increased mileage.  In each one of these circumstances the calf muscles are adapting to the stress from the increase in activity.

RC: When treating runners with sore calves, what are the most commonly reported practices that have potentially led to the problem? 

MF: There is normally some sort of change that precedes sore/tight calves.  In addition to the changes I already mentioned it can come from a change in running shoes (usually a shoe with a lower heel such as a racing flat will put more stress on the calf), a change in running surface or increased hill running.

RC: What techniques do you and your staff employ to address this problem and what can runners to do maintain the work at home? 

MF: I usually focus on three things: massage, stretching and functional strengthening.  Massage can be done by a professional therapist or at home using a foam roller or "the stick."  This can be done on a daily basis for 5 - 10 minutes.  Stretching should focus on both the upper calf (gastrocnemius) using a straight knee calf stretch and the lower calf (soleus and Achilles) using a bent knee calf stretch.  I recommend stretching after massage as well as an additional 2-3 times a day.  Each stretch should be held for at least 30 seconds.  Functional strengthening is one of the most important pieces in preventing sore/tight calves from occuring in the first place.  A great way to incorporate functional strengthening is doing heel drops off the edge of a stair.  These should initially be done on a daily basis and eventually shifted to two to three times per week for maintenance.