Wednesday, October 25, 2017

Older Men And Calf/ Hamstring Injuries

Both the calf and hamstrings
After last week's post, I was just talking to Rachel and she mentioned to me this past week she's seen a few cases of patients tearing the calf muscles too. All happened to be male patients on the older side of 40 years old.

I thought of my own patients with calf muscle strains/ tears and realized that they too tended to be the older male patients too.

I was pleasantly surprised that Rachel's and my observation was spot on. A recently published article in the British Journal of Sports Medicine investigated over a thousand articles on the risk factors of calf muscle strains. Ten articles satisfied their inclusion criteria of which more than 5000 athletes in football, rugby union, Australian rules football, basketball and triathlon were involved.

As you get older, your aging athletic body has a few things going against you. You have a higher incidence of disc degeneration and the potential of L5 nerve root compression as mentioned in last week's post.

Older athletes lose some muscle power output and rate of force production. (Trust me on this, I have definitely experienced this).

Moreover, as the athlete gets older, your testosterone levels and production start to decline and this may limit your muscles' rate of recovery, which can lead to accumulative fatigue.

The most predictive risk factors were down to age and previous injury of calf strain. Having previous hamstring or groin strain was also a contributing factor. A possible proposed mechanism for this is a change in the change in the muscle architecture following a muscle strain.

When your muscle heals after a previous injury, the damaged muscle is usually replaced by a fibrotic scar tissue. It is often common to get future damage in the areas adjacent to this scarring.

Another factor that may play a role is due to a change in the length and shape of your damaged calf muscle. Shorter muscle fascicle length has been noted as a risk factor for repeat hamstring strains too.

We can't help you when it comes to your age and previous injuries to the calf and/ or hamstrings. But what we can do along with treating you is to ensure you have a sound rehabilitation process with some definite focus on eccentric exercises.

Here's a tip for those who you who haven't seen us in our clinics. Do your eccentric training at the end of the day when you have no training scheduled or only light training the next day. This minimizes the risk of DOMs or delayed onset of muscle soreness.


Reference

Green B and Pizzari T (2017). Calf Muscle Strain Injuries In Sport: A Systematic Review Of Risk Factors For Injury. BJSM. 51: 1189-1194.

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