Calf muscles make up the lower posterior portion of the leg.
2 are the calf muscles, the Gastrocnemius and Soleus.
Find here below a table with the Origin, Insertion and Action of the Gastrocnemius and Soleus.
|Origin||The posterior surface of the lateral and medial condyle of the femurs|
|Insertion||Calcaneus via calcaneus tendon|
|Action||Flex the knee|
Plantar flex the ankle
|Origin||Soleal line; the proximal posterior surface of the tibia and posterior aspect of the head of the fibula|
|Action||Plantar flex the ankle|
So, due to their origins and insertions, we can clearly understand how the Gastrocnemius is involved in knee flexion and how the Soleus is not.
The Gastrocnemius does across the knee, as it originates from the femur itself.
On the other hand, the Soleus doesn’t cross the knee, so it doesn’t play any role at the knee level.
This aspect is so important to differentiate what of these 2 muscles are involved in the restrictive movement at the ankle, and or in calf pain.
Here we go with some testing.
Firstly the patient is lying down in a supine position (face up) doing active dorsiflexion.
Secondly, we will ask the patient to lie in a prone position (face down), and we knee bend (passively) they would go in ankle dorsiflexion one more time.
What happens there is when the knee is flexed passively, the Gastrocnemius is deactivated, and so the ankle dorsiflexion is happening by pulling the soleus only.
Now, 2 are the case scenarios that could happen:
- Still a limited range of motion at ankle dorsiflexion with or without pain
- A better quality of ROM with a greater angle in dorsiflexion.
In the first case, the muscles that present tension could still be both.
In the second case, the Gastrocnemius is clearly the muscle limiting the ROM.
For ankle ROM in dorsiflexion, we are looking for a minimum of 20° to up to 30°.
But can calf pain be related to something else, and not just to muscle pain?
The answer is YES.
Calf muscle pain, especially after a flight, can be a RED FLEG for Deep Veins Thrombosis (DVT).
- Sharp pain;
- Heat at the touch;
- Soreness at the touch;
- Redness on the skin.
In this case, you want to get in touch with your GP immediately. Massages are absolute contraindications.
In conclusion, for a full calf or muscle recovery, we want to look in too some exercises.
Remedial Massage, Myotherapy, and Thai Massage are all great ways to reduce pain and manage symptoms, but to actually heal a muscle, exercises are essential.
Indeed, when we talked about plantar fasciitis, those exercises are something that we can look at for calf strengthening.