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Seth O'Neill

My Talk from the #RTP2016 conference on Managing Calf Injuries and RTP Considerations

Health & Medicine

Managing calf injuries and
RTP considerations
Seth O’Neill
@seth0neill so59@leicester.ac.uk

Epidemiology of Calf injuries
• 4th most common injury
• 4% of all injuries
• 14%-16% of all muscle injuries (FC Barcelona 2009)
• 14.7 days lost – 13% are >28days
• 13% re-injure
• Older players more frequently injured
• Last 15 minutes of game key period

Older players more
frequently injured
Age

Why does the Calf get injured?
@seth0neill so59@leicester.ac.uk

Soleus contributes 50%
of total vertical support
force

Soleus 52%
Med Gas 32%
Lat Gas 16%
Albracht et al 2008

Which muscle?
• 66% are solitary muscles
• Isolated tears = Gastroc : Soleus
49% : 46%
• 34% are combination injuries
• Soleus not normally reported
• Plantaris and Deep muscles occasionally
involved
@seth0neill so59@leicester.ac.uk

What else can Soleus do?
• Control knee flexion
• Control tibial translation
Therefore may link with ACL and Meniscal
injuries and be important pre/post injury
• Control Achilles loads and is implicated in
tendinopathy
Sherbody et al 2003, Mokhtarzadeh 2013, Fleming 2001
@seth0neill so59@leicester.ac.uk

What we can learn from other muscles
• Strength seems important
• Monitoring of strength may be predictive
• Strength may inform RTP
• Fascicle length and pennation angle may be
key
• Injured players may respond differently to
strength changing
@seth0neill so59@leicester.ac.uk

Preliminary data (caution N=9 in each group)
96%
206%
P .00001Rehab needs to be heavy
@seth0neill so59@leicester.ac.uk

Rehab, RTP and prevention
• Identify which muscle and
which location
• Strength >BW
• Endurance
• Rate of force development
• Velocity
@seth0neill so59@leicester.ac.uk

Summary
• Calf injuries are frequent, produce loss of play,
and may link to other pathologies – e.g. ACL
and AT
• Consider intramuscular tendon injuries
specifically Soleus.
• Beware older (senior+expensive) player
• Late game situations
• Rehab heavy
@seth0neill so59@leicester.ac.uk

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