Calf injury prevention and rehabilitation with Brady Green

In episode #494 of the Pacey Performance Podcast, Rob is speaking to Senior Lecturer in Musculoskeletal Physiotherapy at the University of Notre Dame, Brady Green for a detailed exploration of calf injuries, particularly their high prevalence and recurrence in elite sports. Brady sheds light on the limited research surrounding the initial risk factors for calf strains, emphasizing the necessity for focused prevention and effective rehabilitation strategies.

The conversation begins with an overview of how prevalent calf injuries are in sports like Australian rules football and track and field, noting the challenges in reducing their incidence despite ongoing efforts. Brady points out that older athletes and those with a history of previous calf strains are particularly susceptible to future injuries. He suggests that targeted prevention through high-load strengthening and isometric exercises can induce structural adaptations that help mitigate these risks.

The podcast delves into the specifics of screening and testing for calf injury prevention and rehabilitation. It highlights the importance of strength testing in both seated and standing positions, the relevance of dorsiflexion, proper alignment, and the use of a metronome to standardize tests for running-based athletes.

Further discussion focuses on the need for dynamic function testing and training, including reactive strength endurance and horizontal force production, to fully understand and cater to the calf’s range of capacities. Brady emphasizes the biomechanical roles of the calf and the necessity of addressing impairments not just in the calf but also in the thigh, hip, and pelvis to prevent overload injuries.

The podcast concludes with strategies for early loading and strengthening of synergist muscles, progressing towards dynamic activities that focus on force and velocity components essential for calf injury rehabilitation. It also covers the critical steps of a thorough process for returning to play, including monitoring strength markers and assessing non-quantifiable factors like recovery and range of motion.

Finally, Brady touches upon an international collaboration project aimed at preventing calf injuries which includes some of the biggest organisations across the world. You can check Brady out at the Sportsmith Rehab Conference on 12-13 October.

Main talking points:

• Calf injuries prevalent, high recurrence in elite sports.
• Older age, previous strains major risk factors.
• High-load strengthening, isometrics mitigate injury risks.
• Screening includes seated, standing strength testing.
• Dorsiflexion, alignment critical in testing protocols.
• Benchmarks: 20-22 calf raises to failure.
• Address biomechanics in thigh, hip, pelvis.
• Early loading, synergist muscle strengthening essential.
• Dynamic function testing for comprehensive rehab.
• Monitor strength, assess non-quantifiable factors for return