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GASTROCNEMIUS MUSCLE STRAINS The gastrocnemius is one of the most easily visible muscles in the human body—the structure that gives the calf its characteristic bulging shape. It is this shape that inspired the name of the muscle: "belly of the leg," from the Greek gaster (belly) and kneme (leg). The gastrocnemius is a two-jointed muscle, with two halves, or heads—one medial (Image 1A) and one lateral (Image 1B)—that originate at the femur at the back of the lower thigh. Beneath it lies the soleus muscle (Image 1C), which holds the real strength and power in the calf. These two muscles help you to stand, walk, run, and rise up on the balls of your feet. Both are attached to the back of the calcaneous by the Achilles tendon (Image 1D). In this article, we will focus on the gastrocnemius muscle, which is injured a bit more often than the soleus. HOW AND WHY THESE INJURIES OCCUR Picture yourself walking around on the ball of your foot, unable to put your heel down. That's what you would look like if you had a severely strained gastrocnemius muscle. The story I hear most often from people with this injury goes something like this: "I got this pain in my calf a week ago while I was playing ball. I just thought it would go away, so I kept on playing. Now I can't put my heel down when I walk most of the time. It hurts too much." Alternatively, a gastrocnemius muscle tear can happen suddenly, with a snap. A client might say, "It felt like somebody hit me with a racket across my calf, but when I turned to see, no one was there." For a person with this injury, walking is uncomfortable and any greater exertion may cause pain. When pain is extreme, there can be a tear in the muscle so wide that it leaves a half- inch gap you can feel when you run your finger over the calf. In these cases, simply standing with the heel down is excruciating. Usually, though, the fibers are torn only microscopically and the person can stand without pain; it's being more active that makes it hurt. While it's typical for just one head of the muscle to be torn, occasionally both are injured simultaneously. The pain can be felt medially or laterally, or in both places, and is perceived as occurring somewhere near the surface, rather than deep inside the calf. In chronic cases that have healed poorly, the injury gets alternately better and worse. The worst bouts of pain may last as long as six months, because it's difficult to function without walking, yet walking keeps re-injuring the torn fibers. To understand why and how the calf became strained in the first place, you need to look at the total picture—including the person's full body alignment, habitual movement patterns, type of work, and so forth. For example, in an individual with a forward-head posture, the weight of the body is transferred forward, placing more strain on the calf muscles. To get a sense of this, try standing up A B C D Putz/Pabst: Sobotta, Atlas der Anatomie des Menschen, 21st ed. 2000 © Elsevier GmbH, Urban & Fischer München and moving your head forward about 2 inches. Notice what happens to the stress in your calf muscles. If you're able to analyze the underlying cause(s) of the injury, you can help the client take steps so that it doesn't happen again.1 Often, there are multiple causes of this type of injury. Apart from body use and alignment, other common contributing factors include excess connect with your colleagues on massageprofessionals.com 91