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Manual Calf Stretch
The Manual Calf Stretch is an effective and simple exercise designed to stretch and strengthen your calves. This stretch utilizes bodyweight, gravity, and a wall to provide resistance and tension to the muscles, while simultaneously providing a deep stretch. It can help improve flexibility, range of motion, and muscle strength in the calves. It can also help improve circulation and reduce soreness in the calves.
Transcript
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This is Brent coming at you with
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video we're going to go after one of our most commonly overactive muscles, one of
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those muscles that tends to be adaptively shortened in almost everybody,
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definitely everybody with lower leg dysfunction, and that's the calf complex,
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a very stubborn muscle that could use a good stretch in nine out of ten
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individuals that I see. I'm going to have my friend, Leanne, come out and help me
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demonstrate this exercise. Now, Leanne is going to set up so that she scoots
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back on the table lying face up, with her heels just off the table. Now, if I was
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doing this for me without the cameras here I'd want to concentrate on my
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mechanics so I don't hurt myself if I'm going to be doing this all day. I would actually
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have Leanne and go ahead and scoot as close to me and she possibly could, and I'm
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blocking my hip out so I don't push her off the table. And then, I would have this
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ankle nice and centered so that I don't have to lean over the table and
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compromise my own low back. Now, for you for the camera, so that you can
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see everything I'm doing with my hand placement, which is the more complicated
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part, I'm going to move Leanne into a slightly different position. I'm going to
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have Leanne go ahead and scoot back towards you, and then I'm going to
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have her take this leg and move it out of our way. Now, we need to do a little
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review of our anatomy of the ankle, and a little bit on the mechanics of the ankle,
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so that we ensure that this stretch is effective for everybody that we do it on.
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Now, we've got to remember that we've got two bones in the leg attached to our
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ankle. We've got the tibia and the fibula which ends in our medial
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malleoli and lateral malleoli. So those are the top bones of our ankle
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complex, and then just below that we have our talis, which
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we're going to palpate here in a second, and then we have our calcaneus which is
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our heel bone. So, sandwiched between your tibia and fibula and your calcaneus, is
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this often forgotten bone, the talis, which plays a huge role in making sure
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that this stretch is as effective as possible. So, first things first, let's
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find out how to palpate this little bone. I want you to slide your fingers
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over the lateral and medial malleoli, then I want you to go just distal and
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anterior into these little divots right here. If you push into inversion you
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can actually see that divot a little bit, if you push into eversion you
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can see the divot on the other side. If you put your fingers and those divots
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you'll actually feel the bone pop into your hand. So, if I push her this way the
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talis pops into my hand that way, if I go this way the talis pops into my hand this
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way. So now I know where that talis is, I'm nice and comfortable. But
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obviously you know where the heel bone is, so make sure you
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have a good feel of what that calcaneus feels like. So, in individuals with
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dysfunction, this bone has a tendency to move anteriorly, which we look at this
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three bones set, if it moves anteriorly this bone in the middle blocks us
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from getting into dorsiflexion, and we never get this stretch in the calf. I
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know some of you have already felt felt this. You've gone to do a calf
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stretch, either had your calf manually stretched or done it yourself with maybe
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a slant board, and rather than feeling a stretch in your calf you feel nothing at
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all or a pinch in the front of your ankle. So we need to figure out
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how to reduce that. What you're going to do is you're going to wrap your hands
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around the calcaneus like this. We're going to create just a little
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distraction, just a little pull this way so we open up the ankle complex.
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Don't yank on the ankle. I'm not trying to pull the foot off of the
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leg, we're just going for a little distraction. So I'm going to use these
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three fingers for me, wrapped nicely around Leanne's calcaneus, and then all I
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did you saw is I just shifted my body weight over a
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little bit, so that she feels just a little bit of downward pressure on that
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calcaneus. That'll open the space here so that if I use my webspace, and I
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stabilize that talis, as I pull into dorsiflexion this way, I get this nice -
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this is my talis, this is my calcaneus, everything shifts like this. The talis
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should move posteriorly as we go into dorsiflexion. So all I'm doing with all
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of this crazy hand placement is ensuring that that happens. So we got calcaneus, a
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little bit of distraction, talis, a little bit of posterior shift, so
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stabilizing and pushing down a little bit with my webspace, and then I'm going to
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pull up anteriorly on my calcaneus, while wrapping my forearm around this way, to
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bring me into dorsiflexion. So let's review all that really quickly one more time.
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Distraction, posterior shift, pull up on calcaneus, and now we're in the perfect
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position to get a nice stretch on her calf. So I'm in position here, I
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want to make sure that my fingers are wrapped around the front, but my forearm
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is wrapped around behind like this. My arms I want to get nice and straight.
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Once you have your hand position down, you want to get nice and straight
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this way so that I'm pulling her into dorsiflexion by simply taking a nice
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wide step, going into a little lateral lunge, and using gravity and my body
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weight to pull against her calf. Now, obviously I have a huge size advantage
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on Leanne. That is not going to occur with every client or patient that you
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have. So you need to ensure that you're using great body mechanics, and not
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muscle, I see this every once in a while where people are using their
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finger flexors and trying to use their biceps to get a good stretch. You're
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going to wear out. This is a huge strong muscle that lifts somebody's entire body
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weight with every step. So, good body mechanics, I'm going to go a little
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distal, pull a little distraction, stabilize, arms straight, shift over. How
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does that feel? -Great. If you wanted to use your PNF protocols with antagonist
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and agonist contraction you absolutely could. If not, static stretching is very
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effective for increasing the length of an adaptively shortened muscle. We would hold
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this position for 30 seconds to 2 minutes until we felt a release. We'd
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go a little further, and we'd do that for up to three repetitions. Now, just a
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couple things to show you because I know you're probably curious what's
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going on with my hand on the other side, let me see your other leg really
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quickly. Just so you see, if you got all of the setup here, what happens with your
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hand on the other side is actually it just kind of falls into place.
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So I'm going to do my distraction. I'm going to brace down on my talis this way.
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And you can kind of see my thumb just kind of ends up over the bottom of
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my fingers, mostly because I have really large hands. Your fingers might
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end up in slightly different places. I'm going to come this way, and
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then I'm going to pull, and I know you see me blocking this out. So, once
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again, this is my hand position on this side. A couple things that I don't like
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to see on calf stretching which I do see in gyms a lot, as well as some therapy
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studios and some ATCs, it's just a little bit of poor technique that we may
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need to think about a little bit more. Every once in a while I'll see somebody bear
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down on the forefoot this way. I understand the calves are big and strong
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and we're trying to get some leverage, but there are a lot of other joints in
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here, in the forefoot. These muscles that stabilize the bottom of the foot are not
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particularly strong. If I push down on the forefoot I think I am probably just
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as likely to stretch out those muscles that stabilize our medial longitudinal
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arch as I am to stretch out the calf. Of course this has a postural, that is, a
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movement impairment impact. If I continue to stretch out the medial stabilizers of
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my foot, I could, over time, stretch somebody into flat-footedness. So we
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definitely don't want that. The other thing I sometimes see, which really,
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really worries me more than anything else, is every once in a while I'll see
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somebody get up here and try to stretch down on the calf. Now, usually this is a
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pretty intense feeling, and sometimes people end up feeling it all the way
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into the back of their leg. Well, if we use a little logic we know that our
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calves don't cross up into the back of our leg, they certainly don't cross our
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hip, right. Our gastroc crosses the knee, I get it, but it certainly doesn't
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go up this high. So if we have a sensation, we might need to think about
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some of the other structures that we can affect. The only structure that crosses
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behind our hip, behind our knee and behind our ankle, and would be stretched
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by all three joints combined going into flexion, extension, and dorsiflexion, is
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our sciatic nerve. So this becomes an awesome sciatic nerve
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stretch, and there's not a reason to stretch a nerve. Stretching nerves, as we
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know, reduces their blood supply, and could create damage, could create some
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sort of at least short term damage. You could end up with a very upset patient
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or client who has tingling for several weeks while that nerve has time to, I
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guess, regenerate or recover from the stretch that you just did. We need to
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make sure that when we do stretches we're in a nice neutral position at the
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hip, nice neutral position of the knee, so that no matter how far we press into
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dorsiflexion we're not going to end up stretching nerves and stretching
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structures that we didn't intend to stretch. So, a really quick review here,
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we're going to go a little bit of distraction, we're going to place our web
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space just below our medial and lateral malleoli, we're going to press
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distraction, press down posterior on the talis. We're going to wrap our forearm
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around so it's just underneath the metatarsal head to the ball of the foot,
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I'm going to get my arms up nice and straight and I'm going to shift over. I
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hope you get great results from this stretch, I think with a little
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practice you'll see some really big benefit that maybe you haven't seen in
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