MAYO CLINIC

DEAR MAYO CLINIC: I tore my calf muscle while running a few months ago and went to physical therapy for treatment. It seemed to heal well, but last weekend I tried running for the first time since the injury. After a couple of miles, I felt a strain in my calf. Is there anything else I can do, or will I have to give up running? I am a 51-year-old male.

ANSWER: Your situation is common, especially for runners your age. You probably won't have to give up running. But you may need to ease up a bit, and you will need to give your body more time to heal. Additional physical therapy can help as you work through that process.

Calf muscle injuries are among the most common for runners over 40, particularly men. This type of soft tissue injury can heal, but it's going to take time. For younger runners, recovering from a calf muscle injury usually takes about six to eight weeks. At 51, however, you've lost some flexibility and elasticity in your soft tissue. That means recovery is going to take longer - possibly 12 weeks or more.

Taking it slow is key to a successful recovery. A general recommendation for returning from this kind of injury is to start at just 15 minutes of running every other day, and stay at that level for one week. If you are able to do that without pain, in the second week, move up to 20 minutes of running every other day. Once you can comfortably achieve that, add another five minutes to your runs each week. At that time, you also can add one more day to your weekly running schedule. If at any point you feel discomfort, take your running down to the previous level you were able to achieve without pain. Recognize that even when you are completely healed, you may not be able to run as far or as fast as you once did.

As you work on returning to running, you also may want to incorporate cross-training into your exercise routine to help you stay fit without raising your risk of another injury. An elliptical trainer or a stationary bike, swimming, or outdoor biking can provide quality workouts.

At this time, it would be wise to see your physical therapist for additional evaluation and therapy. He or she can provide guidance on exercises that may be useful for strengthening your calf muscle, such as eccentric exercises that focus on lengthening contractions in the muscle. An example of this type of exercise involves standing on a step with your heels hanging over the edge, and then slowly lowering your heel down, so you control the descent of your leg with the calf muscles.

You may want to consider undergoing a runner's evaluation, too. A physical therapist or sports medicine physician can conduct this assessment while you run on a treadmill. As you run, your provider will watch your gait for signs of biomechanical issues that could raise your risk for injury. Correcting those issues could reduce your chances of future injuries.

Another step you can take to help prevent additional injury is to ensure you always warm up thoroughly before you start running. It can be as simple as taking a few minutes to walk before you run. A warm-up allows for more blood flow to your muscles, making them more elastic and less likely to strain.

If running is a priority for you, using a slow, measured approach with guidance from a physical therapist is the best method for recovering from this type of injury. It will take some time, but with discipline and patience, you'll likely be able to enjoy running again. - Matthew Butters, M.D., Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, Ariz.