What do you use thousands of times on a daily basis…
That contains a frame consisting of over: 30 solid parts – which interact with a corresponding network of nearly three dozen joints and is crossed by a web of ligaments, and is supplied with thousands of nerve endings?
What, if not properly paid attention to, can also potentially wreak havoc on your squat, deadlift, and impede performance in just about every sport?
If you answered, the foot, ankle, and lower leg, you’d be correct.
When people talk about the body’s foundation, they are often referring to the core. Core training has been discussed a billion times throughout the years; however, people don’t talk about what is the body’s literal foundation – the foot, ankle, and lower leg.
No, I’m not a podiatrist – who, unfortunately are frowned upon in the medical world. No, I’m not Rex Ryan, the New York Jets head coach, who admittedly has a foot fetish. And lastly, no, I’m not trying to piss off coaches and trainers who have discussed the importance of proper core training throughout the years. I’m just shedding light on an important area that has some pretty big implications on performance and may negatively impact the rest of the kinetic chain if not paid attention to.
If you haven’t been in an anatomy class since George W’s first term in office, I would suggest checking out the section below, which will discuss the region’s bones, joints, superficial and deep musculature, and the one thing that Rex Ryan gets more excited than pissing off the rest of the AFC East – the foot.
Along with a web of ligaments and network of muscles, which will be discussed later, the tibia is the bone that essentially links the knee and ankle joints. It is the second longest bone in the entire body and among one of the strongest due to supporting the weight of the body.
The fibula sits lateral to the tibia, attached by proximal and tibiofibular joints. Its head serves as an attachment for biceps femoris and the lateral collateral ligament (1). The fibula isn’t as strong as the tibia, making it more susceptible to fractures; however, the recovery time from a full fibular fracture is much shorter than a full tibial fracture.
In 2003, Michael Vick was able to bounce back from a fibular fracture after just three months and Reggie Bush came back after missing just seven games this year due to a fibular fracture. Their recovery periods were much shorter than that of Bryant Young, a retired defensive tackle, who gruesomely fractured his tibia and fibula, when a teammate’s helmet collided into his lower leg. The injury took Young nearly one full year to recover.
Posterior lower leg muscles
If you don’t do anything but read bodybuilding magazines found on the shelves of newsstands, then you may have not heard of any muscles beyond the gastrocnemius and the soleus. Along with the plantaris, they are the superficial muscles of the posterior leg – which plantar flex (move the toe away from knee) the foot.
The gastrocnemius is comprised of two heads: the medial head, which originates slightly above the medial condyle of the femur, and the lateral head, which originates slightly above the lateral condyle of the femur. The medial and lateral heads insert into the calcaneus through the lateral portion of the calcaneal tendon.
Both heads help stabilize the knee and ankle when standing, and as mentioned above, plantar flex the foot in concert with the soleus. The gastrocnemius contains the most fast twich fibers out of the three (1), making it more capable of providing the rapid plantar flexion required to achieve triple extension in Olympic lifting, jumping, and in the rear support phase of sprinting. The gastrocnemius also assists with knee flexion – which is why you’ll see it highlighted on a diagram of a leg curl machine.
The soleus orginates in the upper fibula and from the soleal line of the tibia. It inserts in the calcaneus, or heel bone, through the medial portion of the calcaneal tendon. The soleus also plantar flexes the foot, but since it has a far greater proportion of slow twitch fibers in comparison to the gastrocnemius and because it does not cross the knee, it is better suited for postural actions – such as standing for prolonged periods.
The plantaris muscle orginates just above the lateral head of the gastrocnemius on the femur, blending with the calcaneal tendon. It too, assists with plantar flexing the foot.
Going deeper, we encounter the Tibialis Posterior, which stabilizes the ankle, inverts and adducts the foot, and helps plantar flex the footand the Flexor hallucis longus, which assists the tibialis posterior with plantar flexing, inverting, and adducting the foot; and the Flexor digitorum longus, which also helps the tibialis posterior with its tasks.
Now let’s examine the Anterolateral lower leg muscles.
The Tibialis Anterior is the strongest dorsi flexor (toe to knee) of any of the Anterolateral lower leg muscles. It orginates from the lateral condyle of the femur and the superior half of the lateral surface of the tibia with the medial and plantar surfaces of the base of the first metatarsal and the cuneiform as its points of insertion.
The peroneal group consists of the Peroneus longus, the Peroneus brevis, and the Peroneus tertius. Together they evert and abduct the foot. Its recommended that individuals with a history of inversion ankle sprains and injured lateral ligaments strengthen the peroneals (1). This can be accomplished via banded ankle traction exercises and isometric foot abduction against a wall or another solid surface.
Smaller muscles of the Anterolateral compartment, include the Extensor digitorum longus, which assists with eversion of the foot, and the Extensor hallucis longus, which is a weak with inverter and adduct[er]. Together the extensor muscles assist with dorsiflexion.
Running the entire length of the lower leg, stemming from the calcaneus and blending into the fibers of both the medial and lateral aspects of the gastrocnemius and the soleus is the Achilles Tendon. The Achilles is the longest and strongest tendon in the entire body and is subjected to forces much greater than body weight during sprinting and jumping activities, when it acts as a mechanism for the plantar flexion initiated by the gastrocnemius and soleus. It is susceptible to overuse injuries, which often present themselves in endurance athletes.
Traveling further down the leg, we find the ankle, its three main joints and the foot. Because of this region’s complexities due to its intricate structure of 26 or so bones, 33 joints, and over 100 ligaments and my lack of professional expertise in this area, it will only be briefly described. You know that’s why medicine dedicated an entire field to its study – it’s called podiatry. But we’re going to examine the main areas of the ankle and foot, as well as highlight some concerns which may land you in a podiatrist’s office.
The ankle is comprised of three main joints: the Talocrural joint, a hinge joint, formed the distal heads of the fibula and tibula that enclose the upper surface of the talus*. It is responsible for both dorsi flexion and plantar flexion. The Subtalar joint also involves the articulating surfaces of the talus as well as the calcaneus and inverts and everts the foot. It also helps absorb shock during landing from jumps and helps reduce impact throughout the gait cycle. Lastly, the Inferior Tibiofibular joint, comprised of proximal and distal joints, is a strong joint linking the distal segments of the tibia and fibula.
*The talus is a smallish, square-shaped bone that sits between the heads of the fibula and tibula and the calcaneus and is crucial in the multi-planar movement of the ankle and foot.
The main ligaments in the ankle include the lateral collateral ligament and the medial collateral ligament. The lateral collateral ligament consists of three parts: the Anterior talofibular ligament, which passes from the fibula to the front of the talus bone, the Calcaneofibular ligament, which connects the calcaneus and the fibula, and the Posterior talofibular ligament, which passes from the back of the fibula to the posterior surface of the calcaneus. The medial collateral ligament, which is sturdier than the lateral collateral ligament, covers the distal end of tibia, and inner surfaces of the talus and calcaneus.
I’ll leave Rex Ryan out of this one, but if Sal Alosi tripped…okay I’ll leave the Jets out of it. Much like they’ll be left out of the playoffs in a week or two. Ouch! I’m just kidding. But something that does hurt and definitely isn’t a laughing matter are foot injuries. The main muscles of the foot and its common pathologies of injury will be discussed.
Among one of the most commonly discussed and problematic is the plantar fascia. Its widely speculated that Plantar Fasciitis results from excessive pronation (or Pes Planus) of the foot due the lack of a supportive medial arch. This condition is often worsened by inappropriate footwear, excessive or improper exercise protocols, specifically, endurance exercise, and of course being overweight. All of these factors can lead to tight calves, which can also cause foot pronation. Excessive pronation may be a contributing factor to patellofemoral issues. Pes Plavus, which is characterized by a supinated foot with a coiled arch, may also cause patellofemoral issues.
Before things get too out of hand and require the intervention of a medical professional, one may want to consider using a ball to roll beneath the foot to break up any adhesions in the tissue. I’d suggest using a tennis ball at first, progressing to harder balls (such as a softball, or lacrosse ball). I’ve found that rolling your foot on the ball throughout the day (i.e. at your cubicle, on your couch, even between sets at the gym) to be helpful in addressing a tight plantar fascia. If you can’t handle a tennis ball, then you should most likely seek out medical help.
Plantar Fascia Ball Roll. Video Ball roll for Plantar Fasciitis
So we talked about a stiff foot, but what about a stiff ankle?
Ankle mobility or lack thereof, is an issue that has received more coverage from trainers and coaches than when CourtTV covered the O.J. Simpson murder trial. So instead of rehashing everything they’ve said, I will say that a lack of ankle mobility will impede your athletic performance and for all you “I hate leg day” newbies and bodybuilding magazine reading wannabes – could make leg training even more unsavory.
Achieving good depth on squats and being able execute a 1.5 BW power clean won’t be possible if you have poor ankle mobility. A lack of ankle mobility may render the calves rigid, causing your body to adopt compensatory mechanisms to walk (tight calves affect gait) and lift – which will likely invite back pain.
Ankle Mobility Exercises
- Wall Ankle Mobility Drill
- Ankle Circles (in water)
- Dynamic Dorsi Flexion Stretch
- Heel Wipers
- Ankle Pivots
- Ankle Drillers
- Ankle ABCs
Here are some surefire things you can do to address tight calves:
- Foam Roll Calves, courtesy of Todd Bumgardner, MS, PES, of beyondstrengthperformance.com
- Foam Roll Anterior Tibialis, courtesy of Todd Bumgardner, MS, PES, of beyondstrengthperformance.com
- Stick Calves
- Stick Peroneals
Here are some exercises you can use to strengthen the ankles:
- Iso Inversion
- Iso Eversion
- Ankle Traction Exercises with Tubing or Banding
- Backwards Heel Walk
- Lateral Plate Sweeps
- Bosu Toe Crushes
- Reverse Calf Raises
I got this one from Josh Hewett, CSCS
Now once you have a good understanding of the anatomy of the lower leg, ankle, and foot and have addressed any joint mobility issues and establishing extensibility of the surrounding tissues, only then should you consider training the calves.
Calf Training for Hypertrophy*
Outside of possessing 20” arms and a rock hard chest that looks like it is carved from granite, nothing is more coveted than a prized pair of wheels. When I say wheels, I’m referring to the lower leg – which many commercial gym goers haphazardly train on leg day, that is, if they even have a leg day. Then of course you have the faction of people that piss and moan they can’t add any size to their calves “due to genetics.”
That’s a copout, sorry. In fact, I was hard pressed to find any studies regarding genetics specifically determining the size of a person’s calves. Though genetics can influence one’s muscle bellies and insertion rates, you can still turn your calves into bulls, if you adhere to the guidelines listed below.
1. Use compound exercises. To the newbs out there: try putting a barbell equaling your bodyweight and putting it on your back. Take it a step further by simultaneously sinking your hips and bending your knees. Did you know that you just trained your calves? Indirectly, albeit. But still, you trained them. When you have a loaded barbell on your back, just about every muscle is firing to keep your body erect, so the loaded barbell doesn’t tumble down on you, as it did on Jean-Pierre Fux, during a FLEX magazine photo shoot years ago. The muscles that are keeping you erect include your calves, which are isometrically contracting to give your body the firm base it needs upon descending into a squat.
2. Eat more. Pretty simple stuff here. It’s January, so unless you reside in the Southern Hemisphere, having a visible linea alba is irrelevant. Also, having a defined six pack serves no purpose if you’re trying to crush PRs and by the way, unless you’re running some crazy ass compounds, your “ABZ” will likely fade if you’re trying to add some mass. Also, if you add some size, say 20 pounds during your winter bulk, you’re going to indirectly grow your calves, because now they’re forced to lug around something that’s 20 pounds heavier than it was once accustomed to.
A few things that did not make the list include: Synthol, having Lymphedema, calve implants, or ultra high volume calf workouts.
*This section was dedicated to the trolls – you know the people who want pictures of isolation exercises and programs to get bigger body parts.
Calf Training for Functional Hypertrophy
A lot of people think that merely loading up the stack on a standing calf raise machine and bobbing around as if they’re having an epileptic seizure while performing a few choppy reps will elicit increases in size. To me, using a standing calf raise and doing reps with a limited range of motion is just flawed calf training for a few reasons.
1. If you’re already subjected to a lot of axial loading via training and contact sports, why on earth do you want to place compressive forces on the spine unnecessarily? Often times, people use way more poundage on the standing calf machine than they do on a free weight squat. In fact, you see displays of these not-so-impressive feats of strength on YouTube.
2. Shortchanging your range of motion. People, including champion powerlifters, get flamed by armchair strength coaches for not performing ass-to-grass squats on YouTube, however, if the same powerlifter was doing some calf raises with a limited range of motion, I bet the video would have zero comments in its thread. Also, I’ve had a host of clients who couldn’t even perform a body weight calf raise during their initial assessments.
If you want bigger calves, that function the way they were intended to function, you should use a full range of motion. Full range of motion mimics the plantar flexion required for the lauded triple extension to occur, so you can be a faster, stronger, more powerful athlete.
3. What carryover does the standing calf raise have to sports? Very little, if you’re using a load that’s far too heavy to budge in the first place. Again, calf training should focus on achieving plantar flexion via a full range of motion – you want the movement to be explosive, yet controlled.
Considerations for Calf Training
Often debated is the importance of foot placement and the correlating muscles that are targeted when you rotate your foot either inward or outward. EMG studies have shown that altering your foot placement can impact what muscles are targeted, as in this study conducted on cyclists (2) and what heads are predominantly called upon during partial weight bearing, isometric plantar flexion contractions under varying percentages of body weight and maximal contractions (3). If you evert, or rotate your foot outward, you’ll hit the medial aspect of the gastrocnemius more, if you invert your ankle, or rotate your foot inward, you’ll hit the lateral aspect of the gastrocnemius more. Protocols employing the principle of time-under-tension have been proven effective, because in comparison to the rest of the body’s muscles, calves are largely slow twitch, thus responding better to longer sets.
- Smith Machine Seated Calf Raises
- Donkey Calf Raise with Dip Belt
- Glute Bridge Calf Raises
- Towel Rolled Calf Raises
- Braced Dumbbell Calf Raise
Typically, I’ll toss these in following my ankle mobility exercises, or in between my sets of assistance exercises, following a set x rep scheme of 3-5 x 15 – 20. If you do, I’d suggest training calves one to two times per week.
Also, performing hill sprints will torch the calves in addition to hitting the hamstrings, glutes, and quads.
Hill Sprints, courtesy of Tom Conner, of Snap Fitness, Marlton, NJ and tctrainingsystems.com
Well hopefully some of the major issues involving calf training and its relation to foot and ankle issues have been addressed.
Joe Giandonato is a Philadelphia-area healthcare support professional and personal trainer, he holds an M.S. in Exercise Science and has nearly a decade of personal training experience. Presently, he trains clients at Broad Street Fitness in Philadelphia, PA, before and after his day job as an office grunt. He is also pursuing a MBA and is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association. He is also certified as a Performance Enhancement Specialist (PES) through the National Academy of Sports Medicine. More of his articles can be found on elitefts.com, joshstrength.com, beyondstrengthperformance.com, personaltrainersunited.com, and frequency555.com.
1. Neumann DA: Kinesiology of the Musculoskeletal System: Foundation for Physical Rehabilitation, Ed. 1. Mosby, St. Louis, 2002
2. Sanderson DJ, Martin PE, Honeyman G. Gastrocnemius and soleus muscle length, velocity, and EMG responses to changes in pedaling cadence. J Electromyogr Kinesiol. 2006;16(6):642-649.
3. Fiebert IM, Spielholz NI, Applegate B. A comparison of iEMG activity between the medial and lateral heads of the gastrocnemius muscles during partial weight bearing plantarflexion contractions at varying loads. Isokinetics and Exercise Science. 2000;8(2):65-72.
Special thanks to Todd Bumgardner, of beyondstrengthperformance.com and Tom Conner, of Snap Fitness, Marlton, NJ and tctrainingsystems.com, for allowing me to use their videos.
Thanks for all of your help. Saw the doc – got a combined dx – which didn’t lead to and end of my joy of running…got a good rec for shoes, and I am on my way.
Thanks Joe. I saw a second orthopedic doc for achilles tendonitis (after the first misdiagnosed my pain with plantar fasciitis) and doc #2 callled my attention to the calf asymmetry. He prescribed an orthotic and PT but I didn’t notice much of a change. It’s a difference of about an inch.
However, at least I am pain free. I believe my shoes were the culprit.
Also, for Lisa, I had the wrong diagnosis from a Rothman physician and subsequently, went to the Premier Orthopedics group.
Joe Giandonato, MS, CSCS says
My pleasure, Lisa.
Nike is one of the best shoemakers out there, however, Shox aren’t ideal for most people because they elevate the heel, which throws off the body’s center of gravity. Now because your body’s center of gravity is thrown off, your pelvis anteriorly tilts and your lumbar spine slips into extension. The prolonged heel elevation during your shifts as you stand, walk, and push heavy things around takes its toll as your calves and hamstrings grow tighter. I’m not a podiatrist, nor have I see your shoes insoles and soles, so I don’t know how much your pronating, supinating, etc, but I will tell you that a flat sole is usually better. Ideally, you want your foot to make the most contact with the ground as possible.
There are shoes out there that accomplish this – Vibrams are great, as are Nike Frees, and if you decide on picking up a pair for yourself, ease yourself into them, because the many of muscles of your foot will fatigue due to a lack of proper use throughout the years of wearing heel elevated and excessively cushioned shoes.
Also, hamstring injuries are quite common in dancing. I’ve worked with a couple of former dancers, some that were in good shape and others that hadn’t been physically active since their dancing careers ended and one commonality that I noticed is that they had retained great flexibility, yet they were rife with tight muscles.
Perform some self myofascial release with a foam roller on the hamstrings. Place the foam roller an inch above the knee and hold for 10-20 seconds, or until the discomfort/tightness decreases by atleast 50%. Reset the foam roller and inch or two below the gluteal fold and repeat. As you progress and your hamstring tightness improves, you may slowly roll on the foam roller within that range of motion (one or two inches above the knee to one or two inches below the gluteal fold).
There are many great orthos and DPMs in the Philadelphia-area. I’ve had great experiences with Rothman and NovaCare, but just shop around – ask your coworkers and colleagues. I mean this should be ideal, because you work at a hospital. LOL! See which ones take your insurance, et cetera, and go from there.
Joe Giandonato, MS, CSCS says
First and foremost, I would pay attention to your footwear.
How old are your shoes?
Do you rotate them?
Are you wearing shoes that have an elevated heel – even if they are cushioned
Is the sole too stiff? A less pliable sole may cause Achilles problems and plantar faciitis.
Tight muscles can also be a culprit, specifically tight gastrocnemius and hamstring muscles – gentle massage or self myofascial release will improve their extensibility and performing light static stretching will help improve their length. Since you pushing and pulling patients all day (a ton of nurses do this – I was surprised to see this when I worked in a hospital during college), your taxing the legs for 8 to 12 hours.
If the pain is that debilitating – in my experiences people who cannot plantar flex, or perform any unloaded toe raises without pain have severe tendinopathy or worse yet, a ruptured Achilles. I’d suggest seeing a specialist who can can further assess you and treat your condition.
Thanks so much…
I do try to rotate shoes, and yes, I have found my NIKE shokz to be a culprit – any shoe suggestions are welcomed.
I know from years of dancing that my L hami is tight, always has been – that’s the achilles side too (did I mention the hip?)
Do you rec an orthopod or podiatrist? I ask b/c I saw an orthopod – he said, “you have achilles tendonitis” – handed me a brace and said he would see me in 6 weeks – I put a hole in the brace while running, in less than 2 weeks (it was the aircast brand with the pump in the heel)…needless to say I didn’t go back – I just changed up my cardio. Perhaps that’s the hardheaded ER RN in me..
Joe Giandonato, MS, CSCS says
Asymmetries are quite common, if the size difference is that noticeable, you may want to consider adding more direct calf work to the smaller leg, however, the larger leg could be compensating more during gait, which may require the use of orthotics. If this sounds like the case, or additional problems persist, I’d suggest seeing a specialist.
Strengthening the surrounding musculature (calves, muscles of the feet) will most certainly help with the Achilles tendon. What problems are you facing specifically?
Unable to point (plantar flex) my foot without discomfort, and pain after running (which I have pretty much cut out, but still love – esp. with the warmer weather approaching)…I am a nurse – so after 12 hours of pushing stretchers and moving patients – I have foot/ankle/lower leg pain…hope this helps.
Will the ankle exercises assist in strengthening a weakened Achilles? Desperately trying to avoid and expensive/unnecessary trip to an orthopod.
Good article. I’m a firm believer in calf training. However, my left calf is about an inch larger than my right and has been for at least a year. Would you recommend more single calf raises on the smaller leg?