Activating The Calf After ACL Surgery

A lot of focus during recovery from ACL reconstruction is placed on restoring quad strength and size after surgery, and rightfully so.  We shared a few tips on ways to efficiently do just that here and here. However, many athletes also have difficulty fully activating the calf muscle after surgery. This article will cover why this occurs and what to focus on in order to ensure you’re getting the most out of your calf exercises.

The calf muscle is crucial for an athlete’s explosiveness. It is a muscle that provides stability and power as we transfer energy from the larger muscles in the hips and legs through the ball of the foot.  This transfer of energy occurs every time we explosively push off the ground, whether it is walking, running, or jumping. If the calf muscle is not activating properly, you will likely feel less explosive and be more prone to future injury.

After tearing an ACL, the nervous system immediately reorganizes movement to decrease stress on the knee.  In layman’s terms, that means those who suffer an ACL tear will almost always start to limp.  When we limp, the knee bends, and we push very little through the ball of the foot.  You may also notice that you develop a preference to push off either side of the foot, rather than straight through the foot. All of these patterns decrease activation of the calf muscle.

Over time, the noticeable limp dissipates, but less noticeable changes to your movement pattern may stick around.  For instance, your knee may not extend (while performing) quite as much as you used to or you may not push off the ground with quite as much force.

In order to activate the calf optimally, you will need to work to identify and restore the proper movement patterns.

In order to restore efficient activation of the calf muscle after ACL surgery, you will need to focus.  You’ll need to understand how the body compensates when the calf isn’t activating properly and work to overcome those compensations.

It’s likely that you’ve already been introduced to the exercise that will be most helpful – the calf raise.

It’s less likely that you’ve heard how important it is to do the exercise properly if you want to fully activate the calf.

Failing to do the exercise properly will only reinforce the patterns that caused the calf to “deactivate” in the first place.  In order to make sure the calf is being activated during calf raises, focus on the following;

• Toes pointed straight forward
• Push through the ball of the foot
• Ankle in neutral position (not rolling in or rolling out)
• Knees straight
• Standing tall through the hips
• Torso as upright as possible
• If needed, you can stand closely to a wall for a little bit of balance.

Try incorporating focused calf raises into your routine with at least a 1 second pause at the top of the range of motion.  Once you perfect the form, see if you can hold it at the top for 60 seconds at a time.  Coordinating all of the cues listed above may be difficult at first – pay close attention to how your body compensates and take note.  These will be the patterns you need to overcome in order to achieve full activation of the calf again.

If you end up trying it, please let us know how it goes!  How do you notice your body cheating?