Medial Gastrocnemius Strain

For the second time over the past few months, I pulled a calf muscle on a run the day after a particularly challenging SUF session.

The first was back in October (Attacker on 24th; run, 25th), while the most recent was yesterday/today (Nine Hammers his time). Terrain on the run was different (flat v. rolling today), and today’s pace was a bit quicker, but the effect was felt just before two miles.

My questions, then, are these:

  1. Has anyone else experienced MGS on a run following a SUF session?
  2. If so, what treatment did you use to get back in SUF-fing shape, on & off the bike? (Me: RICE for today, followed by SUF yoga, and increased indoor rowing, but I’m open to suggestions, as that method takes a LONG time to get back to running.)
  3. Also, if so, what adjustments (if any) did you make to SUF sessions? I’ve adjusted my fit (for the better) and did a more accurate FF just last week. Should I decrease intensity for these more aggressive sessions?

I’m not on a training plan (long story, but the gist is that serving as caretaker for a disabled spouse & two small kiddos means I take what time I can get, when I can get it—which is neither often nor predictable [example: it’s taken me nearly an hour to type this]), and COVID has kept me out of the gym since February, so I know everything is stacked against me (believe me, I know), but a response from Sufferlandria at large would be nice.

Ouch! Sorry to hear about the injury @SirDale.

I haven’t experienced that particular injury, but I’m conscious that I’m often feeling pretty stiff and sore from time on the bike, and that I’m on the edge of muscle strains when I’m running.

For me, two things have helped:

  • foam roller on calves, quads, hamstrings, glutes, ITB as regularly as I can
  • activation sessions (especially for glutes) prior to running

Best of luck with your recovery.

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Have done/tried both but to no avail. Thank you for the suggestion & feedback.

Have you tried periodically applying heat to the muscle after you have finished with the RICE?
My physician once told me that the medical literature is unclear as to when cold or heat is appropriate.

Not heat, no. Mostly compression, though I have also (this time) incorporated a Strassburg sock. Rolling on a ball reveals the source of the problem appears to be much higher up, where what feels to be the semitendinosus meets the gluteus maximus.

I sometimes get the impression that the scientists are still guessing when it comes to treating these kinds of injuries, partially because it depends so much on how an individual will respond.

I hope you find a solution soon!


Hope you find a solution soon! Best of luck with the recovery and future injury prevention.

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Is the pain definitely gastroc and not soleus?

Firstly, I wouldn’t necessarily look too much into your bike fit. The injury comes on during running, not cycling. So I think you’d better be served by looking into footwear than the bike fit.

Secondly, to help with recovery, if you can just the usual… Massage (you can do this yourself easily enough). Ince the injury has. Passed the acute stage I avoid ice for any patients I treat. In fact, unless any inflammation is clearly impeding healing I avoid ice full stop for various reasons. Heat will be better after the acute stage (few days to a week).


Once your injury has recovered somewhat then you need to look at why it’s happened, exactly what the injury is, and what to do to prevent it. If indeed it is medial gastroc then look at some eccentric calf exercises, basic things like hopping/skipping. If it’s soleus then any exercises loading the calf should be with a bent knee.

Unfortunately without really examining you it is hard to say exactly what should be done. Have a look at the soles of your running shoes and check for differences in tread wear pattern, if it is different and if it persists, it may be worth looking to see a podiatrist first. If there’s no significant difference then see any musculoskeletal specialist and they should be able to help.


I had to look up the word since most popular culture is foreign to me, and has been for years. I used Google Image search to find out from where the GIF came.

Did you pick this GIF on purpose since the word might be of Canadian origin?

My eyes pricked up when I read 2 miles. For about 6 months early last year I’d pull my calf @ 2.4km. I tried everything. Eventually a new pair of shoes (New Balance 880 wider fit) & a prosthetic insert under my Right Big toe. Problem went away immediately, 6 weeks later I ran 68km trail (over 3 consecutive days) & I’ve not had the problem recur since May…

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Thank you so much for the detailed response @Ross. To address the points…

  1. I do not know a definitive diagnosis. Though the pain manifests in the calf, I am convinced it is due to a weakness further up or down stream, so Dr. Google & I spent some time reviewing muscles along the backs of the legs, and MGS seemed to be the most likely candidate. The soleus, however, also seems a possibility.

  2. I concur about ice and actually did skip this yesterday as there was no visible swelling. Compression has been the mainstay, courtesy of Air-Relax compression boots & jumper.

  3. Rest is on my calendar for the next few days, but continuing to assist my wife with wheelchair transfers does take its toll. Following her surgery on 12/16, I’ve been needing to essentially deadlift and pivot her on her limp legs until she regains a bit more functionality. I’ve tried to be mindful of my form but (for sure) noticed it in the calf yesterday morning, post-run.

  4. Diagnosis by internet is not something I typically pursue, but, being the weekend and that I have to return to work on Monday, I was somewhat desperate. Again, thank you for the detailed response and questions. I’m not convinced it’s the shoes as the October instance was in a different pair of shoes (Brooks Ghost 12) and on the right leg; yesterday, Altra Escalante 2.0 & left leg. (So, @Pulawater, I’m unsure if the different shoe & insert are wholly warranted, especially since I had been having such good runs the past couple of weeks in the Escalantes. The only outlier for yesterday, as well as in October, was the intense SUF session the day before.)

Many thanks with much to mull over.

I use “samesies” a lot just to be funny. Oftentimes, attempts at humor fail me with my colleagues (and/or students) who find themselves unsure of how to react to an otherwise austere person. Think Severus Snape (of Harry Potter) trying to be funny and you’ve got me.

As for the gif, it was a random choice, typically using Amanda Seyfried from 2004’s Mean Girls.


UPDATE: Another failed trial run today with continued cramping in the left calf—this time after just over one mile instead of the typical two.

Scheduled an appointment with a biomechanics expert for Thursday. He tends to agree that (from the sound of it) my bike fit on the trainer is causing issues with my running, most likely due to pelvic positioning essentially shutting off my glutes.

Hope to get a proper indoor fit and back to “normal” soon, in & out of Sufferlandria.

I guess it sounds like there’s some question whether it’s actually a “strain.” I think people use the word strain a lot but IIRC that really means a muscle tear, albeit often a small one.

FWIW, i have had a small strain in my calf before. It happened on the bike during a twenty minute test. I didn’t notice it during the interval (some people describe a feeling of a “pop”) but on the ride home, i noticed pain that felt like bad pain (not good pain) during some on-bike movements. Later that night during foam rolling, pain again plus a bruise rose to the skin surface, classic signs of a strain. It was clearly mild, so i didn’t ice it (pain wasn’t that bad, and swelling wasn’t bad). Instead i used the heat of sitting in a bath, and very gentle foam rolling each evening. I took a couple days off the bike, then a couple days riding easy (read: no SUF), and after about five total days, i could bounce on the balls of my feet without any pain or more importantly, fear, so i started training again. So, less than a full week and i was good to go. I’m not sure there’s much to prevent this other than getting plenty of sleep, good nutrition, and reasonable training load ramp rates. So, stuff that’s already good practice anyway.

If it’s a muscle weakness or imbalance, then you probably rather want some physio-type exercises that strengthen the problem, i’d guess.

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