You’re Definitely Not Doing Enough Calf Raises!
Time to get back in the gym!
There seems to have been a strange uptick in calf-related injuries this NFL season. Even if we just focused in on high-profile Quarterbacks, we’ve got Cincinnati’s Joe Burrow battling a calf strain from the preseason, Hall of Famer Aaron Rodgers well into his rehab for an Achilles rupture, & now Minnesota’s Kirk Cousins has gone down with a torn Achilles! It’s a really strange coincidence, if nothing else.
This does spark a question for me, though: Are we training our calves enough?
Looking back at some of my past workout plans, I never really spent any significant time training my calves until I had an Achilles injury of my own; it’s only recently occurred to me how much we actually have to load our calves to see any significant gains!
When we’re talking about the calves, we’re typically focusing in on two specific muscles: the gastrocnemius & soleus. Two heavy-lifting muscles that are used to supporting & propelling our full bodyweight for great periods & over great distances! The soleus, specifically, is usually made up of about 80-percent slow-twitch muscle fibers (Gollnick; 1974)! That means that it’s extremely fatigue-resistant and requires a ton of time under tension & extra reps to really see any growth!
Diagram of the Calf's Anatomy, Gastrocnemius, Soleus, and Achilles Tendon
A good majority of my early career has been spent working with the geriatric population. Just from looking around, I’ve noticed that my patients with thick, well-developed calves are the highest functioning – stronger, faster, safer walkers, better balance, & less falls. When I get to the gym after work & look around, I almost never see anyone doing calf raises (though, I’ve not been going to the best gyms lately)!
It seems like we may be missing the mark!
Our calves generally aren’t our most talked about muscle group, but they’re definitely in the conversation for the most important! They’re so important, in fact, that they’re often referred to as our “second heart”!
“Activity of the calf muscle pump is the motive force that significantly affects venous circulation in the lower extremity. It produces streaming of venous blood in both vertical and horizontal directions. The vertical flow has two components: a centripetal flow during calf muscle contraction and a centrifugal flow during muscle relaxation. Pressure changes are generated in deep lower leg veins. Calf muscle contraction elevates the pressure to approximately 140 mm Hg and expels venous blood into the popliteal and femoral vein...”
“Function of the calf muscle pump. The calf muscle pump helps to return venous blood from the legs to the heart and reduce venous hypertension. By performing calf exercises, such as walking or ankle pumps, the calf muscle contracts to squeeze the blood through the valves to move blood back up to the heart.” Fukaya et. al; 2022
Prolonged inactivity with the assistance of the downward pull of gravity can lead to a good amount of blood pooling in the lower extremities, especially as we get older and start to see more cardiovascular issues – this could lead to pain & swelling, as well as blood pressure related abnormalities such as dizziness & light-headedness!
Of course, that’s not ideal, so what’s the answer? More Calf Raises!
“Therefore, the main findings of the present systematic review were that [Exercise Training]:
1) improves venous reflux, ankle range of motion, muscle strength, and health-related quality of life in patients with mild [Chronic Venous Insufficiency] and;
2) improves ejection fraction, residual volume, ankle range of motion, and muscle strength in patients with advanced CVI and skin changes or leg ulcers, without changing venous reflux parameters.
These findings reinforce the importance of [Exercise Training] in clinical management of all stages of CVI, mainly by increasing muscle strength, ankle range of motion, and calf pump function.”
Now there’s plenty of strong evidence linking stronger calves to better blood flow; so, wouldn’t it make a little sense that relative calf size would be a good indicator of health as well? At the very least, calf size should be a good indicator of cardiovascular health, right? Muscle size is, in fact, one of the most proven indicators of strength! So does the literature bare that out?
Of course it does!
In their study looking at over 1,000 elderly men & women, Hsiang et. al found that the larger a subject’s calves were, the lower their risk of a heart attack or sudden death!
“… the most remarkable finding was that [Calf Circumference] and FRS-CHD revealed a significantly negative correlation in both genders in all models (all P < 0.05). Moreover, the results also indicated that the highest quartile of [Calf Circumference] had more significantly negative correlation with FRS-CHD compared with the lowest quartile in both genders”
You should get the point by now! Adding some bulk to your calves will give you more than just aesthetic benefits – the research points to reduced mortality (Fernandes et. al; 2022), as well as fewer cardiac & metabolic risk factors (Bian et. al; 2023)!
Your calves are a major indicator of your overall health!
So stop skipping leg day -- it’ll benefit you in the long run!
You’re definitely not doing enough calf raises!
Works Cited & Further Reading
Gollnick, P. D., Sjödin, B., Karlsson, J., Jansson, E., & Saltin, B. (1974). Human soleus muscle: a comparison of fiber composition and enzyme activities with other leg muscles. Pflugers Archiv : European journal of physiology, 348(3), 247–255. https://doi.org/10.1007/BF00587415
Recek C. (2013). Calf pump activity influencing venous hemodynamics in the lower extremity. The International journal of angiology : official publication of the International College of Angiology, Inc, 22(1), 23–30. https://doi.org/10.1055/s-0033-1334092
Fukaya, E., Klein, A., Lau, J., & Ratchford, E. V. (2023). Vascular Disease Patient Information Page: Venous leg ulcers. Vascular medicine (London, England), 28(1), 89–92. https://doi.org/10.1177/1358863X221118120
Silva, K. L. S., Figueiredo, E. A. B., Lopes, C. P., Vianna, M. V. A., Lima, V. P., Figueiredo, P. H. S., & Costa, H. S. (2021). The impact of exercise training on calf pump function, muscle strength, ankle range of motion, and health-related quality of life in patients with chronic venous insufficiency at different stages of severity: a systematic review. Jornal vascular brasileiro, 20, e20200125. https://doi.org/10.1590/1677-5449.200125
Hsiang, C. H., Wu, C. J., Kao, T. W., & Chen, W. L. (2020). Calf circumference and risk of cardiovascular disease. Geriatrics & gerontology international, 20(12), 1133–1137. https://doi.org/10.1111/ggi.14052
Fernandes, D. P. S., Juvanhol, L. L., Lozano, M., & Ribeiro, A. Q. (2022). Calf circumference is an independent predictor of mortality in older adults: An approach with generalized additive models. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 37(5), 1190–1198. https://doi.org/10.1002/ncp.10780
Bian, L. L., Lan, A. C., Zheng, Y. K., Xue, H. Y., & Ye, Q. (2023). Association between calf circumference and cardiac metabolic risk factors in middle-aged and elderly women. Heliyon, 9(6), e17456. https://doi.org/10.1016/j.heliyon.2023.e17456
