Lower leg injuries - how to stay trouble-free

Dick Travisano Ph.D. explains how to avoid lower leg injuries.

All impact sports play havoc with the shins, calves, and ankles. For instance, over 40% of all running injuries occur there, and the list of possible disorders is like a menu of pain from which athletes make frequent selections. Tendinitis and muscle soreness are the starters, while the heavy-hitting main courses that can keep you on the sidelines for weeks and months are compartment syndromes, shin splints, and stress fractures. But it does not have to be like that! Research shows exactly how the muscles in the ankle and lower part of the leg function during running and provides clues about how to keep the areas between your knees and your feet injury-free.

We'll show you what to do

In an investigation carried out at the Centinela Hospital Biomechanics Laboratory in Inglewood, California, 15 competitive and recreational runners ran at different speeds. At the same time, their lower leg muscles were hooked up to a device that measured muscle activity. Five important muscles were studied, including three calf muscles (the gastroenemius, soleus, and tibialis posterior), one shin muscle (the tibialis anterior), and a unique muscle --- the peroneus brevis-which runs down the lateral side of the lower leg to the outside of the foot.

Three crucial facts emerged from the Centinela study:

The calf muscles contract most powerfully during the "stance phase" of running when the feet are in contact with the ground. Contrary to popular belief, the three calf muscles do not provide much power for push-off but instead prevent the ankle joint from collapsing forward when the foot hits the ground.
Although the calf muscles are busy while the feet are on the ground, they're pretty lethargic during the rest of the gait cycle when the feet are off the ground, moving backward or forwards. The most active lower leg muscle is the tibialis anterior, a strip of sinew that runs down the shin to the inside edge of the foot and pulls the foot inward and upward. During running, the tibialis anterior contracts forcefully about twice as often as any of the other four muscles, so it is probably the muscle most prone to fatigue. As it becomes tired, the risk of shin splints and stress fractures is likely to rise, as does the amount of pronation occurring at the ankle joint (excessive pronation has been linked to a variety of running problems, including knee injuries). Thus, athletes must make their tibialis anterior muscles as strong and fatigue-proof as possible.
The peroneus brevis muscle contracts somewhat lazily during medium and slow speed running but dramatically increases its activity at race speeds. Strengthening the peroneus brevis should improve foot speed and stabilize the ankle during high velocity running, lowering the risk of injury.

So how do you add steel to your calves, strengthen your tibialis anterior muscles and prop up each peroneus brevis? It's easy, with the following drills, which should be carried out on a track, basketball court, aerobics floor, or grassy surface, but not on concrete. Before you start the drills, walk or jog for ten minutes to warm up. Then begin jumping in place, keeping your weight on the balls of your feet, and avoiding actual contact between your heels and the ground. Complete about 30 "hops" not too fast and not too slow. Pretend you are jumping on a warm stove and get off the floor before your feet have a chance to warm up too much.

Lightning hopping

After a moment's rest, pretend the stove is now red hot and jump quickly, making contact between your feet and the ground as brief as possible. Complete about 40 super fast jumps in about 8 to 12 seconds, just barely getting your feet off the ground and avoiding heel contact. After 30 seconds of rest, complete this "hop and lightning hop" routine once more, and further strengthen your calves by walking quickly forward on your toes for 20 metres. Then point your feet outward at about a 45-degree angle ("duck walking") and stride along on your toes for 20 more metres. Finally, angle your toes inward ("pigeon-toed" walking) and walk on your toes for a further 20 metres. For these manoeuvres, always make sure your hips are rotated outward or inward, so your knees are lined up with the spaces between the big and second toes.

Walk, skip and jog

After these three types of fast walks, skip on your toes using all three techniques. Twenty metres with feet straight ahead, 20 metres with toes out, and 20 metres with toes slanted in. Finally, jog on your toes at a moderate pace using the three methods, for about the same distance. After a minute's rest, complete this walk-skip-jog protocol one more time. For several weeks, gradually increase the amount of hopping, walking, skipping, and jogging that you do. Begin by doing the exercises twice a week, advancing progressively to four or five times a week. After several weeks, try doing the warm and hot stove hops on only one leg at a time, and cut the repetitions in half. Instead of carrying out 40 super-fast jumps using both feet, for example, hop 20 times on your right foot and 20 times on your left.

Backs to the wall

But what about your inferior tibialis anterior muscles, the ones that work hardest during running? Strengthen them by carrying out the following five exercises:

Stand about a foot away from a wall with your back to it and your feet directly below your hips. Lean backward until your buttocks and back touch the wall and then, while keeping your heels on the ground, flex your ankles so that your toes rise as high as possible towards your shins. Let your feet sink back so that they almost touch the ground and repeat this action 15-20 times (the reps increase over time). On the descent, do not let your feet rest on the ground, which would give your tibialis anterior muscles too much of a rest between flexions. Treat the ground as if it was an eggshell, too much pressure would crack it.
After a moment's rest, try a slightly different tibialis-anterior exercise. This time, from the same basic body position, flex your ankles so that your toes ascend as high as possible, but do not let them move more than an inch towards the floor on the downswing. Quickly move your feet up and down within this one-inch arc for 15-20 repetitions (adding more reps later), and then rest for a moment.
Once you have become adept at the first two exercises for several weeks, you can move on to an advanced exercise. For this, keep your back and buttocks against the wall again but stand on only one foot at a time while carrying out No. 1 above. Position the foot slightly to the inside of the hip.
You can also work on the anterior tibialis muscles while jumping. Again, try for quickness rather than height as you jump, but this time "dorsiflex" your ankles each time your feet leave the ground (i.e. try to pull your toes up to your shins on each ascent). 20 jumps should be about right for your first effort, with the total increase over time.
A fifth exercise is to walk on your heels for 20 metres or so. This heel walking can follow the walking, skipping, and jogging routine described above.

Overall, these five exercises have helped many athletes afflicted with shin splints. Another strategy, designed to strengthen all five calf and shin muscles simultaneously, is to run barefoot on a somewhat uneven but soft grassy surface, such as a well-maintained athletic field or a golf fairway. Start cautiously, though, with no more than a half-mile on your first barefoot effort, adding an extra quarter-mile during each subsequent run. The ultimate aim of these exercises is to fortify your feet, ankles, shins, and calves so that injuries are unlikely. However, injury prevention won't be the only outcome. As you progress, your ankles become as powerful as rocket boosters and your feet will act as mini-trampolines. When you run, each foot strike will involve an explosion of propulsive force, not a sad collapse of your foot against the ground.

Article Reference

This article first appeared in:

MACKENZIE, B. (2003) Lower leg injuries - how to stay trouble-free. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 2 / June), p. 3-4

Page Reference

If you quote information from this page in your work, then the reference for this page is:

MACKENZIE, B. (2003) Lower leg injuries - how to stay trouble-free [WWW] Available from: https://www.brianmac.co.uk/articles/scni2a3.htm [Accessed

About the Author

Brian Mackenzie is a British Athletics level 4 performance coach and a coach tutor/assessor. He has been coaching sprint, middle distance, and combined event athletes for the past 30+ years and has 45+ years of experience as an endurance athlete.


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All impact sports play havoc with the shins, calves, and ankles. For instance, over 40% of all running injuries occur there, and the list of possible disorders is like a menu of pain from which athletes make frequent selections. Tendinitis and muscle soreness are the starters, while the heavy-hitting main courses that can keep you on the sidelines for weeks and months are compartment syndromes, shin splints, and stress fractures. But it does not have to be like that! Research shows exactly how the muscles in the ankle and lower part of the leg function during running and provides clues about how to keep the areas between your knees and your feet injury-free. We'll show you what to do In an investigation carried out at the Centinela Hospital Biomechanics Laboratory in Inglewood, California, 15 competitive and recreational runners ran at different speeds. At the same time, their lower leg muscles were hooked up to a device that measured muscle activity. Five important muscles were studied, including three calf muscles (the gastroenemius, soleus, and tibialis posterior), one shin muscle (the tibialis anterior), and a unique muscle --- the peroneus brevis-which runs down the lateral side of the lower leg to the outside of the foot. Three crucial facts emerged from the Centinela study: The calf muscles contract most powerfully during the "stance phase" of running when the feet are in contact with the ground. Contrary to popular belief, the three calf muscles do not provide much power for push-off but instead prevent the ankle joint from collapsing forward when the foot hits the ground. Although the calf muscles are busy while the feet are on the ground, they're pretty lethargic during the rest of the gait cycle when the feet are off the ground, moving backward or forwards. The most active lower leg muscle is the tibialis anterior, a strip of sinew that runs down the shin to the inside edge of the foot and pulls the foot inward and upward. During running, the tibialis anterior contracts forcefully about twice as often as any of the other four muscles, so it is probably the muscle most prone to fatigue. As it becomes tired, the risk of shin splints and stress fractures is likely to rise, as does the amount of pronation occurring at the ankle joint (excessive pronation has been linked to a variety of running problems, including knee injuries). Thus, athletes must make their tibialis anterior muscles as strong and fatigue-proof as possible. The peroneus brevis muscle contracts somewhat lazily during medium and slow speed running but dramatically increases its activity at race speeds. Strengthening the peroneus brevis should improve foot speed and stabilize the ankle during high velocity running, lowering the risk of injury. So how do you add steel to your calves, strengthen your tibialis anterior muscles and prop up each peroneus brevis? It's easy, with the following drills, which should be carried out on a track, basketball court, aerobics floor, or grassy surface, but not on concrete. Before you start the drills, walk or jog for ten minutes to warm up. Then begin jumping in place, keeping your weight on the balls of your feet, and avoiding actual contact between your heels and the ground. Complete about 30 "hops" not too fast and not too slow. Pretend you are jumping on a warm stove and get off the floor before your feet have a chance to warm up too much. Lightning hopping After a moment's rest, pretend the stove is now red hot and jump quickly, making contact between your feet and the ground as brief as possible. Complete about 40 super fast jumps in about 8 to 12 seconds, just barely getting your feet off the ground and avoiding heel contact. After 30 seconds of rest, complete this "hop and lightning hop" routine once more, and further strengthen your calves by walking quickly forward on your toes for 20 metres. Then point your feet outward at about a 45-degree angle ("duck walking") and stride along on your toes for 20 more metres. Finally, angle your toes inward ("pigeon-toed" walking) and walk on your toes for a further 20 metres. For these manoeuvres, always make sure your hips are rotated outward or inward, so your knees are lined up with the spaces between the big and second toes. Walk, skip and jog After these three types of fast walks, skip on your toes using all three techniques. Twenty metres with feet straight ahead, 20 metres with toes out, and 20 metres with toes slanted in. Finally, jog on your toes at a moderate pace using the three methods, for about the same distance. After a minute's rest, complete this walk-skip-jog protocol one more time. For several weeks, gradually increase the amount of hopping, walking, skipping, and jogging that you do. Begin by doing the exercises twice a week, advancing progressively to four or five times a week. After several weeks, try doing the warm and hot stove hops on only one leg at a time, and cut the repetitions in half. Instead of carrying out 40 super-fast jumps using both feet, for example, hop 20 times on your right foot and 20 times on your left. Backs to the wall But what about your inferior tibialis anterior muscles, the ones that work hardest during running? Strengthen them by carrying out the following five exercises: Stand about a foot away from a wall with your back to it and your feet directly below your hips. Lean backward until your buttocks and back touch the wall and then, while keeping your heels on the ground, flex your ankles so that your toes rise as high as possible towards your shins. Let your feet sink back so that they almost touch the ground and repeat this action 15-20 times (the reps increase over time). On the descent, do not let your feet rest on the ground, which would give your tibialis anterior muscles too much of a rest between flexions. Treat the ground as if it was an eggshell, too much pressure would crack it. After a moment's rest, try a slightly different tibialis-anterior exercise. This time, from the same basic body position, flex your ankles so that your toes ascend as high as possible, but do not let them move more than an inch towards the floor on the downswing. Quickly move your feet up and down within this one-inch arc for 15-20 repetitions (adding more reps later), and then rest for a moment. Once you have become adept at the first two exercises for several weeks, you can move on to an advanced exercise. For this, keep your back and buttocks against the wall again but stand on only one foot at a time while carrying out No. 1 above. Position the foot slightly to the inside of the hip. You can also work on the anterior tibialis muscles while jumping. Again, try for quickness rather than height as you jump, but this time "dorsiflex" your ankles each time your feet leave the ground (i.e. try to pull your toes up to your shins on each ascent). 20 jumps should be about right for your first effort, with the total increase over time. A fifth exercise is to walk on your heels for 20 metres or so. This heel walking can follow the walking, skipping, and jogging routine described above. Overall, these five exercises have helped many athletes afflicted with shin splints. Another strategy, designed to strengthen all five calf and shin muscles simultaneously, is to run barefoot on a somewhat uneven but soft grassy surface, such as a well-maintained athletic field or a golf fairway. Start cautiously, though, with no more than a half-mile on your first barefoot effort, adding an extra quarter-mile during each subsequent run. The ultimate aim of these exercises is to fortify your feet, ankles, shins, and calves so that injuries are unlikely. However, injury prevention won't be the only outcome. As you progress, your ankles become as powerful as rocket boosters and your feet will act as mini-trampolines. When you run, each foot strike will involve an explosion of propulsive force, not a sad collapse of your foot against the ground. Article Reference This article first appeared in: MACKENZIE, B. (2003) Lower leg injuries - how to stay trouble-free. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 2 / June), p. 3-4 Page Reference If you quote information from this page in your work, then the reference for this page is: MACKENZIE, B. (2003) Lower leg injuries - how to stay trouble-free [WWW] Available from: https://www.brianmac.co.uk/articles/scni2a3.htm [Accessed About the Author Brian Mackenzie is a British Athletics level 4 performance coach and a coach tutor/assessor. He has been coaching sprint, middle distance, and combined event athletes for the past 30+ years and has 45+ years of experience as an endurance athlete.