Calf muscle pain, strains and tears are very common in athletes, especially middle aged male runners. In the triathlon and running communities these are often referred to colloquially as ‘mad calf disease’, and it is always surprising how many people suffer from it. The underlying cause of the injury varies and a thorough investigation is required to deduce if it is related to weakness, training load, shoes, running surface, stiffness or lumbar spine issues. Or often a combination of these underlying causes. As we have a special interest in runners and endurance sports we are well placed to manage these issues, with non-invasive treatment. Our treatment is aimed at reducing scar tissue, improving lumbar spine function and ensuring the sciatic nerve is tracking easily through fro the spinal cord to the muscle. We also aim to increase calf flexibility and strength, measuring the one leg heel raise off a step – we aim for people to be able to do 30 raises.