How strong are your calves? It could affect your dementia risk

New research shows that weak calf muscles are linked to cognitive decline.

Novak Djokovic of Serbia plays a shot between the legs on day ten of Wimbledon. Picture: Clive Brunskill/Getty Images

How strong are your calves? It is a question that matters not just for aesthetics, but for your health. Strong calf muscles are essential for supporting good posture, better walking and running, and for preventing the painful lower leg injuries which physiotherapists say peak at this time of year, when many of us decide to pick up tennis rackets or take up running for the first time in a while.

“Poorly developed calf muscles will limit everyday functional movement and raise the risk of tendon and knee injuries, as well as muscle strains,” says the physiotherapist Lucy Macdonald, a spokeswoman for the Chartered Society of Physiotherapy. “Yet these important muscles are often overlooked at the gym in favour of building powerful thighs and glutes.”

The calf, she explains, has two main muscles. “Starting from behind the knee, the gastrocnemius runs down to the achilles tendon and is the more bulky calf muscle that visibly contracts when you stand on tiptoes. Beneath it lies the soleus, which runs from below the knee to the heel.” Both are essential for propelling us forward when we move and for providing power when we hop and jump. “They are the only muscles that go through a full range of motion when we run or walk briskly,” says the sports physiotherapist Paul Hobrough. “We need them to be strong and when they are not it leaves middle-aged tennis players, footballers and runners highly prone to strains and pulls.”

Studies also show a link between strong calf muscles and brain health. Researchers reporting in the journal Clinical Interventions in Aging showed how preserving calf muscle strength as we age helps to maintain normal blood pressure and blood flow to the brain, potentially helping to reduce the risks of some types of dementia. And a paper published in the Journal of Clinical Medicine last year found that older people with a relatively low calf muscle circumference, signifying a loss of muscle mass in the lower leg, were more physically frail and also more prone to cognitive decline. Meanwhile, a study at the University of Mississippi reported how older adults with stronger lower legs, including calf muscles, had better cognitive functioning scores.

From left: calves belonging to Carlos Alcaraz, Taylor Fritz and Andy Murray. Pictures: Getty Images

Despite the soleus muscle representing only about 1 per cent of your body weight, repeatedly flexing it with small movements can even help to control blood sugar, according to Marc Hamilton, professor of health and human performance at the University of Houston. For a study published in iScience, Hamilton showed how activating the soleus muscle repeatedly throughout the day produced a 52 per cent improvement in blood sugar fluctuations, a benefit that lasted not just for minutes but potentially for several hours. The effects were similar to those seen with intermittent fasting or other forms of exercise using larger muscles.

All of this, says Harry Jameson, the personal trainer and Times columnist, points to the fact that we have much to gain from simple calf workouts. “When you do calf-specific exercises, you will also strengthen tendons, such as the achilles, that attach to the muscles,” he says. “People neglect stretching their calves as much as they neglect strengthening them, so since calf muscles bear the brunt of running and jumping effort, it is very important to focus on stretching them post-exercise.”

Here’s how to improve your calf muscles:

Do calf raises every other day to boost strength

Your calf muscles need to be “incredibly strong” to prevent injury from middle age onwards, Hobrough says. “Most physios will agree that one of the best ways to strengthen the muscles is by performing daily calf raises.” Standing on the floor, using a wall for support, rise up onto your tiptoes before slowly lowering heels back down. Do three sets of 20 raises every other day for the first two weeks and then increase to four sets of 20 raises every other day. Once this is manageable, progress to single-leg raises. “As you get much stronger you can add weights when doing these, but don’t rush your progress,” Macdonald says.

Heel drops will improve range of motion

When we run or jump, our calf muscles go through a wide range of motion, Macdonald says, “so it’s important to replicate this in exercises”. Otherwise, she explains, suddenly attempting to do so unprepared, like running for a bus, can cause injury.

French rider Mathieu Burgaudeau cycles during the 8th stage of the Tour de France. Picture: AFP

Stand on tiptoes on the edge of a step or low platform with your heels off the edge. Place hands on a wall or a banister for balance and slowly lower your heels as far as possible. Return smoothly to the top of the move and repeat. Slower is better - aim to take up to six seconds in each direction with no bouncing at any point. “Focus on putting your weight through your big toe joint which will target the calf muscles much more effectively than if you roll to the outer part of your foot when doing them,” Macdonald says. Try three sets of 15 repetitions on each foot on alternate days.

Hopping and skipping will build powerful calves

Your calf muscles get a really effective workout through skipping and hopping. “Anything that involves a powerful jump or skip on the balls of your feet is great for strengthening the calves and simulating the kind of activity involved in any sport that involves running,” Jameson says. “If you have a skipping rope, use it, but if not, simply hopping for 8-10 seconds on each leg is fine.”

In March, researchers at the University of Tokyo published findings in the Journal of Applied Physiology that showed how hopping forces your legs to behave like springs, absorbing and returning energy with each upward bound and developing key muscle fibres in the calf.

Do a dynamic downward dog before every gym session

The downward dog is a great exercise to prepare your calves for action whatever the workout that follows. Start on all fours with knees behind your hips and hands shoulder-width apart. Pressing your hands into the mat, tuck your toes under and lift your knees to straighten your legs as much as possible. “Form a V shape with your body and then pedal your heels alternately, aiming to get them as close to the ground as you can,” Jameson says. An alternative is to get into a high press-up position and to walk your toes towards your hands. “As you move your feet forward on tiptoes, try lowering your heels a bit closer to the floor with each step,” Hobrough says.

And stretch your calves after every workout

N American Simone Biles during her beam routine on her way to winning the gold medal in 2024 . Pic: Michael Klein

You really must stretch your calf muscles after every bout of exercise, Hobrough says. “To stretch the soleus, stand facing a wall 10-20cm away with one foot in front of the other and bend both knees until you feel a stretch in the calf muscle and hold for 45 seconds,” he says. “Then repeat with the other foot forward.”

You can stretch the gastrocnemius in a similar way but with straight legs. “Also try standing closer to a wall with your right foot behind the body and the toes of your left foot placed just above the skirting board and heel on the floor,” Hobrough says. “Use your right foot to push you gently forward so that you feel a stretch in your left calf, hold for 45 seconds and repeat three times before changing sides.”

Try massage (or use a massage gun) if your calves are really tight

There is evidence that massaged calf muscles heal faster and stronger than those left untended. “Having a massage can help to ease tension in your calves,” Macdonald says. A massage gun might also help, according to researchers from Harvard University who published their findings in Science Translational Medicine journal. They used tiny robotic machines, similar to fashionable massage guns, on the leg muscles of injured mice and showed that, after two weeks, healing was more advanced in the massaged mice than in those who had not received the treatment. “Gentle muscle contractions that occur when you walk can also help to ease muscle tension,” Macdonald says. “And remember that tight calves are generally weak calves, so it’s another reminder to pay attention to your lower leg exercises at the gym.”

The Times