What is a Calf Strain?

A calf strain is when there is a tear to one or both of the two muscles at the back of the lower leg. The two muscles in the calf are called the soleus muscle and the gastrocnemius muscle and they combine together at their bases to form the Achilles tendon. The severity of a muscle strain is classified from grade 1 to 3:-

Grade 1 muscle strain is a mild injury, where there are micro tears to only a few muscle fibres
Grade 2 muscle strain involves significantly more muscle fibres and normally immediate pain is felt
Grade 3 muscle strain is the most severe form of muscle strain, where there is complete tearing or rupturing of the muscle and there is often a lump of muscle tissue above the tear. With a grade 3 calf muscle strain it is unlikely that you will able to walk without significant pain and a limp.

When might you Strain your Calf

Often sports involving running and sudden changes of direction can cause a calf strain, however everyday activities such as climbing stairs and running for a bus can also strain your calf. Occasionally a calf strain may occur as a result of gradual wear and tear from overuse, such as distance running, repetitive jumping or excessive walking.

There are several factors which can predispose you to developing a calf strain. Some of these factors include:
• poor calf flexibility
• inappropriate training
• poor biomechanics or foot posture
• inadequate warm up
• ankle joint stiffness
• calf weakness
• inadequate rehabilitation following a previous calf strain
• decreased fitness
• fatigue
• neural tightness

Strained Calf Muscle Signs and Symptoms

A calf strain injury may cause immediate pain and the sensation of being kicked in the back of the calf. You may hear a “pop” or “snap” and there may be bruising or swelling that develops over the following 24 hours. At the area of the injury it may be tender to touch and rising up onto the toes or stretching out the calf may be painful.

Calf Strain Recovery Times

Grade 1 calf strain will normally take 3-4 weeks to heal
Grade 2 calf strain will usually heal within 4-8 weeks
Grade 3 calf strain often takes 8-12 weeks for a full recovery

Calf Strain Treatment

Treatment will vary dependent on the severity of the injury and whether there are co-existing injuries. In general for the first 72 hours it is important to avoid things that will increase blood vessel dilation in the calf, such as heat/hot baths/saunas and calf massage and following the R.I.C.E. protocol is recommended for the first week:–

  • Rest – avoid any movements or activities which cause calf pain, as this may delay tissue healing
  • Ice – apply ice to your calf for 10 minutes, two to three times a day (up to 5 times a day for the first 72 hours). Care must be taken not to use ice for longer than 10 minutes at a time to avoid causing an ice burn to your skin
  • Compression – a compression bandage can help reduce pain and swelling and promote healing
  • Elevation – keeping your leg raised with your foot just above your hip will allow any swelling to drain away from the calf

After the initial 72 hours have passed, your physiotherapist will advise you of specific gentle calf exercises, which will promote scar tissue healing. Calf rehabilitation in the early stages will usually involve range of movement work and gentle stretching with a gradual introduction of soft tissue massage as your pain allows. As you improve, your physiotherapist will start to introduce resistance exercises and then proprioceptive and balance exercises, which will enable you to regain the strength in your calf and most importantly prevent re-injury. Rehabilitation will be tailored to get you back towards your specific sports/activities.

Calf strain prevention

Maintaining the strength and flexibility of the calf muscle will allow it to absorb greater forces and decrease it susceptibility to being overstretched and reinjured.

Completing a proper warm up with calf stretches before activity will also help increase the muscle’s ability to perform and overcome re-injury. Allow several training sessions to gradually build up duration and intensity of sport before returning to competitions. Dedicating adequate time for recovery after training sessions or exercise and wearing supportive footwear at all times during sport.

Contact Information

To book an initial consultation at Kensington Physio & Sports Medicine with one of our expert physiotherapists, please call us on 0207 6030040 or email us at info@kenphysio.com.