Calf Strains are a common injury on and off the sporting field.
What is a Calf Strain
A calf strain is a common injury occurring when the calf muscle fibres in the back of the lower leg are damaged by overstretching or excessive force. The calf muscles are made up of 4 different individual muscles (2 heads of gastrocnemius, soleus and plantaris). These muscles work to plantar flex the ankle and assist with bending the knee.
Calf strain Causes
Calf strains are most commonly caused during sports when an athlete pushes their foot off the ground rapidly for a sudden burst of speed. If pushed beyond its limit, then the muscle can sprain or tear. Calf strains can occur as an acute injury or slowly over time as an overuse injury.
Symptoms depend on how badly the muscle has been strained or torn but can include
- Sudden popping sensation in calf
- Pain with walking
- Mild ache to moderate pain when using the muscle
- Pain with stretching the muscle
- Redness or bruising to skin
- Weakness when plantar flexing the ankle
Healing Time of a Calf Strain
Healing time can depend on the severity of the injury. There are three grades of calf strain and the diagnosis of which grade depends on range of motion, muscle strength and palpation of the muscle itself.
Grade 1: A grade 1 strain is when less than 25% of the muscle fibres are torn during the injury. Pain will most likely be mild and the athlete normally returns to sport within 1 to 3 weeks post injury.
Grade 2: Grade 2 covers a broad range as anywhere between 25-90% of torn muscle fibres is considered a Grade 2 injury. Pain will be more noticeable on walking and bruising + swelling are likely to occur in the calf and ankle. Expect 4-8 weeks for returning to sport.
Grade 3: A grade 3 injury is when >90% of fibres have torn. This can include a complete rupture of the calf muscle. This injury is extremely painful and often the person may require crutches or a moon boot to assist with walking. If the muscle is completely ruptured then the calf muscle cannot move at all. Surgery can be required in these cases and 3-4 months is often needed before returning to sport.
The acute phase of soft tissue healing with a calf strain is no different to management of any other soft tissue injury.
Follow the RICE principle
Rest: allow the tissue time to heal to avoid further aggravating the injury
Ice: apply ice to the area for 10-15-minute intervals every few hours. Make sure to have a layer of material between skin and the ice to avoid cold burns.
Compress: use bandage or a compression sleeve to help minimise swelling in the area
Elevate: elevating the affected area above the heart helps minimise swelling by draining fluid from the area
Unless a calf strain is severe it should heal fully with conservative management. In this time it is important to rest, as to allow adequate tissue healing time.
Conservative treatment includes
- Passive stretching exercises to prevent calf shortening and a loss of range of motion in the ankle and knee.
- Muscle strength beginning with isometric exercises
- Muscle strengthening with changes to the muscle length (concentric/eccentric)
- Gradual weight-bearing and loading exercises. The sooner you are able to safely commence these, the quicker the recovery and return to sport will be
- Once your range of motion and strength is sufficient, you can begin sport specific drills before full return to sport
- Massage and electrotherapy can be helpful adjunct therapies for pain relief
- While healing from an injury, use of proper footwear is advised
- Check out our Video on Calf Stretches