Calf Injuries

A calf strain is an injury involving one or more of the calf muscles and causes pain at the back of the lower leg.

Calf strains are commonly seen in running sports such as soccer, rugby, netball and basketball. They often occur when attempting to accelerate from a stationary position, or when jumping or lunging forward. The calf muscles can also be injured as a result of overuse. Repetitive jumping, long distance running or walking, especially up hills or on uneven surfaces can predispose you to a calf strain. 

The calf consists of two major muscles. The gastrocnemius originates from above the knee joint, and the soleus from below the knee joint. They both insert onto the heel bone via the Achilles tendon. The calf muscles work to plantarflex the ankle (point your toes downwards), and also assist in bending the knee. The most commonly injured calf muscle is the medial gastrocnemius, which is on the inside of your calf.

Symptoms of a calf strain

Patients can feel various symptoms when injured with a calf strain. The most common symptoms of a calf strain are:

  • Sudden sharp pain or stabbing sensation at the back of the lower leg
  • The feeling as if you have been hit in the back of the leg
  • You may hear an audible pop
  • The muscle will be tender to touch
  • Swelling or bruising may occur depending on the severity
  • Inability to weight bear on the affected leg in severe strains

Grade 1 Calf Strain

Grade 1 is a mild strain involving a small number of muscle fibres. You will have pain but mostly retain your function. Grade 1 strains will take approximately 2 weeks to recover.

Grade 2 Calf Strain

Grade 2 is a moderate strain whereby a significant number of muscle fibres are affected and you will have moderate loss of function. Full recovery will take 4-6 weeks and you will require proper rehabilitation. If you are aiming to return to high impact or high speed sport, you must consult your physiotherapist to help rehabilitate you back to full function to avoid a re-tear of the muscle. 

Grade 3 Calf Strain

Grade 3 is a severe strain. You will have difficulty weight bearing on the affected leg and will most likely have to walk with a limp. You may also have swelling or bruising. With a severe tear you may be able to see a visible deformity in the muscle. In some cases you may completely rupture the Achilles tendon. Full recovery may take several months and you will need to seek professional treatment to help you return to your full functional capacity.

What To Do When You Injure Your Calf

1. Immediate treatment of a calf strain should follow the RICER protocol. That is, rest, ice, compression, elevation and referral to a healthcare professional. You may also take pain medication to help settle down the pain and swelling. 

2. After 72 hours you can start to apply heat to the injured area to help relax the muscles and relieve your pain. If you are heavily limping and are having trouble putting weight through the leg, a heel lift in your shoes will help to reduce the load through the muscle and will allow you to walk more easily. You may require crutches or a walking stick to lighten the load through the injured leg.

3. You will need to resume your activities gradually to enable your muscle to heal properly and prevent you from injuring it again. 

4. You must also ensure you warm up before physical activity and include calf muscle stretches, especially before doing any quick changes of direction, sprinting or jumping.

How Can Physiotherapy Help With Calf Strains?

Physiotherapy aims to relieve your pain through soft tissue massage, ultrasound, hot or cold packs and TENS. We give you advice on how long you need to stay off sport, and when it is safe to return. We will assist you in regaining your range of motion and building up your strength. We prescribe you with exercises that are safe to do while you’re off sport to help target your flexibility, strength and endurance. We make your exercises sports specific so that you are better able to handle all the challenges that your sport requires. We will help to rehabilitate quick changes of direction and sharp push-offs for your sport. Your exercise program will include all aspects of fitness including flexibility, power and endurance. Our comprehensive rehabilitation program will help to return you to your sport or other activities as quickly as possible and help to prevent further recurrences.

Tips for preventing calf injuries

1. Make sure to warm up properly before sport or exercise. Your warm up should include dynamic stretching, light cardio and sports specific drills

2. Stretching of the calf muscles before and after physical activity

3. Allow adequate recovery time between training sessions to prevent your muscles from fatiguing, which can make them more susceptible to injury

4. Gradually increase the intensity and duration of training to avoid overtraining.

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