Sudden pain that occurs in the calf muscle during activity may be the result of a pulled or torn calf muscle. This is called a calf strain or a calf pull. It occurs when part of the muscles of the lower leg (gastrocnemius or soleus) are stretched beyond their ability to withstand the tension. This stretching can result in small microtears to the muscle fibers or, in a severe injury, a complete rupture of the muscle fibers.


Calf Muscle Cramp

A far less severe, but often painful, cause of calf pain is the calf calf muscle cramp or spasm. This involuntary contraction of a muscle, is short-lived, but in may be so strong that it causes a bruise.


Achilles Tendon Tear

A calf strain is similar to an Achilles tendon tear or rupture, but occurs higher up in the back of the leg. The signs of a calf strain are also similar to that of an Achilles tendon rupture – you may think you’ve just been hit in the back of the leg and hear an audible “pop.” There will be sudden, sharp pain in the back of the lower leg, or pain, swelling and even bruising over the calf muscle. Most calf injuries will make it difficult to tolerate weight on injured side and make it very difficult to stand on the toes.


Calf Strain Cause and Severity

A calf strain or pull often happens during acceleration or an abrupt change in direction while running. A torn calf muscle may spasm, and contract forcefully so that the toes will automatically point downward. Bruises show up over the injured area as well as in the foot and ankle due to pooling of blood from internal bleeding.



Calf strains may be minor or very severe and are typically graded as follows:


Grade 1 Calf Strain: The muscle is stretched causing some small micro tears in the muscle fibers. Full recovery takes approximately two weeks.

Grade 2 Calf Strain : There is partial tearing of muscle fibers. Full recovery takes approximately 5-8 weeks.

Grade 3 Calf Strain: This is the most severe calf strain with a complete tearing or rupture of muscle fibers in the lower leg. Full recovery can take 3-4 months and, in some instances, surgery may be needed.


Calf Strains Treatment

The first treatment is P.R.I.C.E. (Protection,Rest, Ice, Compression, Elevation). Wrap the calf to keep the blood from pooling in the foot, and keep it elevated for the first 24 hours to reduce swelling. Anti-inflammatory medication may help reduce pain. Eventually, the muscle reattaches to the tendon; however, and the calf is often shorter than before the injury and prone to repeat injury.


Protection: If injured, stop playing and protect the injured part from further damage. Avoid putting weight on the injured part, get help moving to a safe area off the field.


Rest: Rest is vital to protect the injured muscle, tendon, ligament or other tissue from further injury. Resting the injured part is important to promote effective healing.


Ice: When icing an injury, choose a cold pack, crushed ice or a bag of frozen peas wrapped in a thin towel to provide cold to the injured area. An ice massage is another extremely effective way to direct cold to the injured tissue.


Cold provides short-term pain relief and also limits swelling by reducing blood flow to the injured area. When icing injuries, never apply ice directly to the skin (unless it is moving as in ice massage) and never leave ice on an injury for more than 20 minutes at a time. Longer exposure can damage your skin and even result in frostbite. A good rule is to apply cold compresses for 15 minutes and then leave them off long enough for the skin to re-warm.  


Compression: Compression helps limit and reduce swelling, which may delay healing. Some people also experience pain relief from compression. An easy way to compress the area of the injury is to wrap an ACE bandage around the swollen part. If you feel throbbing, or if the wrap just feels too tight, remove the bandage and re-wrap the area so the bandage is a little looser.


Elevation: Elevating an injury help control swelling. It’s most effective when the injured area is raised above the level of the heart. For example, if you injure an ankle, try lying on your bed with your foot propped on one or two pillows.


A visit to a physician and or a physical therapist is recommended to ensure in fast rehab.


Typical rehab for a calf strain depends upon the severity of the injury, and includes the following.

Rest the Muscle. Avoid activities that cause pain. Avoid impact activity or excessive stretching (no running, jumping, or weightlifting). Do not return to your sport until you are pain-free.


Taping the Calf. Some athletes find that taping the calf can reduce pain and help protect from further injury. Applying special precut tape, such as Scrip Spidertech Calf Tape, is one way to easily tape the calf muscle.



Range of Motion Stretching Exercises. When acute pain is gone, begin stretching the muscle moderately with passive range of motion stretching. Gently pull your foot and toes up with legs straight if possible to stretch the calf muscle. Hold for 10 seconds and repeat 5 to 10 times.


Progressive Calf Stretching Exercises. As you heal, you can begin using a regular stretching and flexibility program to gain range of motion and prevent future calf injury. Follow the advice of your therapist when beginning these exercises.


Use a Foam Roller. Performing gentle self-massage with a foam roller as your calf injury heals can help reduce scar tissue formation and improve blood flow to the area.


Progressive Strengthening Exercises. Start with exercise tubing or a band and hook it under your toes and press down gently using light resistance. Point your foot down against resistance and then slowly return to the start position. Do 10 reps, rest and repeat 5 to 10 times. Over time you will progress to the Calf Raise Exercise.


Achilles Tendon Strengthening. Once you have healed and experience no pain with basic strengthening exercises, consider strengthening your Achilles tendon to prevent related lower leg injuries.


The goal of rehab is to return to normal activity as quickly as possible without any long-term effects. If you return too soon, you risk developing a chronic injury. Keep in mind that everyone recovers at a different rate, and your rehab needs to be tailored to your needs and your progress not the calendar.


You can safely return to your sport when you meet the following conditions:

You have your physician’s “okay.”

You are pain-free.

You have no swelling.

You have full range of motion (compared to the uninjured side).

You have full or close to full (90 percent) strength (again, compare with the uninjured side)

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can jump on both legs without pain and you can jump on the injured leg without pain.


Source: American Academy of Orthopaedic Surgeons, Sprains and Strain



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