Calf Strain

Synonyms for calf strain:

• Calf muscle tear
• Calf muscle strain
• Myo-aponeurotic lesion of the calf

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What is a calf strain?

It is a significant stretch or tear of the muscle fibers in the calf muscles (soleus and gastrocnemius).

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What are the causes of a calf strain?

A calf strain occurs when a significant force is applied to the muscles through contraction or stretching.

This can be caused by:

• A rapid change of direction while playing a sport
• A jump
• Rapid acceleration while running (such as when starting a sprint)

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What are the risk factors for developing a calf strain?

• Having had a previous calf injury
• Athletes who play sports involving running, such as:
  • Soccer, rugby, athletics and football
• Injuries of this type often occur during periods of overtraining or general fatigue, which makes you more vulnerable to injury.
• Lack of warm-up before playing a sport

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What are the symptoms of a calf strain?

The symptoms are:

• Sudden, sharp pain in the calf that appears immediately at the time of injury (feels like a stab)
• The pain may radiate behind the knee or towards the foot.
• The pain is often increased by:
  • Walking (worse when going uphill)
  • Stretching the calf (lifting the foot upwards)
  • Going up/down stairs
  • Running or jumping is often impossible for a while.
• There may or may not be bruising behind the calf, which can appear up to 24 hours after the injury.

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If the pain appeared gradually without a specific incident, it is not a calf strain.

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How to diagnose a calf strain?

Diagnosis is made through a review of the symptom history and a clinical examination.

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When should I see a physiotherapist for a calf strain?

You should consult a physiotherapist if you have symptoms as described above, or if your doctor has already ruled out any other cause that may explain your pain.

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, the physiotherapist will be able to tell you.

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What are the physiotherapy treatments for a calf strain?

As with all traumatic injuries, we must first allow the body to do its natural healing work.

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« Inflammation is a normal and necessary process for proper healing. There is therefore no miracle way to speed up healing. »

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However, it is very important to make sure to eliminate all factors that could slow down healing.

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Here are some examples of things that could slow down healing:

• Improper dosage of exercises and daily activities
• Poor biomechanics of your movements
• Stiffness in the joints, muscles, and nerves
• Worries or fears related to the injury or pain

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« For this reason, your physiotherapist can help you optimize the healing of the injury. They will be able to guide you in the best possible direction to ensure that the injury heals effectively. »

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Think of healing from a traumatic injury like taking care of a plant. Pulling on the plant won't make it grow faster. However, you can make sure it gets enough water, sunlight, and fertilizer. We want to put the plant in a good environment to heal. It's the same for a traumatic injury.

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Your physiotherapist will perform an assessment to determine your limitations and the severity of the injury by evaluating the following:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Mobilize your joints and nerves to reduce pain and improve your movement
• Give you specific exercises to re-educate the control of movements of your joints.
• Give you exercises to regain mobility, reduce pain and regain your muscle strength.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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What to do at home for a calf strain?

As with any traumatic injury, follow the PEACE and LOVE principles.

Read the blog post about PEACE and LOVE (coming soon), and then read the advice here that applies to calf strains.

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PEACE and LOVE advice specific to quadriceps strains:

(make sure you have read the blog post that explains the PEACE and LOVE steps in detail)

For C = Compression:

Use a compression bandage or taping to wrap your calf.

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For L = Load:

• Start walking and putting weight on the leg gradually without increasing the pain. 
• Wait until you no longer limp before increasing the duration of your walks.
• From the 2nd day after the injury, you can start contracting the painful muscle with a pain level of 4/10 or less if you respect the following:
  
  • Pain after exercise decreases in less than 30 minutes
  • During exercise, there are no leg cramps or sudden sharp pain
  • The next day, you should be able to do the same exercise again

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For V = Vascularisation:

Light to moderate cardio activity without pain accelerates healing. For a calf strain, you can do stationary cycling without pain.

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If you don't see any improvement after 10 days, you should consult a physiotherapist.

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If you are a runner, refer to the blog post on running (link coming soon) for specific running tips.

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Sources

• Green B, Pizzari T. Calf muscle strain injuries in sport: a systematic review of risk factors for injury. British journal of sports medicine. 2017 Aug 1;51(16):1189-94.
• Thorborg, K. (2020). "Prevention and Rehabilitation of Hamstring Injuries ". Springer.
• Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE.