Everything You Need to Know About a Calf Strain

A calf strain is an injury to the muscles of the back of the lower leg. These injuries are most often caused by minor tears of muscle fibers. Usually, the bulk of the muscle tissue remains intact.

More severe strains may be caused by a complete tear of the muscle, which can lead to a loss of function.

How long a calf strain lasts depends on the severity and location of the injury. For a minor strain, healing may be as little as eight days. For severe strains, healing may take six months or more.

This article looks at the causes, diagnosis, and treatment of calf strain injuries.

Calf Strain Symptoms

If you strain your calf, you may notice a sudden, sharp pain in the back of your leg. 

This injury usually occurs between the knee and ankle. When a muscle strain occurs, this part of the calf becomes tender and swollen.

A calf strain can be quite painful. The amount of pain depends on the severity of the injury.

Calf strains are usually graded as follows:

• Grade I calf strain: Mild discomfort, often minimal disability. Usually minimal or no limits to activity.
• Grade II calf strain: Moderate discomfort with loss of strength and range of motion (ROM). Limited ability to perform activities such as running and jumping. May have swelling and bruising.
• Grade III calf strain: Severe injury with severe pain and inability to walk. Common complaints of muscle spasms, swelling, and significant bruising. The muscle may be misshapen.

Causes of Calf Strains

The calf muscles span the distance from the knee to the ankle. The Achilles tendon connects your calf muscles to the heel bone in the lower part of the leg. 

The calf muscle is made of two major muscles: 

• The two-headed gastrocnemius muscle 
• The soleus muscle

A calf strain is a tearing injury to the gastrocnemius or soleus muscle. Most often, the injury occurs in the medial gastrocnemius. This part of the muscle is on the inner side of the back of your leg.

This is often called a "muscle strain." Muscle fibers can tear when a muscle is overstrained. The muscle remains intact with less severe strains.

Diagnosis of Calf Strains

A calf muscle strain is usually a clear diagnosis. Still, there are other causes of calf pain that may be considered, including:

• Baker's cyst
• Leg cramps
• Deep vein thrombosis (DVT)—a blood clot in the lower leg

Severe calf strains should be seen by a doctor. Rarely, there may be complete muscle rupture. When this happens, surgery may be necessary to reattach the torn ends of the muscle. 

Fortunately, this is rarely needed, even in patients with Grade III calf strain injuries. Most patients can be treated successfully without surgery.

See a doctor if you aren't sure if you have a calf strain or if your symptoms don't go away quickly because there are other conditions that can be confused with a calf strain.

How Calf Strains Are Treated

Treatment of a calf strain usually depends on the severity of the injury. Rest is the key to successful treatment. 

As a rule of thumb, if you have a calf strain, you can do activities that don't make your injury worse.

Rest until you are pain-free. This will allow the injured muscle to heal. If you don't get enough rest, it may take longer to recover. 

Common treatments used for calf strains include:

• Rest: Get plenty of rest after the injury. This will help the muscle heal. Let pain guide your level of activity. Avoid activities that cause symptoms.
• Calf muscle stretching: Gentle stretching is helpful. It should not be painful, though. Excessive stretching can be harmful and may slow the healing process. Simple calf stretches can help you along with your rehab.
• Icing the injury: Apply ice to the injured area in the first 48 hours after injury. Apply ice after activities, too. Ice will help slow blood flow to the area and decrease swelling.
• Heat application: Gentle heat can help loosen the muscle before activities. Apply a heat pack to the calf before stretching or exercising. As a rule of thumb, heat the area before exercise and ice after.
• Anti-inflammatory medications: Oral anti-inflammatory medications like Advil (ibuprofen) or Aleve (naproxen) can help relieve pain and calm inflammation. These medications are most effective if you start taking them in the early stages just after the injury.
• Physical therapy: A physical therapist can help guide treatment and speed your recovery. Exercise-based therapy can help. Therapies like ultrasound or therapeutic massage may have additional benefits. Work with your physical therapist to find the right treatment for your condition.

Recovery time depends on the severity of the injury.

Calf strain injuries don't usually require surgery. Unlike an Achilles tendon rupture, calf muscles don't usually tear completely.

This means calf muscle strains should heal with noninvasive treatments rather than surgery. An Achilles tendon rupture, on the other hand, may not completely heal without surgical treatment.

Recovery Time for Calf Strain

There has been a wide range of reported times to recovery after a calf strain.

The time it takes for a calf strain to heal depends on the severity and location of the injury as well as the type of activities you do. For example, someone who is active or plays sports for pleasure will have a faster recovery time than an elite athlete returning to optimal performance.  

• Grade I calf strains may heal within about eight days but have been reported to take an average of 16 weeks to return to the preinjury level of performance in elite athletes.
• Grade II calf strains take about four to six weeks to heal but one study found it took up to 50 weeks on average to return to the prior level of competition for dancers.
• Grade III calf strains usually take two to three months to heal, but can take up to six months to recover if surgery is needed due to extensive injury.

Running on an injured leg can worsen the injury. A calf strain needs rest to heal. Avoid running or engaging in other strenuous movements until you no longer feel pain. Your healthcare provider will let you know when you can start to run again after a calf strain.

Summary

A calf strain is an injury that affects the muscles on the back of the leg. The amount of pain depends on how severe the injury is.

Grade I strains only hurt a little. Grade II strains are more painful and will limit your activities. Grade III strains may impair your ability to walk.

Calf muscle strains are usually easy to diagnose. Sometimes, though, calf pain may be caused by something else. If your pain doesn't go away quickly, see a doctor.

Rest is the key to recovery. Your physical therapist may also recommend ice, heat, and gentle stretching exercises. Over-the-counter medication can help with pain. 

Recovery from a calf muscle strain depends on its severity. Most strains take anywhere from eight days to three months for complete recovery, while some grade III strains will take even longer.