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Calf Strain

What Is a Calf Strain? How Is One Treated?

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Updated April 04, 2014

calf strain

The calf muscle is commonly injured in sports activities.

Photo © Maridav

A calf strain is an injury to the muscles of the back of the leg. The calf muscles span the distance from the knee to the ankle, becoming the Achilles tendon in the lower part of the leg. The calf muscle is made of three major muscles, the two gastrocnemius muscles and the soleus muscle.

What Happens to the Muscle When You Experience a Calf Strain?

A calf strain is an injury to the gastrocnemius muscle -- a "muscle strain." When a muscle is strained, the muscle is stretched too far. Less severe strains pull the muscle beyond its normal excursion. More severe strains tear the muscle fibers and can even cause a complete tear of the muscle. Most commonly, calf strains are minor tears of some muscle fibers, but the bulk of the muscle tissue remains intact.

Symptoms of a Calf Strain

An acute calf strain can be quite painful, depending 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 walking, and limited ability to perform activities, such as running and jumping; may have swelling and bruising associated.
  • Grade III Calf Strain: Severe injury that can cause inability to walk. Often patients complain of muscle spasm, swelling and significant bruising.
Calf strains are most common in men between the ages of 30 and 50. Typically, individuals who sustain a calf strain notice a sudden, sharp pain in the back of the leg. The most common muscle to injure when a calf strain occurs is the medial gastrocnemius. This muscle is on the inner side of the back of the leg. The injury usually occurs just above the midpoint of the leg (between the knee and ankle). This area of the calf becomes tender and swollen when a muscle strain occurs.

A calf muscle strain is usually a clear diagnosis, but there are other causes of calf pain that should be considered. Other causes of calf pain include a baker's cyst, leg cramps and blood clots.

When to See a Doctor

If you have symptoms of a severe calf strain, you should be evaluated for proper treatment. Some signs of a severe calf strain include:
  • Difficulty walking
  • Pain while sitting or at rest
  • Pain at night
Severe calf strains should be evaluated because, in some very rare situations of complete muscle rupture, surgery may be necessary to reattach the torn ends of the muscle. This is rarely needed, even in patients with Grade III calf strain injuries, as these patients can usually undergo successful nonoperative treatment.

If you are unsure if you have a calf strain or the symptoms do not quickly resolve, you should be seen by your doctor. As described above, other conditions can be confused with a calf strain, and these should be considered if your symptoms do not resolve promptly.

Calf Strain Treatments

Treatment of a calf strain is usually guided by the severity of the injury. Resting a pulled calf muscle is the key to successful treatment. As a general rule of thumb, if you have a calf strain, you can do activities that don't aggravate your injury. You should rest until you are pain free to allow the injured muscle to heal. Resting inadequately may prolong your recovery.

The following are the common treatments used for calf strains:

  • Rest
    It is important to rest following the injury to allow the injured muscle to properly heal. Allow pain to guide your level of activity; this means that activities that cause symptoms should be avoided.

  • Calf Muscle Stretching
    Gentle stretching is helpful, but it should not be painful. Stretching excessively can be harmful and slow the healing process. There are some simple calf stretches that can help you along your rehab.

  • Ice the Injury
    Apply ice to the injured area in the acute phase (first 48 hours after injury) and then after activities. Ice will help calm the inflammatory response and stimulate blood flow to the area.

  • Heat Applications
    Before activities, gentle heating can help loosen the muscle. Apply a heat pack to the calf prior to stretching or exercising. As a general rule of thumb, remember to heat the area before and ice after; learn to know when to ice and when to heat an injury.

  • Anti-inflammatory Medications
    Oral anti-inflammatory medications (such as Ibuprofen, Aleve or Motrin) can help relieve symptoms of pain and also calm the inflammation.

  • Physical Therapy
    Physical therapists can be helpful in guiding treatment that may speed your recovery. Some people find modalities, such as ultrasound, therapeutic massage and specific exercises, particularly helpful. You should see your physician to determine if these would be appropriate for your condition.

Calf Strain Healing Time

The length of time needed for healing a calf strain depends on the severity of the injury. A typical grade I calf strain will heal in 7 to 10 days, a grade II injury within about 4 to 6 weeks, and a grade III calf strain within about 3 months. The most common injury is a grade II calf strain that takes about 6 weeks for complete healing.

Source:

Noonan TJ, and Garrett WE, "Muscle strain injury: diagnosis and treatment" J. Am. Acad. Ortho. Surg., Jul 1999; 7: 262 - 269.

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