Calf Strain: Understanding Your Calf Pain and How to Recover
Calf pain is a common complaint, especially for those who are active. Often the culprit is a calf strain, an injury to the muscles in the lower back leg. This blog will delve into the anatomy of the calf complex, how strains occur, and the different stages of recovery. We'll also explore how a Sports Therapist or Physiotherapist can help you get back on your feet.
The Calf Complex: More Than Just One Muscle
The calf complex is actually comprised of two main muscles: the gastrocnemius (the one that forms the upside-down heart-shaped bulge in your calf) and the soleus (located deeper beneath the gastrocnemius). Both muscles join the Achilles tendon to insert onto your heel bone (calcaneus).
Powering your push-off
These muscles work together to generate propulsion as you push off the ground when walking, running, and jumping. Together they generate more than half of the total power required. They are also active during initial ground contact matching the upward ground reaction force to maintain vertical stiffness.
Common Causes of Calf Strains
Calf strains occur when the muscle fibers are overstretched or torn by the demand on them outweighing their capacity. This can happen due to:
Previous Injury: 38% of calf injuries occur again. This may be due to incomplete rehabilitation, returning too soon or failure to address underline factors
Sudden increases in activity: Starting a new exercise routine or pushing yourself too hard too soon can put stress on the calf muscles.
Hamstring or Quadricep Weakness: The calf muscles work in unison with the rest of the leg, contracting at different points throughout the gait cycle, each has a specific role to play. Weakness in one muscle will potentially cause compensation and overload in another.
Improper warm-up: Preparing your brain and body for what is to come enables the nervous system to effectively recruit muscle fibres for the job. A warm-up can also improve activation of other muscle groups and range of motion in key joints.
Sudden changes in footwear: Knowing the specification of your training shoes is really important. Read more about this here. Suddenly changing from a high to low heel drop can cause an increase in calf load. Learn more about what to look for in your trainer specification.
Gait Pattern: Some common gait patterns are associated with calf strains. These include overstriding and a cross over gait.
Signs and Symptoms of a Calf Strain
The severity of a calf strain can vary depending on the extent of the tear. Here's what to look out for:
Pain: This is the most common symptom, ranging from a dull ache to a sharp, stabbing pain. Often an injury that is sharp or described as a ‘ping’ will be the gastrocnemius, whereas the Soleus is often described as progressively ‘tightening’.
Tenderness: The calf muscle will be tender to the touch, especially at the site of the injury.
Swelling: There may be some swelling in the calf, particularly with more severe strains.
Bruising: In some cases, bruising may appear on the calf.
Weakness: Difficulty pushing off the ground or flexing the foot upwards.
Grades of Calf Strains and Recovery Timelines
Calf strains are typically graded based on the severity of the tear:
Grade 1 (Mild): Microscopic tears in the muscle fibers. Pain is mild and walking is possible with minimal discomfort. Recovery: 1-2 weeks.
Grade 2 (Moderate): More significant tears in the muscle fibers. Walking may be difficult and there will be noticeable pain and weakness. Recovery: 4-6 weeks.
Grade 3 (Severe): Complete muscle tear. Significant pain, swelling, and bruising. Walking is often impossible. Recovery: 8-12 weeks, possibly requiring physical therapy.
Important Note: These are general timelines. It's crucial to consult with a healthcare professional for a proper diagnosis and personalized recovery plan.
How a Sports Therapist or Physiotherapist Can Help
A Sports Therapist or Physiotherapist can assess the severity of your calf strain and develop a tailored treatment plan that may include:
PEACE & LOVE protocol: Pain is your guide in the early period, this may initially involve offloading the calf using crutches or a boot. You should avoid anti-inflammatory medication, and progressively utilise active pain-free movement. Read more about PEACE & LOVE here.
Manual therapy: Techniques like massage and mobilization can improve blood flow and reduce the sensation of tightness, whilst helping to improve the integrity of new muscle tissue.
Stretching & Strengthening Exercises: Gentle stretches followed by progressive strengthening exercises are crucial for regaining flexibility and strength in the calf complex. Complete rehabilitation plans should involve dynamic jumping activity and return to running programs.
Taping or bracing: Kinesio taping or a supportive brace may be used to provide support and stability during the healing process.
Best Exercises for Calf Rehab:
Here are some general exercises for calf rehabilitation, but remember, it's important to consult with a healthcare professional before starting any exercise program:
Calf raises: Stand on the floor and slowly raise your heels onto your tiptoes. Variations can be done with one leg at a time or off the edge of a step as pain and recovery allows.
Wall calf stretches: Stand facing a wall with your hands shoulder-width apart on the wall. Lean forward while keeping one leg straight behind you and the other foot flat on the floor. You should feel a stretch in your calf.
Neural stretch: Sit with your leg extended and the other leg bent. Loop a towel around your foot and gently pull back to stretch your calf. This can also be done in the lying position with a raised straight leg. Aim to only pull the foot/toes towards you for a few seconds. Nerves can be quite reactive.
Hopping, bounding & jumping. If your goal is to return to activity the muscle needs exposure to this type of stimulus. Start by doing a hop & hold on the spot. Progress to jumping up onto a small step & down. These exercises then progress to double leg repeated jumps.
Hi, I’m Danielle a Sports Therapist with nearly 20 years of experience within professional sport and private practice.
Find out more about me or drop me a message to discuss (free of charge, with no obligation) your issue and how I can help support you.
My ethos is to EDUCATE you about your injury, to EMPOWER you with the tools to be able to PERFORM, whatever that looks like for you.
References
Dixon JB. Gastrocnemius vs. soleus strain: how to differentiate and deal with calf muscle injuries. Current reviews in musculoskeletal medicine. 2009 Jun 1;2(2):74-7.
Wikimedia Commons contributors, "File:1123 Muscles of the Leg that Move the Foot and Toes b.png," Wikimedia Commons, the free media repository, https://commons.wikimedia.org/w/index.php?title=File:1123_Muscles_of_the_Leg_that_Move_the_Foot_and_Toes_b.png&oldid=276846515 (accessed July 25, 2018).
Hamner SR, Seth A, Delp SL. Muscle contributions to propulsion and support during running. J Biomech. 2010 Oct 19;43(14):2709-16. doi: 10.1016/j.jbiomech.2010.06.025. Epub 2010 Aug 9. PMID: 20691972; PMCID: PMC2973845.
