Calf muscle strain

A  Calf muscle strain occurs most commonly in the middle aged or older  patient. The calf muscles are made up of the larger superficial gastrocnemius muscle and the smaller deeper soleous muscle. Both muscles join together to form the achilles tendon at the back of your ankle.

A  calf strain is caused by a tearing of part of the gastrocnemius or soleus muscle.  Calf strains are most commonly found in the medial  (inside) part of the gastrocnemius.  A sudden pain is felt in the calf, and the patient often reports an audible or palpable “pop” in the back of the lower leg, or they have a feeling as though someone has kicked them in the back of the leg. Substantial pain and swelling usually develop during the following 24 hours.  Strains in the gastrocnemius are also referred to as a “tennis leg” as the classic presentation is a middle-aged tennis player who suddenly extended the knee.

Muscle strains are graded 1-3 with 3 being the most severe.

  • Grade 1 strain- may present with a feeling of tightness. The pain may  be at the time of activity or afterwards. The discomort is mild and time off sports is usually  1-3 weeks. Less than 5% of the muscle fibres are affected.
  • Grade 2- this is a partial muscle tear. There may be swelling and bruising and you will have difficulty walking on the leg and you may need a crutch for a day or two. Time to return to sports can be anywhere from 3-6 weeks.
  • Grade 3- this is a complete tear of the muscle tendon unit and can take months to heal. In severe cases surgery may be required.



1. Early stages

Avoid aggravating activities. Use a crutch if necessary in severe strains to aid walking.  Apply ice Ice for 20 minutes at a time 2-3 times a day for the first few days to limit swelling and aid pain relief. Avoid heat in the early stages as it may increase swelling and bleeding within the muscle. Use a compressive stocking if the leg is swollen.

 2. Stage two

Commence ankle ROM exercises and static bike work. The ankle movements include ankle pumps and circles.

  3. Stage three 

Start gentle painfree stretching of the gastrocnemius and soleous muscles. Use theraband to start low level strengthening.  Commence a return to walking programme starting at 5 minutes and gradually increasing as pain allows.

   4. Stage four

Increase calf muscle strength by starting a toe rise programme. Return to jog/running programme can be started at this stage. Start slow and build gradually.

     5. Stage five

Return to sport specific training. The calf muscle must be able to tolerate sprinting and change of direction movements before full return to sports.

This is quick overview. Mild/grade 1 strains can progress quickly through the stages. Here at southside physiotherapy clinic we will tailor the rehab to the individual in front of us. Please click the  following link  to book an in session or online consultation.

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