By Tracy Wilcox, PTA, LAT
Anatomy of the Calf
The calf is composed of two muscles: the gastrocnemius and the soleus. The gastrocnemius is the big muscle at the back of the lower leg. The soleus is the smaller of the two and lies underneath the gastrocnemius. Both muscles contract to produce ‘plantar flexion’ which is the motion that allows you to point your toes. A calf strain is tearing of one of these muscles.
Causes of Calf Strains
Calf strains usually occur either as a result of a sudden, pushing off movement, or from excessive and forced over-stretching of the muscles. This is more likely to occur from a sudden explosive change of direction that causes a sudden sharp pain at the back of the leg when running, sprinting or lunging. This injury is common in running sports that require quick acceleration of changes in direction. A calf strain is also referred to as “Tennis Leg,” because it is so common among tennis players. It usually occurs in people between the ages of 30–45.
Symptoms of a calf strain vary significantly depending on how bad your injury is. A mild strain may feel more like an ache during or after exercise. With a more severe calf strain, you will feel a sudden sharp pain at the back of the lower leg and there is usually tenderness on the calf muscle; especially on the inner side. You may have difficulty in contracting the muscle or standing on tiptoe, and there may be pain, swelling or bruising in the calf muscle.
Muscle strains are graded as mild, moderate and severe. The more severe the strain, the longer the time to recover.
- First Degree (Mild): This injury is the most common and usually the most minor. This injury is a ‘pulled muscle’ with a structural disruption of less than 5 percent. With a first-degree injury, you can expect to be back to sports within 1 to 3 weeks.
- Second Degree (Moderate). This injury consists of a more significant, but still incomplete muscle tear. This is a partial muscle tear and requires 3 to 6 weeks of rest and recovery before you can return to full activity.
- Third Degree (Severe). This injury results in the complete tearing of the muscle-tendon unit. A third-degree muscle strain can take many weeks or months to fully heal.
Immediate treatment for a calf strain includes PRICE:
- Protect – Stop playing or running to prevent further damage. A compressive walking boot can permit pain-free walking, and expedite healing in more severe cases
- Rest – in the early acute stage complete rest is best. Once the acute phase has passed then active rest (walking) may be more beneficial than complete rest. As a general rule of thumb, any activity that elicits pain at or near the injured site may be causing further injury and will only delay your recovery.
- Ice – can be used to control the pain
- Compression – a compression bandage or calf support can be used to support the muscle and reduce swelling
- Elevation – can be used to decrease the swelling.
It is recommended for more severe calf strains of a grade 2 or 3 you follow up with your physician who can rule out severe damage and refer you to physical therapy when appropriate. If attending PT at JOI you will work with highly qualified physical therapists, physical therapist assistants, and athletic trainers to return you to your previous level of function. The therapists at JOI have extensive knowledge treating all patients from those with a sedentary lifestyle, to parents chasing kids, to weekend warriors, to professional athletes.
JOI Physicians are currently offering ASAP fracture and injury care. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care. Make an appointment by calling (904)JOI-2000.
Author: Tracy Wilcox, PTA, LAT