The calf consists of two major muscles – the soleus (deeper calf muscle) and the gastrocnemius. A calf strain occurs when the one or both of the fibres or tendons of these muscles are stretched or torn.
• Gastrocnemius Strain
A typical gastrocnemius strain presents with an acute onset of a stabbing or tearing feeling in the muscle. Gastrocnemius strains usually occur as a person accelerates from a stationary position or when lunging. Most commonly the medial muscle bulk is affected. On examination there will be tenderness at the site of the strain and sometimes bruising or swelling. Pain would be reproduced on stretching or resisted contraction of the muscle. Commonly calf raises reproduce pain in all calf strains.
• Soleus Strain
Soleus muscle strains can occur with an acute onset or with a history of gradual calf tightness over a period of days or weeks. Soleus strains are a relatively common sports injury and often the athletes feel more pain on walking and jogging than sprinting. If a soleus strain has occurred there will be tenderness of the muscle deep to the gastrocnemius. Pain will also be reproduced on stretching and resisted contraction of the soleus.
Treatment of calf strain
Treatment of a calf strain will depend on the severity of the injury. Your physiotherapist will be able to determine the severity of the strain through examination of your calf. If your therapist suspects a complete tear of your calf muscle then you will be referred back to your doctor as often surgery is required to repair the tear followed by rehabilitation involving your physiotherapist. Mild to moderate calf strains can be treated by your physiotherapist.
Initial treatment of a calf strain aims to reduce pain and swelling. Your therapist may use electrotherapeutic modalities and ice in this early stage. In some cases if weight bearing is very painful or impossible your therapist may give you crutches to use in the initial stages. If this is the case then your therapist will encourage a gradual increase in weight bearing as tolerated. Also a heel raise may be given to you to take the calf muscle off stretch and thus reduce pain while walking.
Once the initial pain and swelling is settled then gentle stretching of the calf muscle will begin as well as soft tissue therapy. A program of muscle strengthening will also be commenced and will gradually be progressed by your therapist as appropriate. Your therapist will also help in assisting you to a gradual return to sport and correcting any predisposing biomechanical factors.
In some cases people may suffer from chronic calf strains. This is usually due to inadequate rehabilitation following an acute calf strain that leads to an area of disorganised scar tissue that is prone to strain. In this case your therapist would perform deep tissue treatment as well as commence a program of stretching and strengthening.