Dealing with Calf Strains

The muscles (gastrocnemius and soleus) run down the back of the lower leg from the back of the knee to the back of your heel. Injuries to the calf are common in sports involving running, acceleration or changes in direction such as football, basketball and hockey. Injury can also occur through gradual wear and tear, occasionally straining whilst simply walking across the road.
Tears to the calf muscle can range from a small partial tear whereby there is minimal pain and minimal loss of function, to a complete rupture which may require surgical reconstruction. Early treatment of a strained calf can help to speed recovery and minimize the symptoms.


  • A sudden sharp pain or pulling sensation at the back of the lower leg during exercise.
  • May feel like you have been hit in the leg and potentially hear a “pop”.
  • Pain on stretching the muscle.
  • Difficulty walking properly or standing on toes.
  • Swelling and bruising may be present.
  • If the rupture is severe a gap in the muscle belly may be felt.

Severity of a Strained Calf:

Calf strains may be minor or very severe. Strains are graded 1, 2 or 3 depending on severity. Grade 1 consists of minor tears within the muscle, a grade 2 is a partial tear in the muscle and grade 3 is a severe or complete rupture of the muscle.

Grade 1:

  • The muscle is overstretched causing small micro tears in the muscle fibres.
  • Mild discomfort, often minimal disability.
  • Recovery takes approximately 2 to 3 weeks if you do all the right things.

Grade 2:

  • There is partial tearing of muscle fibres.
  • Moderate to severe discomfort with walking, and limited ability to perform activities, such as running and jumping.
  • May have swelling and bruising associated.
  • Full recovery takes approximately 5-8 weeks with good rehabilitation.
  • Professional assistance is highly recommended.

Grade 3:

  • This is the most severe calf strain with a complete tearing or rupture of muscle fibres in the lower leg.
  • Severe injury that can cause inability to walk. Often patients complain of muscle spasm, swelling and significant bruising.
  • Full recovery can take 3-4 months and, in some instances, surgery may be needed.

Acute Management

It is vitally important that treatment for a strained calf starts immediately following injury. The most important phase for treatment is the first 48 hours post-injury. Early management will have you back on the field faster. Suggestions for immediate treatment of a strained calf include:

  • Stop your activity.
  • Rest the injured leg.
  • Use icepacks every two hours, applied for 15 minutes.
  • Bandage the calf firmly with an elasticized bandage.
  • Elevate the leg above heart height whenever possible.
  • Avoid exercise, heat, alcohol and massage in the first 48 hours, as these can all exacerbate swelling.

Professional Help

If the pain from a grade 1 calf tear that you are managing yourself has not improved after a day or so, or it is a more severe grade 2 or 3 tear, it is best to seek medical advice and consult with a physiotherapist or health care provider to get an accurate diagnosis of the injury and suggest the most appropriate treatment plan.

Physiotherapy Provides Rehabilitation and Support

Physiotherapy treatment will depend upon the severity of the injury. The success rate of treatment is largely dictated by patient compliance. Treatments may include:

  • Hands on therapy for damaged tissues. Soft tissue therapy is excellent for reducing inappropriate scar adhesions while promoting faster healing conditions.
  • Rehabilitation and strengthening exercises are used to rebuild the strength of the injured muscle in order to prevent re-injury.
  • A stretching program can be started as soon as the pain and swelling subsides to encourage full range of pain-free movement.
  • A core stability retraining program is highly recommended.
  • A speed, agility and power program that prepares you for your sport is the best chance to ensure a successful outcome and full return to your pre-injury status.
  • Correction of any predisposing biomechanical misalignments (e.g. excessive foot pronation or rolling in) and muscle imbalances.
  • Provide mobility aids such as crutches.

Inadequate rehabilitation commonly results in recurrent and more severe calf strains.

Preventing a Calf Strain

Suggestions to prevent calf strains:

  • One of the most important methods of preventing a calf strain is to warm up. This should consist of some light aerobic exercise followed by dynamic stretching (stretching while moving) and sports specific drills.
  • Consult your physiotherapist for calf strengthening exercises.
  • Include calf stretches in your workout routine. A calf strain is more likely in athletes who have tight calf muscles.
  • Update footwear regularly as overused shoes can lead to poor biomechanics and foot posture.

If you would like further information on the management of a calf strain contact one of the physiotherapists at Jubilee Sports Physiotherapy.

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