Calf Muscle Pain, Strain or Pull - How To Tell If It's Serious

A common cause of calf muscle pain is a pulled or torn calf muscle

calf pain
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If you have a sudden pain in the calf muscle during activity, it is likely the result of a pulled or torn calf muscle. This is called a calf strain or a calf pull. It occurs when part of the muscles of the lower leg (gastrocnemius or soleus) are stretched beyond their ability to withstand the tension. This stretching can result in small micro-tears in the muscle fibers or, in a severe injury, a complete rupture of the muscle fibers.

 But there are other reasons your calf may suddenly cause you pain. Namely cramps and Achilles injuries:

  • Calf Muscle Cramp - A far less severe, but often painful, cause of calf pain is the muscle cramp or spasm. This involuntary contraction of a muscle is short-lived, but in may be so strong that it causes a bruise.
  • Achilles Tendon Tear - A calf strain is similar to an Achilles tendon tear or rupture but occurs higher up in the back of the leg. The signs of a calf strain are also similar to that of an Achilles tendon rupture - you may think you've just been hit in the back of the leg and hear an audible "pop." There will be sudden, sharp pain in the back of the lower leg, or pain, swelling and even bruising over the calf muscle. Most calf injuries will make it difficult to tolerate weight on injured side and make it very difficult to stand on the toes.

     

Calf Strain Cause and Severity

A calf strain or pull often happens during acceleration or an abrupt change in direction while running.

A torn calf muscle may spasm, and contract forcefully so that the toes will automatically point down. Bruises show up over the injured area as well as in the foot and ankle due to pooling of blood from internal bleeding.

Calf strains may be minor or very severe and are typically graded as follows:

  • Grade 1 Calf Strain: The muscle is stretched causing some small micro tears in the muscle fibers. Full recovery takes approximately two weeks.
  • Grade 2 Calf Strain : There is partial tearing of muscle fibers. Full recovery takes approximately 5-8 weeks.
  • Grade 3 Calf Strain: This is the most severe calf strain with a complete tearing or rupture of muscle fibers in the lower leg. Full recovery can take 3-4 months and, in some instances, surgery may be needed.
     

Calf Strains Treatment

The first treatment is R.I.C.E. (rest, ice, compression, elevation). Wrap the calf to keep the blood from pooling in the foot, and keep it elevated for the first 24 hours to reduce swelling. Anti-inflammatory medication may help reduce pain. Eventually, the muscle re-attaches to the tendon; however, and the calf is often shorter than before the injury and prone to repeat injury.

A visit to a physician and or a physical therapist is recommended to ensure in fast rehab.

Typical rehab for a calf strain depends on upon the severity of the injury and includes the following.

  1. Rest the Muscle. Avoid activities that cause pain. Avoid impact activity or excessive stretching (no running, jumping, or weightlifting). Do not return to your sport until you are pain-free.
  1. Taping the Calf. Some athletes find that taping the calf can reduce pain and help protect from further injury. Applying special physical therapy or kinesiology tape  is one way to easily tape the calf muscle. 
  2. Range of Motion Stretching Exercises. When the acute pain is gone, begin stretching the muscle moderately with passive range of motion stretching. Gently pull your foot and toes up with legs straight if possible to stretch the calf muscle. Hold for 10 seconds and repeat 5 to 10 times.
  3. Progressive Calf Stretching Exercises. As you heal, you can begin using a regular stretching and flexibility program to gain range of motion and prevent future calf injury. Follow the advice of your therapist when beginning these exercises.
     
  4. Use a Foam Roller. Performing gentle self-massage with a foam roller as your calf injury heals can help reduce scar tissue formation and improve blood flow to the area.
  5. Progressive Strengthening Exercises. Start with exercise tubing or a band and hook it under your toes and press down gently using light resistance. Point your foot down against resistance and then slowly return to the start position. Do 10 reps, rest and repeat 5 to 10 times. Over time, you will progress to the Calf Raise Exercise.
  6. Achilles Tendon Strengthening. Once you have healed and experience no pain with basic strengthening exercises, consider strengthening your Achilles tendon to prevent related lower leg injuries.

The goal of rehab is to return to normal activity as quickly as possible without any long-term effects. If you return too soon, you risk developing a chronic injury. Keep in mind that everyone recovers at a different rate, and your rehab needs to be tailored to your needs and your progress, not the calendar.

You can safely return to your sport when you meet the following conditions:

  • You have your physician's "okay."
  • You are pain-free.
  • You have no swelling.
  • You have a full range of motion (compared to the uninjured side).
  • You have full or close to full (90 percent) strength (again, compare with the uninjured side)
  • You can jog straight ahead without pain or limping.
  • You can sprint straight ahead without pain or limping.
  • You can jump on both legs without pain and you can jump on the injured leg without pain.

Sources:

American Academy of Orthopaedic Surgeons, Sprains, and Strains: What's the Difference? [http://orthoinfo.aaos.org/topic.cfm?topic=A00111]

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