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A calf muscle strain is a mild injury, often without any damage or tear. It affects either or both of the calf muscles, Soleus and Gastrocnemius. It can feel like tightness, aching or a pulling sensation.
A “strain” is not a medical classification but refers to mild muscle injuries. It is roughly equivalent to a Grade 1 or low Grade 2 muscle injury. (There are three grades of muscle injury, Grade 3 being the most severe).
Calf muscle strains are most common after a running activity, including football, basketball or running itself. It can present as a sudden stabbing pain although it’s more commonly felt as a gradually worsening tightness.
Our Physio experts have listed the key shoe features to look for if you’ve got calf pain, including recommended brands and models.
TIPS FOR FIXING A CALF MUSCLE STRAIN QUICKLY
- The most commonly injured muscle in the calf is the Soleus
- The Soleus muscle is the deeper (closer to the bone) of the two calf muscles
- It’s function is to brace the ankle (hold it rigid) on landing
- This bracing action protects the ankle joint and allows the Achilles tendon can store elastic energy
- Calf circumference measurements can be useful to track swelling and bleeding in this injury
- Measure the calf muscle while relaxed and lying prone (on your stomach)
- Find the largest measurement with a cloth tape measure
- Compare sides:
- Differences of <1cm are unlikely to be relevant
- If the injured side is larger by 1cm or more, this may indicate an accumulation of swelling or bleeding. This may indicate a Calf muscle tear instead of a strain
- Add a heel wedge (like this example) to your regular shoes or wearing shoes with a medium (5-8cm) broad heel
- This is helpful in the early weeks as it reduces the stretch and pressure on the muscle
- However a narrow heel or unstable shoe can cause the muscle to become more active. This would have the opposite effect
- Select a shoe with a broad stable heel, such as a wedge or block heel
- Massage can be helpful at managing symptoms during rehab
- It can be helpful in the early phase in relieving muscle soreness and aching
- As rehab progresses, massage can be used to relieve the feeling of tightness and fatigue
- Massage should be gentle in the early phase and can gradually increase in pressure over the weeks
- Massage shouldn’t be used if a tear is suspected or with an increased calf circumference (see point above)
AVOID THESE MISTAKES WHEN TREATING YOUR CALF STRAIN
- Calf raises (aka Heel raises) a common calf muscle exercise, are rather ineffective for rehab of calf muscle injuries
- The main role of the most commonly injured muscle is to brace the ankle, not push you up on your toes
- Movement is too slow to train the muscle for rapid propulsion
- The loading is insufficient to adequately rehab a calf strain
- Stretching a recently torn muscle is counterproductive
- Stretching may overload the healing tissue and delay recovery
- It doesn’t offer any benefits for muscle length or tissue tolerance
- Strength exercises alone are insufficient to prepare for a return to running sports
- The calf muscles rapidly generate forces up to 8x body weight
- They need both heavier loads and faster movements to be ready for running
- Following on from strength training, a full return to play program should incorporate aspects of calf function including sprinting and slowing down quickly
WHAT ELSE COULD IT BE?
As a calf muscle strain can come on gradually and without an obvious cause, it’s important to consider other diagnoses that have a similar presentation.
- If it’s a deep constant ache, it could be a Tibial Stress Fracture
- Consider this to be more likely if the ache is present without weight on the leg and it lasts for >24 hours after exercise
- When there’s a concurrent knee injury with knee swelling, you may have a ruptured Baker’s Cyst
- This injury can present as an increasing ache in the calf without obvious cause
- On calf circumference measurement (see point above in Tips), the calf will be significantly larger on the affected side
- If it’s a vague pain that extends further up the leg, it may be Sciatica
- Sciatica doesn’t have to cover the whole leg and may just present with calf pain
- However, if your calf pain begins to extend above the knee or below the ankle, suspect the Sciatic nerve as a potential cause