Muscle injuries are very common, with bruises and strains accounting for 90% of all muscle-related injuries. The calf is an essential component during weight-bearing and locomotive activities; therefore, an injury to this area, if not managed appropriately, can be quite debilitating, and can increase the risk of re-injury and prolong recovery.
The calf is commonly injured while sprinting, during fast acceleration or deceleration activities, or due to an increase in running load. It presents as a sudden sharp pain felt in the calf, sometimes with an audible “pop”, or a feeling of being kicked in the back of the leg. The pain is often accompanied by weakness and an inability to stretch due to discomfort. Bruising and swelling may also be present after injury.
Muscle strains are graded from I to III, with grade III being the most severe. Typically, most calf strains will take between 2-6 weeks to heal; although, treatment and rehabilitation vary widely depending on the severity of the injury.
Essential Anatomy
To better understand calf strains, it is important to understand some basic human anatomy.
The calf is a group of muscles on the back of the lower leg, traveling from the knee down to the Achilles tendon on the back of the heel. It is composed of two muscles;
- The gastrocnemius is the larger calf muscle. It has two parts or “heads”, which together create its diamond shape
- The soleus is a smaller, flat muscle that lies underneath the gastrocnemius muscle
Both muscles taper at the base of the calf muscle and merge together with the Achilles tendon. The Achilles tendon then inserts into the heel bone (calcaneus). The main action of these muscles is to pull the heel up when walking, running, or jumping, which allows forward movement.
What Causes Calf Strains?
Factors that lead to calf tears include age (older athletes are more at risk), lack of calf strength or endurance, and lack of sports-specific training (ie. starting to play a fast-paced sport without any speed or agility training). One of the key risk factors for a calf strain is a previous calf injury. As recurrence is not uncommon, it is essential that an appropriate graduated strength and conditioning program is completed in order to facilitate return to activity and minimise the chance of re-injury.
Physiotherapy Treatment
The principle treatment, regardless of the location or severity of the calf strain, is a continued focus on the recovery of strength and flexibility of the affected muscle and surrounding joints, as this is critical to reducing the likelihood of a recurrence.
Your physiotherapist will also help ascertain if problems with your flexibility, control, and/or strength are contributing factors to your calf strain.
Mobility:
Common mobility issues include:
- Tight gastrocnemius and soleus muscles
- Tight Achilles tendon
- Stiff knee joint
- Stiff ankle joint
To address these, manual therapy and soft tissue massage may be used, as well as stretching and self-manipulation with tools, such as foam rollers.
Control:
Control refers to the ability for an individual to monitor and adjust their body position and posture through a variety of different settings. When it comes to calf strains, control of the hip, knee, and ankle is important. Your physiotherapist will assess your control to determine if this is a contributing factor to the problem.
In many cases, control exercises have a beneficial therapeutic effect as they introduce the body to safe and pain-free ranges of motion that the person may not have been aware of.
Strength:
Strength is very important when it comes to the rehabilitation of calf strains! Strong and resilient tissues are able to absorb increased loads and help to promote optimal function. This means they are less likely to become tight or weak during exercise or when under duress and subsequently send pain signals to the pain.
Summary
In summary, if you are suffering from a calf strain remember:
- Calf strains are a common muscle injury and respond well to physiotherapy treatment
- Mobility, control, and strength deficits need to be identified and addressed
- Completing a graded strength program is the best way to treat and prevent recurrence of calf strains!
If you are suffering from a calf strain, book in with your Physio for a thorough assessment using this link – [FREE initial assessment]. Once the cause has been identified, a plan can be designed specifically for you and get you back to doing what it is you love.
Check out our Instagram page for self-help videos on calf strains as well as many others!