Calf Strain
A calf strain is a tear to the fibers of one of the calf muscles. There are three muscles that make up the calf in the lower leg; gastrocnemius medial and lateral heads, and soleus.
Calf Anatomy
Collectively the calf muscles are known as the triceps surae because there are three muscles working together. More on the anatomy of the calf muscles.
Gastrocnemius
This is the muscle that most people think of when they hear the term “calf strain.” It is broken into two “heads,” medial and lateral.
Medial
The medial head or inside head arises from the medial condyle, which is the back of your femur (thigh bone). Gastrocnemius strains are fairly easy to identify because the muscle is more superficial to the surface.
Lateral
The lateral head of the gastrocnemius is on the outer part of the lower leg and arises from the lateral condyle of the thigh bone (femur). The muscle then goes down the back of the leg and joins the deeper soleus muscle. They both form the Achilles tendon and attach to the back of the calcaneus (heel bone).
Soleus
This muscle is shorter and more slender, connecting to the Achilles tendon, and lies under both heads of the gastrocnemius.
Soleus strains are a little more difficult to pinpoint because they can sometimes feel like Achilles tendon problems.
Causes of Calf Strain
A calf strain is caused by a tearing of part of the gastrocnemius or soleus muscle from the top of the Achilles tendon.
A sudden sharp pain at the back ofthe leg when running, sprinting or lunging is how the injury presents and occurs.
There is usually some tenderness in the calf muscle, particularly on the inner side.
Calf Strain Symptoms
There are several factors that show you have incurred a calf strain. And they will feel different depending on the grade of strain:
- Sudden pain
- Muscle spasms
- Tightness or stiffness
- Range of motion limitations
- Decreased strength in calf
- Bruising or discoloration in the area or in your ankle or foot
- Swelling in the ankle or foot
- “Knot” in your calf
- “Pop” sound when the injury occurs
- Divot or bump in the affected area due to the torn muscle fibers
Severity of calf strains
According to the Boston Sports Medicine and Research Institute, muscle strains are graded as mild, moderate, and severe. The more severe the strain, the longer the time to recover.
- First Degree (Mild). This injury is the most common and usually the most minor. This injury is a ‘pulled muscle’ with a structural disruption of less than 5 percent. With a first-degree injury, you can expect to be back in sports within 1 to 3 weeks.
- Second Degree (Moderate). This injury consists of a more significant, but still incomplete muscle tear. This is a partial muscle tear and requires 3 to 6 weeks of rest and recovery before you can return to full activity.
- Third Degree (Severe). This injury results in complete tearing of the muscle-tendon unit. A third-degree muscle strain can take many weeks or months to fully heal.
Diagnosis
The diagnosis of a calf strain is made clinically, taking into account your detailed medical history and physical exam alone. However, sometimes imaging tests, like an ultrasound or X-ray, may be needed depending on the severity of the injury.
Treatment for Calf Strain
The first line of treatment after sustaining a calf strain is RICE:
- Rest. Stop running and take time off to heal.
- Ice. Apply immediately to slow swelling.
- Compression. Wrap with an ace bandage or compression wrap.
- Elevation. Raise your strained calf above your heart.
Recent evidence supports the critical role of compression in preventing secondary tissue damage. Wrap that injury.
The treatment for acute calf strains is to decrease the pain as well as any secondary inflammation in the area. Inflammation is to be expected at the start of the healing process, but a large inflammatory response can also lead to secondary inflammation and secondary cell injury. This can affect other tissues, not directly related to the initial injury.
Swelling from a calf injury often ends up in the ankle or foot because gravity pulls it downwards. This is why elevating the foot and ankle can help assist in moving excess tissue fluid back toward your heart and away from the foot.
Medication
To ease the pain and inflammation, over-the-counter medication can often be very helpful in the overall treatment of a calf strain.
Prevention
To prevent muscle strains in your calf, it’s important to:
- Warm up before you run. Start slow, then gradually increase speed.
- Stretch your calf muscles before a run.
- Cool down after your run. Slow down for at least 10 minutes before stopping completely. Stretch again.
- Stay hydrated. Not just water, but also electrolytes, potassium, magnesium, and calcium.
- Don’t overdo it, especially in very hot weather.
- Limit alcohol. It may also help stave off muscle cramps.
