The term ‘calf muscle’ is collective for a group of three muscles in the lower leg – Gastrocnemius, Soleus and Plantaris – all of which share a joint Achilles tendon that inserts onto the heel bone (calcaneus). Calf muscle strains are usually the result of a sudden acceleration force or eccentric overstretch, i.e. when a sportsperson lunges forward when playing tennis, or runs onto a kerb and the heel drops suddenly. They predominantly occur in the medial (inner side) Gastrocnemius muscle or at the musculotendinous junction. Acute calf muscle strains are a common sporting injury, particularly in people of middle-age who play racquet sports such as tennis or squash.
A ‘popping’ or ‘tearing’ sensation associated with acute pain is indicative of a calf muscle strain. The severity of the tear can often be guided by the degree of disability a person suffers following an injury. During assessment the site of the strain may be tender, stretching the muscle will reproduce pain and weakness during plantarflexion or push-off may be present.
Several factors can predispose a person to calf muscle strains. Some of these include:
Poor biomechanics – excessive foot pronation may overload the calf muscles during propulsion, causing muscle tightening and reduced shock absorption
Recent or sudden change in activity, environment and/or footwear
Poor technique when jumping or landing
Muscle strength imbalances and fatigue
History of previous calf muscle strain
Initial treatment often includes RICE therapy (Rest, Ice, Compression, Elevation) to manage pain and swelling. Early stage strengthening can commence at 24 hours post injury and your Physiotherapist will progressively increase your exercise program to effectively balance load, strength, endurance and coordination. A graduated return to running program may also be necessary to help you return to sport as soon and safely as possible. It is important to rehabilitate a calf muscle strain appropriately to prevent recurrence and inelastic scar tissue formation. Repeated episodes of calf muscle cramping during sport can often indicate a muscle has not been rehabilitated correctly. See your Physiotherapist early if you believe you have suffered from a calf muscle strain.
Be aware: Calf pain that occurs with lower back pain, or that does not have a mechanism of injury but may be after a surgery or prolonged traveling in car or airplane needs to be investigated by a Doctor as soon as possible, as these may be signs of more sinister issues.