Strained Calf Muscle

 What is it?

The calf muscles are comprised of the gastrocnemius and soleus muscles which are situated at the back of the lower leg. They taper down to form the Achilles tendon as it inserts into the heel bone. Strains are characterised by localised pain which is commonly felt in the inside portion of the gastrocnemius belly or lower as it tapers down to the tendon. The soleus muscle, which is the deeper of the two calf muscles, is usually strained on the outside part of the calf, deep to the gastrocnemius. Depending on the severity of the injury strains can vary from grade 1, mild strains with pain felt on the ‘push off’ part of walking, to grade 3 muscle tears whereby a palpable gap may be felt and significant bruising and pain is experienced, limiting the ability to weight bear through the injured limb.

Causes

These muscles can be strained either suddenly, (acutely) i.e. as a consequence of a rapid lunge forward, as is common in racquet sports or can be longstanding, (chronic) with a gradual onset. Previous tears in the muscle increase the likelihood of a recurrence especially at the junction between the newer scar tissue and the original uninjured tissue. Poor muscle condition, tightness, weakness and overuse can also predispose to either acute or chronic strains.

Treatment

Following a thorough examination and assessment of the presenting problem, advice and treatment may include the following:

For more acute injuries early management is focused on the PRICE principles:

Protection – Strapping and/or heel raises
Rest – from aggravating activities
Ice – to reduce swelling and pain
Compression – to reduce swelling and offer support
Elevation – to aid swelling reduction

For both acute and chronic strains, injury management would progress to include:

• Electrotherapy i.e. short wave diathermy to promote healing

• Acupuncture to control pain and inflammation

• Correction of biomechanical abnormalities or muscle imbalances using soft tissue and joint manipulation

• Orthotics to correct any anatomical abnormalities which contribute to the problem

• Exercise rehabilitation progressing from gentle stretching to a staged strengthening programme to ensure a return to full sports specific fitness