Calf strain

An introduction to calf strain

The calf is the group of muscles in your lower leg. Calf strain is a common muscle injury, most often associated with sports. It occurs when you damage or tear part of your muscle in your lower leg. It seems that men are more susceptible to this injury than women, with the most common age range being 25-45.

There are two muscles in your lower leg. The Gastrocnemius muscle is the larger of the two and it runs from the heel to above the knee joint. The second muscle is the Soleus muscle which spans from the heel to below the knee. Either of these muscles may be strained.

What are the causes of calf strain?

A calf strain occurs when the muscle is pulled or stretched too far and the muscle fibres tear away from the tendon. Often this is when you move your calf suddenly or in an unusual direction. They are common in sports such as squash and tennis because there are sudden sideways movements and lunging from standing. It sometimes happens after repetitive stresses or if your muscles have not been warmed up properly before exercise.

What are the symptoms of calf strain?

The first symptom is usually tightness or a sudden sharp pain in the muscle. The pain is felt more when standing on your toes, as this stretches the calf muscle. Swelling and tenderness when touched may develop, and can be too sore to stand on. The severity of strained calf muscles is categorised, so that the most effective treatment can be found:

• Grade 1 – this is when you have only damaged or torn a few fibres in the muscle. Often you will be able to continue with what you were doing, but you may notice tightness and an increase in pain over the next few days. It can take up to three weeks before you are fit to return to sporting activities
• Grade 2 – this is when a lot of muscles fibres have been torn. You will feel a sudden sharp pain in your calf and you may develop swelling and bruising. The pain is more severe than a Grade 1 injury, and will take longer to recover from, taking up to six week
• Grade 3 – this is the most severe type of injury and is when the muscle has been ruptured, meaning that most or all of the muscle fibres have been torn. There is a stabbing pain and it is very painful to walk. There is often a bulge of muscle tissue where it has been injured and there is usually bruising and swelling. You may need surgery and a rehabilitation programme to recover, which can take three months or more.

What can I do to prevent calf strain?

There are several simple measures which you can take to cut down your risk of straining your calf muscles:

• Warm up correctly before exercise – if you launch into exercise while your muscles are still cold, you run the risk of damaging yourself. This is because as you warm up your muscles, their flexibility increases and so you are more likely to be able to withstand the pressures of sport. It is also important to give yourself time to stretch your muscles with extra warm up time during the winter or when it is cold outside
• Cool down – stretching after exercise will also reduce your chances of a calf strain as it allows your muscles to be kept strong and flexible
• Feed your muscles – your diet is important for maintaining your general health and wellbeing, and it is important for keeping your muscles strong and healthy too. Make sure that you have a balanced diet containing enough fluids, carbohydrates and protein
• Work with a qualified sports trainer – if you are partaking in sporting activities regularly, a trainer will ensure that you are adapting the correct techniques to minimise injury. Your trainer will also ensure that you are working on appropriate surfaces and in the correct equipment rather than running on uneven ground with old worn out trainers.

What treatments are available?

The treatment you need will depend on the severity of your injury. However, it is important that no matter how badly you have injured yourself you immediately follow the PRICE procedure:

• Protect – your muscles from further injury by ceasing the activity you are performing
• Rest – the muscle and only begin to use it again gently and once the symptoms have cleared
• Ice – the injured area. It is important to wrap your ice-pack or frozen peas in a tea towel or you may injure your skin. Keep re-applying ice packs at least over the next 24 hours
• Compress – using a bandage to support the injury and to prevent further swelling
• Elevate – if you can. Keeping the injury above the level of your heart will minimise the swelling.

It is also important that you do not HARM your muscle any further in the next 72 hours:

• Heat – is usually not good to apply to a damaged muscle as it encourages blood flow around the injury increasing swelling
• Alcohol – consumption can exacerbate the injury as it slows the healing process
• Running – or any other exercise or sudden movement will only cause further damage to your muscle
• Massaging – immediately will increase blood flow and cause more swelling and pain.

Many people have also found that extracts of arnica, such as Atrogel arnica gel, reduce pain swelling and bruising if applied frequently after the injury.

If you have experienced a Grade 3 injury then you are likely to have to undergo surgery to fix the problem. It is important to go to your doctor or hospital straight away to get this injury attended to.

Your doctor will probably encourage you to go to a physiotherapist to make sure that you develop full movement of your calf muscles after your injury. Frustrating as it may be, it is important not to return to high levels of activity until your injury has completely recovered and you no longer experience any discomfort at the site of the injury.