11984 Health Library | Health and Wellness | Wellmont Health System
  • Calf Muscle Strain

    (Pulled Calf Muscle; Gastrocnemius Strain; Gastrocnemius Tear; Gastrocnemius Muscle Injury)

    Definition

    A strained calf muscle is a partial tear of the small fibers of the muscles. The calf muscles are located in the back of your lower leg.
    The Calf Muscles
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.

    Causes

    A calf strain can be caused by:
    • Stretching the calf muscles beyond the amount of tension they can withstand
    • Suddenly putting stress on the calf muscles when they are not ready for the stress
    • Using the calf muscles too much on a certain day
    • A direct blow to the calf muscles

    Risk Factors

    These factors increase your chance of a strain. Risk factors for calf muscle strain include:
      Sports that require bursts of speed, such as:
      • Running
      • Hurdles
      • Long jump
      • Basketball
      • Soccer
      • Football
      • Rugby
    • Fatigue
    • Tight calf muscles
    • Overexertion
    • Cold weather

    Symptoms

    Symptoms of calf muscle strain include:
    • Pain and tenderness in the calf
    • Stiffness in the calf muscles
    • Weakness of the calf muscles
    • Pain when pushing off the foot or standing on tiptoe
    • Bruising on the calf if blood vessels are broken
    • Possible popping sensation as the muscle tears

    Diagnosis

    The doctor will ask about your symptoms and medical history. You will be asked about your recent physical activity and how the injury occurred. Your calf will be examined for:
    • Tenderness and/or bruising directly over the calf muscles
    • Pain when contracting the calf muscles, particularly against resistance
    The following tests may also be done:
    • Your doctor may need to test your bodily fluids. This can be done with blood tests.
    • Your doctor may need images of your calf. This can be done with:
    Muscle strains are graded according to their severity.

    Grade 1

    • Stretching with some microtearing of muscle fibers
    • Recovery can be complete in about 2 to 3 weeks

    Grade 2

    • Partial tearing of muscle fibers
    • Recovery can take up to 1 to 2 months

    Grade 3

    • Complete tearing of muscle fibers
    • Complete recovery can take more than 3 months
    For a severe calf strain, athletes may have an MRI scan. The scan will help predict the length of recovery.

    Treatment

    Treatment depends on the severity of the strain.
    Treatment usually includes:

    Medications

    Your doctor may recommend that you take over-the-counter medicines, such as aspirin, ibuprofen, or acetaminophen, to help relieve pain. Topical pain medicines, such as creams and patches applied to the skin, are another option.
    If you still have tenderness in the calf while taking these drugs, do not return to physical activity. Check with your doctor.

    Self-care

    Start within first 24 hours:
    • Rest—Do not do activities that cause pain, such as running, jumping, and weightlifting using the lower leg muscles. If normal walking hurts, shorten your stride. Do not play sports until the pain and tenderness are gone.
    • Cold—Apply ice or a cold pack to the calf area for 15–20 minutes, 4 times a day, for several days after the injury. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
    • Compression—Wear an elastic compression bandage around your lower leg to prevent additional swelling. Wrap from the toes up the leg, so as to not cause swelling below the wrapping. Be careful not to wrap the bandage too tightly.
    • Elevation—Keep your leg higher than your heart as much as possible for the first 24 hours to minimize swelling.
    • It is best not to take aspirin or ibuprofen during the first 24 hours if you have a lot of swelling. These medicines can interfere with the clotting mechanism.
    Continued care:
    • Heat—Do not use heat at all during the first 3-5 days. Use heat only when you are returning to physical activity. Then, use it before stretching or getting ready to play sports.
    • Stretching—When the acute pain is gone, start gentle stretching as recommended by a healthcare professional. Stay within your pain limits. Hold each stretch for about 10 seconds and repeat 6 times. Repeat stretches 4-6 times during the day.
    • Strengthening—Begin strengthening exercises for your calf muscles as recommended by a professional. This is important to guard against further problems.
    If you are diagnosed with a calf muscle strain, follow your doctor's instructions.
    If you are diagnosed with a calf muscle strain, follow your doctor's instructions.

    Prevention

    To reduce the chance that you will strain a calf muscle:
    • Keep your calf muscles strong, so they can absorb the energy of sudden physical stress
    • After a short warm-up period, stretch out your calf muscles before physical activity
    • Learn the proper technique for exercise and sporting activities to decrease stress on all your muscles

    RESOURCES

    American Academy of Family Physicians http://familydoctor.org

    American Academy of Physical Medicine and Rehabilitation http://www.aapmr.org

    American Council on Exercise http://www.acefitness.org

    CANADIAN RESOURCES

    Canadian Society for Exercise Physiology http://www.csep.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca

    References

    Armfield DR. Sports-related muscle injury in the lower extremity. Clin Sports Med. 2006;25(4):803-42.

    Calf strain. DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated August 27, 2012. Accessed September 14, 2012.

    Campbell JT. Posterior calf injury. Foot Ankle Clin. 2009 Dec;14(4):761-771.

    Douis H, Gillett M, et al. Imaging in the diagnosis, prognostication, and management of lower limb muscle injury. Semin Musculoskelet Radiol. 2011 Feb;15(1):27-41.

    Foot and ankle. American Academy of Orthopaedic Surgeons. Available at: http://orthoinfo.aaos.org/menus/foot.cfm. Accessed January 23, 2013.

    Hamstring strains: expediting return to play. The Physician and Sportsmedicine. 1996;24(8).

    Renstrom P, et al. Sports Injuries: Basic Principles of Prevention and Care. Boston, MA: Blackwell Scientific Publications;1993.

    Runner's Resource Guide: Basic Stretching Exercises. Nicholas Institute of Sports Medicine and Athletic Trauma website. Available at: http://www.nismat.org/traintip/runner/stretch.html/?searchterm=basic%20stretching%20exercises. Updated March 8, 2007. Accessed January 23, 2013.

    1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

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