That sudden pain in your lower leg from walking, running, or jumping is quite a common issue.
Depending on the severity of the strain you can either suffer some mild discomfort when walking or prevent you from partaking in sports/ hobbies. Hopefully, in this article, we can educate you about anatomy, causes, symptoms, and some rehabilitation for a calf strain.
There are a few different portions to the calf muscles, the gastrocnemius is the muscle most people are aware of when they think calf.
The gastrocnemius muscle crosses both the ankle and the knee joint, at the ankle joint it points the foot downwards (plantar flexes) and at the knee, it helps to bend/assist unlocking of the knee.
The Soleus is the second muscle we will be covering, this is a long flat muscle that sits behind the gastroc, directly along the back of the shin bone. The Soleus works in conjunction with the gastroc muscle to point your foot.
When we bend our knee our gastrocnemius is at a disadvantage (biomechanically speaking) so it is the Soleus doing the majority of the work, for example when your leg is bent in the car pushing the accelerator to peddle- your Soleus is doing most of the work.
Together the two heads of the gastrocnemius muscle (medial and lateral) along with the Soleus muscle are collectively referred to as the Triceps Surae.
The final muscle we will talk about is the Plantaris muscle. It is a very small, thin, rope-like muscle. Located more to the outside of the calf, this muscle also crosses over the knee and the ankle and attaches into the Achilles’ tendon. The combination of all 3 muscles creates the movement of pointing your toes ( plantar flexion).
A calf strain can occur due to one-time overstretching or overworking of the calf ( acute injury) or it can occur from repetitive use of the calf over time ( overuse injury).
Strains can occur in any of the 3 calf muscles – most commonly it’s the gastrocnemius due to its size and function ( more specifically it’s the medial head of gastroc that sustains the most injuries), secondly, it’s the Soleus then the plantaris.
A calf strain most often happens when a person is working eccentrically ( working while under a stretch), such as landing from a jump and during the period when you push off to jump.
As we get older the tissues of the body to lose some elasticity. For this reason, strains are more common in active middle-aged individuals. Which makes it is even more important to keep muscles strong and flexible as we get older.
Recognising a calf strain
Generally, there are 3 categories of calf strain, grades 1, 2, and 3.
There are several symptoms to look out for if you think you have sustained a calf strain ( obviously dependant on the grade of injury).
- Sudden onset of pain, soreness the day after activity
- Muscle spasms in the area
- Stiffness/ tightness
- Pain on touching the area
- Mild, moderate, and severe limitations to range of motion
- Decreased strength
- Local swelling
- Bruising or discolouration in the ankle (gravity caries the bruising down)
- Knotted up feeling
- A local divot or bump in the affected area due to torn muscle fibres ( usually associated with grade 2-3)
Treatment and Rehabilitation
The first port of call if you think you have sustained a calf strain is the application of the I.C.E.R protocol ( Ice, compression, elevation, and rest).
Once the initial inflammation has been dealt with it’s time for some massage therapy, this should assist in reducing pain and swelling in the area.
Medication can also be used to ease swelling and pain, for example, a course of Ibuprofen is more effective the taking the odd one or two here and there.
Once the initial pain and inflammation have reduced consult your practitioner (Physiotherapist, osteopath, massage therapist) and you can begin working on gentle stretching and increasing the range of motion of the are. As you progress more aggressive stretches will be added, however, you should never push through pain while stretching.
In the later stages of rehab more taxing movements can be used to build strength- prolonged walking, stair climbing, jumping, hopping.
Rest! This is a very important part of your rehab process. You should not be pushing through pain, as you get more flexible and strength increases you will find the rest to activity ration switching. You are going in the right direction if symptoms are reducing. If symptoms are increasing then go back a step in your rehab programme until the pain is more manageable.
Calf strains involve a tear to the fibers of one of the calf muscles and can vary in healing time depending on severity. If you experience or suspect you have a calf strain let a professional assist you in determining the level of injury and help you back to everyday activity or sport by guiding you safely through an appropriate rehab programme.