Your Health - Calf Muscle Strain

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

Causes

A calf strain can be caused by:

Stretching the calf muscles beyond the amount of tension that 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)
Popping sensation as the muscle tears (possibly)

Diagnosis

The doctor will ask about your symptoms and medical history. They will also ask about your recent physical activity and how the injury occurred. The doctor will also examine your calf for:

Tenderness and/or bruising directly over the calf muscles
Pain when contracting the calf muscles, particularly against resistance

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 (rupture) of muscle fibers
Complete recovery can take more than 3 months

For a severe calf strain, athletes may have an MRI scans. The scan will help predict the length of their recovery.

Treatment

Treatment depends on the severity of the strain.

Treatment usually includes:

Medications

Take aspirin , ibuprofen (Advil, Motrin), or acetaminophen (Tylenol) to help relieve pain. 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 local 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 (eg, Ace 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. Those meds interfere with the clotting mechanism.

Continued care:

Heat—Do not use heat at all during the first 3 to 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 health care professional. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times. Repeat stretches 4 to 6 times during the day.
Strengthening—Begin strengthening exercises for your calf muscles as recommended by a professional. This is very important to guard against further problems.

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://www.aafp.org/

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

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

CANADIAN RESOURCES:

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

Healthy Living Unit
http://www.phac-aspc.gc.ca/pau-uap/fitness/

References:

American Orthopaedic Society for Sports Medicine. Available at: http://www.sportsmed.org/.

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

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 . Last accessed: July 7, 2008.

The Foot and Ankle. American Academy of Orthopaedic Surgeons. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00144 . Last accessed July 7, 2008.

Last reviewed September 2009 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.