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Calf Strain Physiotherapy

Calf may sound like baby cows, but here it refers to the muscles at the back of our leg. These calf muscle injuries or strains are pretty common actually, for:

  • joggers / runners
  • football / soccer players
  • dancers
  • basketball / volleyball players
  • badminton / tennis / squash players
  • gymnasts
  • …and even normal working people

People usually call an injured calf muscle or calf muscle strain as a “pulled calf muscle”, and they’re right. It’s sort of a pulled injury to the muscles in the calf muscles located at the back of the leg.

And you know, our calf actually has NINE (!) separate muscles, and these can be either injured individually or even together in bunches. Most of the time, calf muscle strains and injuries happen during high impact or high speed movements such as

  • sudden burst of speed to jump
  • running
  • especially when it’s sudden and forceful movements

An 8-year old study of professional soccer player show that soccer players have 13% chance of developing calf muscle strains or injuries.

The chances of straining or pulling our calf muscles (or any other muscles) tends to increase with

  • age
  • intensity of activities or sports
  • motorvehicle accidents

What’s a calf strain?

Remember I mentioned earlier that our calf muscles has 9 different muscles, and they’re part of the 3 large leg muscles called

  • gastrocnemius
  • soleus
  • plantaries

these 3 large muscles attach onto the heel bone, and work together to produce the downward (like a downwards step) motion of the foot.

The other 6 muscles cause knee, toe, and foot movements in different directions; these muscles are the

  1. popliteus
  2. flexor digitorum longus
  3. flexor hallucis longus
  4. tibialis posterior,
  5. fibularis (or peroneal) longus
  6. fibularis (or peroneal) brevis

These extend from the lower leg bones around the sides of the ankle they connect to other parts of the foot and toes. Unfortunately, injuries to these six muscles are sometimes wrongly diagnosed as the earlier 3 large calf muscle groups.

Different calf muscle strain grades

A calf muscle strain can refer to injury to those 9 calf muscles, and these injuries or strains tends to happen suddenly with very intense calf-related movements. Sometimes it can happen with “mundane” stuff too.

There’s different severity levels too to these calf muscle injuries:

  • Grade 1: mild or partial overstretch, typically tearing of a few muscle fibers. The calf muscle is tender and painful, but the good news is that majority of the calf muscle is intact and with near-normal movement and strength. Use of leg is normal with normal walking pattern. Easy.
  • Grade 2 gets a little tougher. Here there’s more damage and greater amount of calf muscle fibers torn. Patient may have experienced some snapping or pulling sensation, with a lot more localized tenderness and pain, obvious lack of strength and bruising / warmness. Using the leg is more impaired with limping.
  • Grade 3 is the most severe of the lot, typically involving a lot of calf muscle tear and can also involve a complete calf muscle rupture. Many patients report hearing or feeling a “popping” sensation when the muscle tore. There will be very obvious bruising and you can sometimes see a concave dent where the muscle was torn. Using the leg is very, very difficult with almost zero power at the calf muscle and ankle.

Within minutes or hours of a full calf muscle tear (rupture), there will be obvious swelling and bruising – go to accident & emergency department as soon as you can!

What does a calf muscle strain feel like? Symptoms.

  • Sharp pain in the calf
  • Weakness at the calf and/or ankle
  • Throbbing and/sharp pains whenever you try to put weight to stand or walk on the injured leg
  • Feeling weak or tightness in the injured calf muscle
  • Calf muscle spasming painfully
  • “Pop” sound or experience in the calf for grade 3 calf muscle injuries
  • Bruising, swelling and warm
  • Limping
  • Cant stand or walk on it

How to diagnose calf muscle injury or strain?

If you consult a physiotherapist, they will start off by a thorough evaluation that includes taking your health history. Some questions you can expect:

  1. What were you doing when you first felt your calf muscle pain?
  2. Where / what location did you feel the pain?
  3. Did you hear or feel a “pop” when it occurred?
  4. Did you receive a direct hit to your calf muscle?
  5. Did you see severe swelling in the first 2 to 3 hours after the injury?
  6. Do you feel pain when moving your ankle or knee, standing, or walking?

Then it’d be followed by specific tests to confirm what type of injury and how severe your calf muscle strain is, they will

  • Observe how you walk
  • Check if you can bear weight on the injured leg
  • Test the different calf muscles for weakness and looseness
  • Look for swelling or bruising
  • Gently feel parts of the muscle to determine the specific location of the injury (palpation).

They may use additional tests to assess possible damage to specific muscles of the lower leg.

In certain cases, they may refer you to an orthopedic or sports doctor to request for more tests, such as xrays (to check for fractures) and MRI (to check for soft tissue injuries such as muscle, tendon, ligament tears etc)

How physios can help your calf injuries

The First 24 to 48 Hours

The physiotherapists may advise you to:

Treatment after first 48 hours

Physiotherapists will provide calf strain physiotherapy treatments with the goals of:

Pain relief

We can use different types of treatments and technologies to control and reduce your pain, including

  • cold therapy which helps to decrease swelling, bruising and pain
  • heat therapy for circulation, healing and improve muscle or joint stiffness
  • ultrasound therapy to accelerate soft tissue healing such as muscle tears, ligament and tendon sprains
  • taping which will help provide extra support
  • specific calf and ankle exercises to help improve muscle strength and healing
  • manual therapy (hands-on therapy), such as gentle massage

Improve range of motion

We’d need to improve the range of movement for the knee and ankle so that you can start and walk and run properly again, as well as prevent stiffness and joint pain later.

Usually, we’d start off gentle, with passive motions that the physios will do to/for you first, and then slowly progress to active movements and then resistive movements as your muscle recovers and gains strength.

Work on strengthening

As your calf muscle heals and strengthens, the physios will choose specific exercises to further strengthen and improve your calf muscle, to improve all levels of strength (balance, agility, control, power, recovery etc)

These may include using

Recovery time

We want to get you the right accurate physiotherapy treatments for your calf muscle injury to get you back to your normal activity and lifestyle faster than you can do by yourself, with focus on full recovery rather than just “wait for pain to go away”.

If your calf muscle needs to be surgically repaired

Typically most calf muscle tears and injuries do not require surgery, but that being said, calf muscle full tears and ruptures usually will require surgery to reattach the torn ends.

The good news is that muscles heal really fast (due to the high amount of nutrient-rich blood supplies; that’s why muscles are so red), and you can heal pretty fast if all things goes well without any complications such as infections.

Physiotherapy will help you

  • minimize pain
  • restore motion
  • restore strength
  • return to normal activities

in the safest and speediest manner possible after surgery.

Where To Next?

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