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Managing a Calf Strain

 

It has been an interesting couple of weeks here at our clinic. We see patients with a broad variety of injuries but every so often we get bombarded with patients presenting with a particular type of injury. Over the last fortnight our patients seem to be straining their calves.
Your calf is made up of a few different muscles, the two main muscles are the Gastrocnemius and the Soleus. If you stand on your tippy toes, you are no doubt activating these muscles. They run from the knee area down to your heel via the Achilles tendon. It is an important muscle for walking, running and jumping.

 

 

The most common cause of a calf strain that we come across is from playing sport. Because these muscles are placed under high loads in sports that require quick acceleration and deceleration, sports like tennis and squash appear to be major culprits.
The other common cause presenting to us is trauma related to trips and falls which are not uncommon to the wet footpaths of Melbourne at this time of year.
When assessing our patients with calf injuries we can see that they often have a lack of mobility through the calves and hamstring on the unaffected side. This tells us that inflexibility is likely to increase the risk of injury.

So how do you prevent a calf strain?
Sports Medicine Australia recommend the following.

  • Keeping calf muscles strong so they can absorb the energy of sudden physical stress.

  • Stretching out calf muscles before physical activity.

  • Learning the proper technique for exercise and sporting activities. This will decrease stress on all muscles, including calf muscles.

  • Undertaking training prior to competition to ensure readiness to play.

  • Gradually increasing the intensity and duration of training.

  • Allowing adequate recovery time between workouts or training sessions.

  • Wearing the right protective equipment including footwear.

  • Checking the sporting environment for hazards.

  • Drinking water before, during and after play.

  • Avoiding activities that cause pain. If pain does occur, discontinuing the activity immediately and commencing RICER.

So how do you know if you might be suffering from a calf strain?
You may experience;

  • A sudden pain at the back of the leg, particularly at the muscular tendinous junction.

  • Difficulty in contracting the muscle or standing on tiptoe.

  • Pain and swelling or bruising in the calf muscle.

  • Pain on resisted plantar flexion or contracting the muscles against resistance.

  • If the Soleus muscle is damaged pain might be incurred lower in the leg and when contracting the muscle against resistance with the knee bent.

Calf strains are graded in three categories according to their severity. There are three grades of muscle strain and each hill have a separate timeline which athletes can expect to recover efficiently to return to their sport.
Grade 1 (Mild)- Sharp pain during or after activity. Return to play at 10-12 days
Grade 2 (Moderate) - Unable to continue activity. Return to play 2-3 weeks
Grade 3 (Severe) - Severe pain at the junction between Achilles and gastrocnemius. Return to play 6 Months if surgery is required.

If you suffer a calf strain immediate management should follow the RICER protocol.
Rest,
Ice,
Compression,
Elevation,
Referral

 

The No HARM protocol should also be applied
No heat,
No alcohol,
No running or activity,
No massage.
This will ensure decreased bleeding and swelling in the injured area.


Rehab and return to play. As pain decreases, your Sports Therapist will likely prescribe some gentle exercise and stretching in addition to some manual treatment modalities.
It is important that the rehab process is conducted with caution under the guidance of a Sports Therapist as recovery rates can be quite slow and the risk of re-injury is considerable.

If you have concerns about a calf injury, please contact us at one of our clinics.