Calf Strains


Calf strains along with hamstring strains are one of the most commonly strained muscles in the leg. Calf strains have a negative stigma attached to them and are often associated with age and are termed an 'old man's' injury. However, calf strains are not specific to just people older of age and can affect anyone. They are often associated with runners and people who participate in sports that involve quick accelerations or decelerations.


So is our calf just one muscle? Lets look at the Anatomy!

When we refer to our calf many people will think of the one big muscle at the back that is easy for us to see. There are in fact a few more muscles in the back of our lower leg.

Gastrocnemius

The gastrocnemius is the 'big' muscle located closest to the skin on the back of our lower leg. It is very recognisable and easy to see. Our gastrocnemius is a very strong and powerful muscle and is responsible for producing large amounts of power. The gastrocnemius has 'two heads' (Medial and lateral) that attach above our knee. These heads then join together before becoming the achilles tendon and attaching onto the back of our foot. As the gastrocnemius attaches above the knee and then below the ankle it helps to create movement at both the knee and ankle joint. It helps to bend the knee and create plantarflexion (pointing toes down) at the ankle. In the above diagram you can see the gastrocnemius has been cut at the attachment site to allow the muscles underneath to be seen.


Soleus

Underneath the gastrocnemius is the soleus muscle. This muscle has the same function as our gastrocnemius but can sustain movement for a longer period of time and is referred to as the 'marathon runners muscle'. So whilst our gastrocnemius produces large amounts of power, our soleus muscle produces smaller amounts of power and force but can sustain it for longer periods. Unlike our gastrocnemius, the soleus attaches on the tibia bone and then joins the gastrocnemius to form the achilles tendon. Therefore it only produces movement at the ankle and helps with plantarflexion. This muscle can also be strained but is much less common than our gastrocnemius.


Plantaris

Plantaris is a small muscle with a long tendon found with soleus. It works alongside gastrocnemius to bend the knee and plantarflex the foot. But overall doesn't contribute significantly to movement. It is believed to be an accessory muscle and some studies have indicated it could be absent in 7-20% of individuals.


Symptoms

When someone suffers a calf strain they are most likely referring to their gastrocnemius. The medial head is the most common area strained. Presentations in individuals do differ. But generally,

  • Sudden pain is felt in the calf on extension or after a movement.

  • There may be an audible or palpable "pop" in the medial aspect of the calf

  • Many people will describe having a feeling as though someone has kicked them in the back of the leg.

  • Pain and swelling usually develop within the first 24 hours.


Recovery Times

Recovery times are dependent on the grade and severity of injury.


Grade 1

  • Tightness/discomfort in calf, may be able to continue activity with or without discomfort.

  • On completion of activity there will be tightness/aching in the injured calf.

  • May be able to perform regular calf raises, but single leg calf raises may be painful

  • General recovery time is 10-12 days

Grade 2

  • Sharp/instant pain at the time of activity/injury in the calf.

  • Won't be able to continue activity

  • Pain whilst walking post-activity.

  • Swelling/mild to moderate bruising.

  • General recovery time is 16 - 21 days

Grade 3

  • Severe pain in the calf at time of injury

  • Unable to continue with activity

  • Significant bruising and swelling.

  • Pain with palpation of calf and cannot contract muscle.

  • General recovery time is 6 months after surgery due to a complete tear.

It is important to get your calf checked out by a qualified physiotherapist if you are experiencing discomfort. A structured rehab program can help to strengthen your calf up and reduce the risk or injury or re-injury.

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