Calf Strain

What is it?

A calf strain is a common leg injury involving a tear in one or more calf muscles. A calf strain can range from mild to very severe, involving a complete calf muscle tear. You have two calf muscles – Gastrocnemius (which has a medial and lateral head) and Soleus.

Mechanism of Injury

• A calf strain is caused by a tearing of part of the gastrocnemius or soleus muscle from the top of the Achilles tendon. A sudden sharp pain at the back of the leg when running, sprinting or lunging is how the injury presents and occurs. Usually there is tenderness on the calf muscle; especially on the inner side. You may think you've just been hit in the leg. Often, there is an audible "pop," and you may turn around to see what has just hit you. 

• There is a sudden pain at the back of the leg, you may have difficulty in contracting the muscle or standing on tiptoe, and there may be pain, swelling or bruising in the calf muscle. This injury is common in running sports that require quick acceleration of changes in direction. Calf strain is also referred to as "Tennis Leg," because it is so common among tennis players. It usually occurs in people between the ages of 30 – 45. 

Severity of Muscle Strains. Muscle strains are graded as mild, moderate and severe. The more severe the strain, the longer the time to recover. 

• First Degree (Mild). This injury is the most common and usually the most minor. This injury is a ‘pulled muscle’ with a structural disruption of less than 5 percent. With a first-degree injury, you can expect to be back to sports within 1 to 3 weeks. 

• Second Degree (Moderate). This injury consists of a more significant, but still incomplete muscle tear. This a partial muscle tear and requires 3 to 6 weeks of rest and recovery before you can return to full activity. 

• Third Degree (Severe). This injury results in complete tearing of the muscle–tendon unit. A third-degree muscle strain can take many weeks or months to fully heal. 

Secondary Factors Causing Stains:

• Poor running mechanics. Usually, this is overstriding or poor pelvic control, which puts the hamstrings in a vulnerable position at ground contact.

• Improper warm-up. Your warm-up must be active and dynamic to prepare the hamstring muscles for the forces involved.

• Inappropriate training loads. Your hamstrings are primarily fast-twitch Type II fibres that fatigue quickly. It would be best to do high-speed work early in the workout to avoid fatigue, as close to warm-up as possible.

• Fatigue (neural and local muscle).

• Lower back pathology. Abnormalities of the lumbar spine or poor pelvic control cause nerve dysfunction, and subsequent muscle weakness can predispose you to injury.

• Your playing surfaces. A wet slippery surface will put more strain on the hamstring due to slipping

Common Management Techniques

• Rest 

• Ice should be applied over the painful area for 20 min every hour. this will help to control swelling and reduce pain. (Heat should not be applied during the first 7-10 days since this may increase swelling and bleeding)

• Compressive walking boot can permit pain free walking, and expedite healing. An elastic wrap or compressive stocking may be applied to the area to assist with swelling control. If the compressive device causes increased discomfort or "pins and needles" in any part of your leg, it is probably too tight. 

• Elevate - lying down periodically with your leg elevated allows gravity to assist with your effort to control the swelling. 

• Though some experts believe early stretching to be valuable, caution should be taken to avoid aggressive stretching (stretching beyond the point of mild discomfort) which may disrupt healing. No stretching or resistive exercise should be done during the first 3 weeks.

• As a general rule of thumb, any activity that elicits pain at or near the injured site may be causing further injury and will only hamper your recovery effort. 

• A gradual conditioning program, specific to your sport, will prepare the calf muscles for the high demands placed upon them during athletics. Don't forget to incorporate a proper warm-up and stretching session into your conditioning program and athletic competition. 

Prognosis

Most patients will recover completely if they follow the recommended treatment plan for Calf Strains. You can help prevent this condition by stretching before any physical activity and performing regular exercises to strengthen and stretch the muscles in the legs.