A pulled calf muscle is a very common sports injury. There is not an athlete who hasn’t had a pulled calf muscle once in their life. If not treated correctly, a pulled calf muscle can lead to serious and long – term problems, preventing an athlete from training and even interfering with daily life activities.
A pulled calf muscle is also commonly known as a calf muscle strain or even a calf muscle tear. Regardless which name you prefer to use, calf muscle damage occurs in cases when the muscle fibers are pulled more than they should, beyond their normal elastic limit. Due to overstretch of these calf muscle fibers, a damage of some or all muscle fibers will occur.
In order to better understand what a pulled calf muscle is, let’s talk a little bit about the anatomy of calf muscles and their function.
The calf muscle is located on the back of the lower leg and it is made up of two muscles:
- The soleus, which is a small muscle located underneath the gastrocnemius muscle, deep in the calf,
- The gastrocnemius muscle, a large muscle of the calf, located just beneath the skin. This muscle is made up of two parts, which are the ones forming its characteristic shape like a diamond.
The soleus and the gastrocnemius muscle of the calf joint together at the middle of the calf, forming this way the Achilles tendon. The Achilles tendon attaches the calf to the foot, or better to say to the calcaneus, at the back of the heel.
Both these muscles when contracted will allow plantar flexion or bending of the leg at the knee joint. The soleus muscle is the one in charge of running for long periods, while the gastrocnemius muscle is the one that is in charge of dynamic movements such as sprinting and jumping. These muscles also play an important role in the stability of the ankle joint.
The most common type of pulled calf muscle is a tear to the medial part of the gastrocnemius muscle
Causes of Calf Muscle Strain
A pulled calf muscle is more likely to occur due to a sudden injury to the calf even though it can develop gradually as well, from an overuse of the calf muscles.
The gastrocnemius muscle is the one that is commonly injured as it is a superficial and large muscle. However, the soleus muscle can get damaged as well, even though rarely compared to the gastrocnemius muscle injuries.
An acute strain of the calf muscles usually occurs due to a sudden overstretching of these muscles, as well as, from a sudden change of direction or speed. Tennis players, football players, basketball players and other athletes are more likely to end up with a pulled calf muscle as they often need to speed up their movement in various directions from a stationary position.
A pulled calf muscle can develop even at a long period of time due to a repetitive use of these two muscles. This is more likely to occur in cases when the muscles are weak, too tight and when an athlete doesn’t warm up properly before playing sports. For this purpose, stretching exercises and warming up before any physical activity is very important.
Having short calf muscles can also lead to a pulled calf muscle. This problem is usually seen among women, especially those who wear high heels for prolonged periods of time during the day. The calf muscles will adapt to the high heels and over time they will become shorter.
When flat shoes are worn, these short muscles will stretch more than they are used to, having a higher possibility to end up with a tear. High heels will also make the calf muscles weaker, besides shorter, which is another problem that significantly contributes to a pulled calf muscle.
Wearing inappropriate and uncomfortable shoes can lead to calf muscle strains as well.
Calf Strain Symptoms
As mentioned, the most common type of pulled calf muscle is a tear to the medial part of the gastrocnemius muscle.
This tear of the gastrocnemius muscle will lead to pain in the upper part of the leg accompanied by painful movement of the knee ligament and sometimes even an inability or extremely painful bending of the knee.
On the other hand, a tear of the soleus muscle is usually located lower down the leg. This tear will not cause any pain when the leg is bent to the knee joint, pain which is common in cases when the gastrocnemius muscle is torn.
Common signs and symptoms of a pulled calf muscle include:
- A sudden and sharp pain in the calf,
- A sensation of tightness in the calf,
- Bruising of the affected area due to damage to the blood vessels,
- Swelling of the affected area,
- A burning sensation of the calf,
- A stabbing sensation of the calf,
- Presence of a lump on the calf caused by a complete tear of the muscle, which tends to gather up above the damage, etc.
Depending on the severity of the muscle damage, there are three grades of calf muscle strain:
Less than 10 % damage to the calf muscle fibers
Damage varying from 10 to 90 % to the calf muscle fibers.
Total tear of the calf muscle fibers.
Normally, the severity of pulled calf muscle will depend on the grade of the injury. Grade 1 injury is a minor damage of the muscle fibers, with a good prognosis and short recovery period, compared to grade 2 and grade 3 injuries where the damage is more severe or the muscle fibers are completely torn. The symptoms of these damages will be more severe as well and they will last longer. The recovery period will take longer too.
A grade 1 calf muscle strain leads to the mild pain felt at the time of the injury or not felt at all. Sometimes, the pain is only felt once the physical activity has stopped.
Painful movement is also possible, as well as, a feeling of tightness in the calf. Calf cramps are also possible. The symptoms, in this case, last no longer than a few days, rarely a couple of weeks.
A grade 2 calf muscle strain leads to moderate and sometimes even sharp pain in the calf, felt at the time of the injury. A certain level of swelling and even bruising of the calf are also common. The injured area is tender to touch. Walking is quite painful and engaging in any kind of physical activity is impossible.
The symptoms, in this case, will last from 4 to 6 weeks, sometimes even longer, always depending on the severity of the damage. A 30 % damage of the muscle fibers is normally less severe than 80 or 90 % damage to the muscle fibers.
A grade 3 calf muscle strain leads to acute and severe pain in the calf, felt immediately at the time of the injury as the muscle fibers are completely ruptured. Walking is impossible.
Bruising and swelling are considerate, but a lump or a bulge of the muscle tissue is noticed as well, as the muscle tissue tends to ping up above the place where the rupture has occurred.
Pulled Calf Muscle Treatment
A pulled calf muscle treatment aims to speed up the recovery in order to prevent long – term problems, as well as, to prevent any further injury of these muscles. Normally, the treatment will depend on the severity of the injury.
Grade 1 calf muscle strain is easier to treat compared to grade 2 and especially grade 3 calf muscle strain where a total rupture of the muscle fibers occurred.
The following treatment methods are commonly used for the treatment of a pulled calf muscle:
PRICE which means protect, rest, ice, compression, and elevation is very important part of the pulled calf muscle treatment.
First of all, you need to protect your injured leg in order to prevent any further damage and worsening of the situation.
Rest is very important once the injury occurred as it will help your muscles recover faster. With rest, you will prevent your injury from getting worse as well.
If you return to your daily activities or to physical activity too son than a grade 1 injury can easily progress into a grade 2 injury or a grade 2 injury can easily progress into a total tear of the muscle, a grade 3 injury.
How long you will need to rest will normally depend on the severity of your injury. Usually, you will need to rest about 2 weeks in cases of a grade 1 injury, and of course, longer for grade 2 and grade 3 injuries.
Stretching your leg should be avoided as well until you don’t feel pain anymore or until your healthcare provider tells you that it is safe to start stretching your calf muscle.
Ice packs are another important part of the treatment while recovering from a pulled calf muscle. Ice packs, when placed over the affected area, will help reduce the pain and discomfort, as well as, the swelling which often accompanies such an injury.
Be careful not to apply ice packs longer than 10 minutes, every 2 hours as you can make your situation worse. If ice is applied directly to the skin, you will end up with an ice burn.
Compression will help you keep the swelling under control as it will reduce the blood flow to the affected area. You can either use specially designed calf wraps or a compression bandage. Just make sure not to compress your calf too much.
Elevating your affected leg is also a must as it will speed up the recovery process. If you keep your injured calf above the level of the heart, the swelling will be reduced, and the pain and discomfort as well.
For this purpose, you can use a couple of pillows placed underneath your calf. However, make sure to correctly support the knee if you plan to elevate your injured leg.
When it comes to medications, over the counter painkillers, as well as, prescribed painkillers are commonly recommended for relieving the pain and discomfort. Before taking any medication consult with your healthcare provider first.
When the pain is less severe, after a couple of days it’s time to start with strengthening and stretching exercises. Your doctor or physical therapist will give you the green light and even instruct you how to perform these exercises.
If you feel pain while performing any strengthening or stretching exercise then you should stop and give it a try again after a couple of days. It is very important to exercise daily in order to ensure that you regain full strength and flexibility of your calf muscle. By having strong and flexible muscles you will prevent any pulled calf muscle in the future.
From stretching exercises, active calf stretch is recommended. This exercise consists in pulling the toe upwards, holding it up for a couple of seconds and then relaxing. 10 to 20 repetitions are recommended.
From strengthening exercises, plantar flexion with a resistant band is the best exercise you can start with. For this exercise, you will need a resistance band which you will put on your foot. By gently pulling the band try to point the foot away in a plantar flexion.
Start exercising just once a day and later as you regain your calf muscle strength exercise at least twice a day. You can shorten the section of the band if you want to increase the resistance. Other strengthening exercises which you can do at home while recovering from a pulled calf muscle include calf raise, seated calf raise, etc.
Another thing you can do for the treatment of pulled calf muscle is to wear heel pads. Remember to wear these heel pads on both of your shoes otherwise, one leg will be shorter than the other leading to other problems. Heel pads will shorten the calf muscle of the affected leg, taking some of the strain from injured muscles, speeding up the recovery process this way.
In late stages of your recovery, you can use a foam roller. With the help of a foam roller, you can gently stretch the connective tissue which surrounds these muscles.
Just roll your affected calf over the foam roller starting from just underneath your knee and down to the ankle and then up again to the knee. Using a foam roller to stretch the muscle fascia is beneficial for preventing muscle injuries in the future.
Using crutches is often necessary, especially for the first few days. Crutches will help you keep any weight off the injured leg. With the help of crutches, you will not only prevent any further damage to the calf muscles, but you will also speed up the recovery.
As long as you rest your leg and don’t put any weight on it then the muscle recovery period will last shorter. Consult with your healthcare provider about which crutches to use as they need to be of the right height.
Sports massage, especially when performed by a professional is very important part of the recovery process. With the help of a sports massage, you can speed up the recovery as the blood circulation will be improved.
Massage of the calf muscles will prevent any scar tissue or build – up of the muscles. The sports massage will stretch the muscles as well.
Ultrasound is another treatment often recommended during the recovery of a pulled calf muscle. Ultrasound will improve the blood circulation to the affected area. It will also break down any cross – fibers that tend to form in the muscle.
Ultrasound will allow the collagen fibers to heal properly and in correct alignment. If the muscle fibers are healed correctly then regaining the muscle strength and flexibility will be a lot easier.
How long does it take to heal pulled calf muscle?
In general, a pulled calf muscle is healed completely in most cases. However, the outlook and the time needed for a pulled calf muscle to completely heal will depend on the severity of the damage.
Normally, grade 1 damages are easier to treat and the recovery period is shorter, compared to grade 2 and especially to grade 3 calf muscle damages. You will probably need at least two weeks and in more severe cases 4 to 6 weeks and sometimes even months.
The rehabilitation afterward which can include stretching and strengthening exercises, as well as physical therapy can last for months until you have fully regained your strength and flexibility of the affected calf.
Calf Strain Prevention
Prevention is always better than cure. When it comes to preventing a calf muscle strain a proper warm up before any physical activity will minimize the risk of ending up with a pulled calf muscle.
Also, it is very important to have strong and flexible calf muscles, which is achieved through various strengthening exercises and stretching exercises. Strengthening exercises will help you improve the muscle strength and their endurance, reducing this way any chance of muscle injury.
On the other hand, stretching exercises, performed especially before and after any physical activity will help you improve the flexibility of your calf muscles, reducing this way any chance of muscle strain.
A pulled calf muscle is a common problem among athletes usually affecting tennis players, football players, basketball players, runners, etc. It is a condition characterized by a partial or complete tear of the muscle fibers leading to calf pain, difficulties walking, swelling of the affected area, bruising, etc.
Strains of the calf muscle usually affect the gastrocnemius muscle which is located on the surface, even though it is possible for the soleus muscle located beneath the gastrocnemius muscle to get damaged too.
Depending on the severity of the damage there are three grades of calf muscle tears, grade 1, grade 2, and grade 3. Grade 1 is any damage of the calf muscle fibers less than 10 %, a grade 2 damage of the calf muscle fibers is any damage between 10 and 90 % of the muscle fibers, while a grade 3 muscle damage is a total tear of the muscle fibers or 100 % damage.
The severity of the signs and symptoms will normally depend on the severity of the damage. The treatment and the prognosis will also greatly depend on the severity of the damage.
PRICE is the goal standard of any muscle strain including calf muscle strain which consists in protection, rest, ice packs, compression, and elevation of the affected leg. Over the counter painkillers and even prescribed painkillers are often a must as part of the treatment of a pulled calf muscle in order to reduce the pain and discomfort.
Preventing is better than treating so proper muscle stretching before any physical exercise will significantly reduce the risk of ending up with a pulled calf muscle.