The calf muscle is commonly injured in sports performance activities when the muscle in the back of the leg is overstretched by jumping or changing direction quickly.
The calf muscle consists of a large muscle called the gastrocnemius and a smaller muscle called the soleus. The gastrocnemius attaches above the knee and inserts into the heel; the soleus attaches below the knee and forms the achilles tendon into the heel. At the junction where the Achilles tendon forms there is another small muscle called the plantaris.
Either of these muscles can be strained thus the athlete can experience pain in the upper or lower calf. By definition a calf strain is the tearing of muscle fibers within the musculature along the posterior aspect of the lower leg. A calf muscle tear is graded from 1 to 3 with grade 3 being the most severe. Common sports performance activities that this injury occurs are running, tennis, football, soccer and basketball. Here in this article I will going into causes, symptoms, treatment and prevention of this common injury.
The most common cause of calf strain while performing sports performing activities is a sudden contraction of the calf muscle when the athlete accelerates from a stationary position to change direction, lunge or jump. This injury can also occur with overuse of the calf musculature with repetitive motion.
Athletes will experience a sudden sharp pain and tightness within the muscle structure of the calf. The athlete will walk with a noticeable limp because of the inability to weight bear on the involved lower extremity. Standing on tip toes is very difficult due to the pain and weakness of the calf muscle. Swelling, tenderness and hematoma will be present along the calf within 48 hours. In cases of a grade 3 tear a visibly deformity in the muscle will be evident.
Initially the athlete must cease all sports performance activity. Following the R.I.C.E. guidelines is essential. To review this stands for rest, ice, compression and elevation. Application of ice with elevation should be done several times per day for 15 minutes. Wear a compression bandage especially while weight bearing is recommended to reduce swelling. Most doctors will prescribe anti-inflammatory medication in the early stages and will tell athlete to get a heel pad to raise the heel in the shoe thus shortening the calf muscle.
Treatment by a qualified physical therapist will consist of the use of ultrasound, electrical stimulation and cold laser. These modalities will relax the muscle, reduce pain, decrease swelling, decrease tenderness and prevent scar tissue formation. It is extremely important to minimize scarring so that the calf muscle does not weaken. The physical therapist will utilize sports massage to stimulate blood flow, decrease bumps in the calf and loosen palpable tight knots. All treatment to soften scar tissue will aid in the healing process. Proper stretching will be shown by the PT. My preference in the early stages is to stretch the calf in a non weight bearing position (sitting utilizing a towel or elastic band). As pain subsides you can progress to a weight bearing stretch against a wall. Stretching by the therapist is usually performed with the athlete in the supine or sitting position.
Once initial healing takes place the program has to shift to strengthening the lower extremity especially the calf musculature. The athlete will be directed to certain pieces of strengthening, conditioning and balancing apparatus. The athlete should not resume sports performance activity until he gets the blessing of the physical therapist.
Proper stretching and strengthening of the calf muscle on a continual basis is extremely important in prevention. Warm up before sports performance should not be overlooked or rushed. The key to proper calf stretching for the calf is to stretch with the knee straight and then with knee flexed.
An easy calf strengthening exercise is calf raises where you stand on your toes on a daily basis. You can perform this 10-15 times with 5 second holds 3x-4x/day. The overall condition of the calf muscle (flexible and strong) is the best way from this injury from reoccurring.