What are the calf muscles?
The calf muscles consist of the Gastrocnemius which is the big muscle at the back of the lower leg and the Soleus muscle which is a smaller muscle lower down in the leg and under the Gastrocnemius.
Gastrocnemius is the larger of the two muscles which attaches above the knee joint and inserts into the heel bone via the achilles tendon. The Soleus attaches below the knee joint and then also to the heel via the achilles. Either of these two muscles can be strained (torn).
Both muscles act to plantarflex the ankle (point the foot away from the body). As gastrocnemius attaches above the knee it also helps with bending the knee. In this position, with the knee bent, soleus becomes the main plantarflexor. If the Soleus muscle is damaged you might get pain lower in the leg and also pain when you contract the muscle against resistance with the knee bent.
All muscle strains are graded from 1-3, with grade 1 being a minor tear, with up to 10% of fibres involved. A grade 2 tear involves up to 90% of the muscle fibres and a grade 3 is over 90% of fibres torn, or a full rupture. This usually occurs at the muscular tendinous junction or the achilles tendon itself.
Symptoms of calf strain include:
Grade 1:
A twinge of pain in the back of the lower leg.
May be able to play on.
Tightness and aching in the 2-5 days after.
Grade 2
Sharp pain in the back of the lower leg.
Pain when walking.
There may be swelling in the calf.
Mild to moderate bruising.
Pain on resisted plantarflexion.
Tightness and aching for a week or more.
Grade 3
Severe immediate pain.
A sudden pain at the back of the leg, often at the muscular tendinous junction (see image below).
Inability to contract the muscle.
Considerable bruising and swelling.
In the case of a full rupture, often the muscle can be seen to be bunched up towards the top of the calf.
A calf strain may be more likely in athletes who have tight calf muscles.
Treatment of calf strain
What can the athlete do?
Applying R.I.C.E. (Rest, Ice, Compression, Elevation) is essential.
Cold therapy should be applied as soon as possible to help to quickly stop any internal bleeding.
Use a compression bandage or sleeve.
See a sports injury professional who can advise on treatment and rehabilitation.
Wear a heel pad to raise the heel and shorten the calf muscle hence taking some of the strain off it. It is a good idea to put heel pads in both shoes or one leg will be longer than the other creating an imbalance and possibly leading to other injuries including back injuries.
What could a sports injury specialist do
Prescribe anti-inflammatory medication e.g. ibuprofen which is beneficial in the first few days after the injury.
Use ultrasound treatment.
Use sports massage techniques after the initial acute phase.
Prescribe a full rehabilitation programme.
Once the initial healing has taken place it is essential the lower leg is fully strengthened in order to reduce the likelihood that the injury will reoccur or have an adverse effect on future performances.
More detailed information on rehabilitation, stretching, strengthening and sports massage is available to subscribers.
Calf Strain Assessment
The following examples are for information purposes only. We highly recommend seeing a sports injury professional or Doctor to receive a full assessment of your injury.
Pain in the calf muscle is often due to a strain however there are other conditions which could cause similar symptoms, including deep vein thrombosis and contusions. A full assessment helps the therapist to determine the most likely cause of the pain.
Assessment of any injury should include questions concerning the patients general health, previous injuries and current injury. The aim of these questions is to determine which structure may be causing the pain and what treatment is appropriate. Following this, the therapist will perform a series of tests, often including:
Observation
Observation is usually the first point of any injury assessment. The therapist usually observes the patient in both standing and laying positions, looking closely for swelling, bruising and deformity, as well as postural issues such as overpronation.
Palpation
The therapist should palpate the entire calf area, looking for tight or painful areas > Play video
Range of Motion
The therapist will usually assess both active (the patient moves) and passive (the therapist moves the joint) range of motion at the ankle with the knee both straight and then bent:
Calf strains usually present with pain and weakness on active plantarflexion > Play video
Passive range of motion is usually pain-free as the muscles are not contracting, although the end of range into dorsiflexion (toes pointing upwards) may be painful as the muscles stretch > Play video
Resisted Muscle Tests
These tests are used to assess muscular strength compared to the other side. Again they should be tested with the knee straight and then bent:
The therapist applies resistance as the patient plantarflexes the ankle (points the foot away) > Play video
A positive result is pain on contraction and weakness compared to the other leg.
Special Tests
Thompson's test for complete muscle rupture > Play video
The therapist squeezes the calf muscles observing for movement at the ankle into plantarflexion (pointing the toes away).
If no movement is seen, suspect a total rupture of one or both calf muscles.
Functional Tests
Assessing the ability to carry out the following tasks gives the therapist a clear picture about the patients current abilities. They can also be used as objective markers to show progression once treatment and rehabilitation have been initiated:
Calf raise
Single leg calf raise
Assess ability to hop on spot with one leg- only do so if previous tests have not proved conclusive or have not elicited any symptoms.
Additional imaging tests such as ultrasound and MRI may be needed to fully diagnose the injury.
The calf muscles consist of the Gastrocnemius which is the big muscle at the back of the lower leg and the Soleus muscle which is a smaller muscle lower down in the leg and under the Gastrocnemius.
Gastrocnemius is the larger of the two muscles which attaches above the knee joint and inserts into the heel bone via the achilles tendon. The Soleus attaches below the knee joint and then also to the heel via the achilles. Either of these two muscles can be strained (torn).
Both muscles act to plantarflex the ankle (point the foot away from the body). As gastrocnemius attaches above the knee it also helps with bending the knee. In this position, with the knee bent, soleus becomes the main plantarflexor. If the Soleus muscle is damaged you might get pain lower in the leg and also pain when you contract the muscle against resistance with the knee bent.
All muscle strains are graded from 1-3, with grade 1 being a minor tear, with up to 10% of fibres involved. A grade 2 tear involves up to 90% of the muscle fibres and a grade 3 is over 90% of fibres torn, or a full rupture. This usually occurs at the muscular tendinous junction or the achilles tendon itself.
Symptoms of calf strain include:
Grade 1:
A twinge of pain in the back of the lower leg.
May be able to play on.
Tightness and aching in the 2-5 days after.
Grade 2
Sharp pain in the back of the lower leg.
Pain when walking.
There may be swelling in the calf.
Mild to moderate bruising.
Pain on resisted plantarflexion.
Tightness and aching for a week or more.
Grade 3
Severe immediate pain.
A sudden pain at the back of the leg, often at the muscular tendinous junction (see image below).
Inability to contract the muscle.
Considerable bruising and swelling.
In the case of a full rupture, often the muscle can be seen to be bunched up towards the top of the calf.
A calf strain may be more likely in athletes who have tight calf muscles.
Treatment of calf strain
What can the athlete do?
Applying R.I.C.E. (Rest, Ice, Compression, Elevation) is essential.
Cold therapy should be applied as soon as possible to help to quickly stop any internal bleeding.
Use a compression bandage or sleeve.
See a sports injury professional who can advise on treatment and rehabilitation.
Wear a heel pad to raise the heel and shorten the calf muscle hence taking some of the strain off it. It is a good idea to put heel pads in both shoes or one leg will be longer than the other creating an imbalance and possibly leading to other injuries including back injuries.
What could a sports injury specialist do
Prescribe anti-inflammatory medication e.g. ibuprofen which is beneficial in the first few days after the injury.
Use ultrasound treatment.
Use sports massage techniques after the initial acute phase.
Prescribe a full rehabilitation programme.
Once the initial healing has taken place it is essential the lower leg is fully strengthened in order to reduce the likelihood that the injury will reoccur or have an adverse effect on future performances.
More detailed information on rehabilitation, stretching, strengthening and sports massage is available to subscribers.
Calf Strain Assessment
The following examples are for information purposes only. We highly recommend seeing a sports injury professional or Doctor to receive a full assessment of your injury.
Pain in the calf muscle is often due to a strain however there are other conditions which could cause similar symptoms, including deep vein thrombosis and contusions. A full assessment helps the therapist to determine the most likely cause of the pain.
Assessment of any injury should include questions concerning the patients general health, previous injuries and current injury. The aim of these questions is to determine which structure may be causing the pain and what treatment is appropriate. Following this, the therapist will perform a series of tests, often including:
Observation
Observation is usually the first point of any injury assessment. The therapist usually observes the patient in both standing and laying positions, looking closely for swelling, bruising and deformity, as well as postural issues such as overpronation.
Palpation
The therapist should palpate the entire calf area, looking for tight or painful areas > Play video
Range of Motion
The therapist will usually assess both active (the patient moves) and passive (the therapist moves the joint) range of motion at the ankle with the knee both straight and then bent:
Calf strains usually present with pain and weakness on active plantarflexion > Play video
Passive range of motion is usually pain-free as the muscles are not contracting, although the end of range into dorsiflexion (toes pointing upwards) may be painful as the muscles stretch > Play video
Resisted Muscle Tests
These tests are used to assess muscular strength compared to the other side. Again they should be tested with the knee straight and then bent:
The therapist applies resistance as the patient plantarflexes the ankle (points the foot away) > Play video
A positive result is pain on contraction and weakness compared to the other leg.
Special Tests
Thompson's test for complete muscle rupture > Play video
The therapist squeezes the calf muscles observing for movement at the ankle into plantarflexion (pointing the toes away).
If no movement is seen, suspect a total rupture of one or both calf muscles.
Functional Tests
Assessing the ability to carry out the following tasks gives the therapist a clear picture about the patients current abilities. They can also be used as objective markers to show progression once treatment and rehabilitation have been initiated:
Calf raise
Single leg calf raise
Assess ability to hop on spot with one leg- only do so if previous tests have not proved conclusive or have not elicited any symptoms.
Additional imaging tests such as ultrasound and MRI may be needed to fully diagnose the injury.
1 comment:
Your electrolytes send the messages to your muscle. If they are not at a normal level, they may not function properly. Because they are your messenger to your muscles, your muscles might not function at it's full potential too. This can also be a risk factor for muscle cramps.
Calf Strain
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