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Calf Strain Physiotherapy

Calf strains are a commonly-occurring problem for

  • runners
  • soccer players
  • basketball players
  • gymnasts
  • dancers
  • even normal working-people

So generally, a calf strain (also known as "pulled calf muscle") is an injury to the muscles in the calf area (located at the back of the lower leg below the knee).

Our calf muscle comprises of up to 9 separate muscles, any of which can be injured individually or together. Calf strains can and usually happen during hi-speed motions like

  • running
  • jumping
  • any type of forceful or uncoordinated movement

Although global statistics are sparse, one 8-year study of professional soccer players shows that soccer players experience 13% calf-strain injury rate. Advancing age can increase the vulnerability of the calf to injury and strain even with less forceful movements.

What our senior physiotherapists do to treat individuals with calf strains is by

  • reducing pain
  • restoring calf muscle strength
  • restoring calf muscle and joint flexibility
  • increase recovery speed

first of all, What is a Calf Strain?

The “calf muscle” consists of 9 different muscles.

The gastrocnemius, soleus, and plantaris muscles attach onto the heel bone, and work together to produce the downward motion of the foot.

The other 6 muscles cause knee, toe, and foot movements in different directions; these muscles are the

  • popliteus
  • flexor digitorum longus
  • flexor hallucis longus
  • tibialis posterior,
  • fibularis (or peroneal) longus
  • fibularis (or peroneal) brevis

They extend from the lower leg bones around the sides of the ankle and attach to various parts of the foot and toes. Injuries to these 6 muscles are sometimes wrongly attributed to the first 3 muscles mentioned here, as calf pain may be experienced generally in the calf muscle.

Most of the time, a calf muscle strain is caused by overstretching or tearing any of the 9 muscles of the calf. Unfortunately, calf muscle strains can occur suddenly or slowly over time, and activities, such as walking, climbing stairs, or running can be painful, difficult, or impossible.

A muscle strain is graded according to the amount of muscle damage that has occurr

  • Grade 1. A mild or partial stretch or tearing of a few muscle fibers. The muscle is tender and painful, but maintains its normal strength. Use of the leg is not impaired (normal), and walking is normal.

  • Grade 2. A moderate stretch or tearing of a greater percentage of the muscle fibers. A snapping or pulling sensation may occur at the time of the injury and after the injury. There is more tenderness and pain, noticeable loss of strength, and sometimes bruising.

    Use of the leg is visibly impaired, and limping when walking is common.

  • Grade 3. A severe tear of the muscle fibers, sometimes a complete muscle tear. A “popping” sound may be heard or felt when the injury occurs. Bruising is apparent, and sometimes a “dent” in the muscle where it is torn is visible beneath the skin.

    Use of the leg is extremely difficult, and putting weight on the leg is very painful.

When our calf muscles are strained or torn, what happens is that the calf muscle fibers and other cells are disrupted and bleeding occurs, which causes bruising. Within a few hours of the injury, swelling can occur, causing the injured area to expand and feel tight and stiff.

After a severe calf strain, bruising may also be seen around the ankle or foot, as gravity pulls the escaped blood toward the lower part of the leg.

How Does a calf strain Feel like?

If you have/had strained your calf muscles, you may feel:

  • Sharp pain or weakness in the back of the lower leg. The pain can quickly resolve, or can persist.
  • A throbbing pain at rest with sharp stabs of pain occurring when you try to stand or walk.
  • A feeling of tightness or weakness in the calf area.
  • Calf muscle spasms (a gripping or severe tightening feeling in the calf muscle).
  • Sharp pain in the back of the lower leg, when trying to stretch or move the ankle or knee.
  • A “pop” or hear a “pop” sound at the time of injury (with a Grade 3 calf strain).

Signs and Symptoms of a calf strain

With a calf strain, you may experience:

  • A snap or pull felt or heard at the time of injury (with a Grade 1 and 2 calf strain). A "pop" may be felt or heard at the time of injury of a Grade 3 calf strain
  • Pain and weakness in the calf area
  • Swelling in the area
  • Tightness in the area
  • Bruising
  • Weakness in the calf when trying to walk, climb stairs, or stand
  • Limping when walking
  • Difficulty performing daily activities that require standing and walking
  • An inability to run or jump on the affected leg

How Is a calf strain Diagnosed?

If you see our senior physiotherapist first, they will start by conducting a thorough evaluation that includes taking your health history. YThey will ask you:

  • What were you doing when you first felt pain?
  • Where did you feel the pain?
  • Did you hear or feel a "pop" when it occurred?
  • Did you receive a direct hit to your calf area?
  • Did you see severe swelling in the first 2 to 3 hours following the injury? 
  • Do you feel pain when moving your ankle or knee, standing, or walking?

They will also perform special tests to help determine whether you have a calf strain, such as:

  • Watch how you walk, and see if you can bear weight on the injured leg.
  • Test the different calf muscles for weakness.
  • Look for swelling or bruising.
  • Gently feel parts of the muscle to determine the specific location of the injury (palpation).

They may use additional tests to assess possible damage to specific muscles of the lower leg.

In certain cases, they may collaborate with our medical network of doctors who may order further tests, such as

  • x-ray
  • magnetic resonance imaging (MRI)

to confirm the diagnosis and to rule out other potential damage. These tests, however, are not commonly required for a calf strain.

How Can our senior PhysioTherapist Help you?

Our senior physiotherapists will design a specific treatment program to speed your recovery, including exercises and treatments that you can do at home to help you return to your normal lifestyle and activities.

The First 24 to 48 Hours

Our senior physiotherapists may advise you to:

  • Rest the area by avoiding walking or any activity that causes pain (RICER approach to fresh/new injuries). Crutches or a brace may be recommended to reduce further strain on the muscles when walking
  • Cold therapy to the painful calf area for 15 to 20 minutes every 2 hours
  • Compress the area with an elastic bandage wrap
  • Insert heel lift pads into both of your shoes
  • Consult with another health care provider for further services, such as medication or diagnostic tests

Treatment Plan

Our senior physiotherapists will provide calf strain physiotherapy treatments with the goals of:

Reduce Pain. We can use different types of treatments and technologies to control and reduce your pain, including

  • cold therapy to bring down swelling and pain
  • heat therapy to improve circulation, healing and improve stiffness
  • ultrasound therapy to accelerate soft tissue healing
  • taping to provide external mechanical support
  • exercises to help improve muscle strength and healing
  • heel lifts
  • manual therapy (hands-on therapy), such as massage

Improve Motion. We will choose specific activities and treatments to help restore normal movement in the knee and ankle. These might begin with "passive" motions that the physical therapist performs for you to gently move your knee and ankle, and progress to active exercises and stretches that you perform yourself to increase muscle flexibility.

Improve Strength. Certain exercises will benefit healing at each stage of recovery; we will choose the appropriate exercises, and teach you how to safely and steadily restore your strength and agility.

These may include using

  • cuff weights
  • stretch bands
  • weight-lifting equipment
  • cardio exercise equipment, such as treadmills or stationary bicycles

Speed Recovery Time. We are trained and experienced in choosing the right treatments and exercises to help you safely heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

Return to Activities. We will collaborate with you to decide on your recovery goals, including your return to work or sport, and will design your treatment program to help you reach those goals in the safest, fastest, and most effective way possible. We will apply hands-on therapy, such as massage, and teach you exercises, work retraining activities, and sport-specific techniques and drills to help you achieve your goals.

If Surgery Is Necessary

Surgery is rarely necessary in the case of calf strain, but if a calf muscle fully tears and requires surgical repair, our senior physiotherapist will help you

  • minimize pain
  • restore motion
  • restore strength
  • return to normal activities

in the safest and speediest manner possible after surgery. Read more in post-surgery physiotherapy.

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Phoenix Rehab Physio Services

Phoenix Rehab Group works with specialist physiotherapists and rehab therapists who are highly trained, qualified, experienced and passionate to provide high level of expert care to our patients.


Patients who sustained injuries to their elbows, forearms, hands, wrists (sprains and fractures) and fingers, usually will benefit / require Hand Therapy to

  1. manage and decrease hand pains
  2. improve range of motion, strength and dexterity
  3. increase the function of their hand following injuries or post-operations

Commonly treated hand pain injuries includes


Clinical Pilates is a form of physical exercise that focuses on posture, core stability, balance, control, strength, flexibility and breathing.

It is a system of safe and effective exercises, which meet specific individual needs, to treat a wide range of injuries and conditions.

You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.


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  • Herbal TCM Medicine & Supplementation


Sports and deep tissue release massage helps to increase nutrient-rich blood flow to tired, tight and tense muscles to accelerate recovery and  shorten downtime / recovery period required.

It also prevents muscles from scar tissue micro-tears (and potential ruptures), and increases muscle performance. Having regular deep tissue and sports massage will keep your muscles healthy and fit with body/movement-confidence.

Read the benefits of regular deep tissue release therapy here.


All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).

See our entire team here with introductions and their specializations.

At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.

Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.

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