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Calf Strain Physiotherapy
Calf strains are a commonly-occurring problem for
- soccer players
- 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
- 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
first of all, What is a Calf Strain?
The “calf muscle” consists of 9 different muscles.
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
- flexor digitorum longus
- flexor hallucis
- tibialis posterior,
- fibularis (or peroneal) longus
- fibularis (or peroneal)
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
Use of the leg is visibly impaired, and limping when walking
- 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
- 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
- magnetic resonance imaging (MRI)
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
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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At the first session, our specialist physiotherapists will carry out a thorough
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