Calf Muscle Injuries

A muscle injury in the calf can be minor or serious.

Types of Calf Muscle Injuries

The calf of the lower leg is made up of soleus, plantaris, and gastrocnemius muscles. These calf muscles, at the back of the leg, are responsible for pulling the heel bone up when pushing off during running and walking. Often, a calf muscle injury is called a “pulled calf”. If the calf muscle experiences a stretch that is forcible, and it is stretched too far, the muscle tissue can tear. A torn calf muscle is also known as a calf strain. The strain is rated by degrees. First degree strain damages only a few of the muscle fibers, second degree damages a much larger number of fibers, and third degree is actually a muscle rupture. Although a grade one strain may not show signs at first, the grade two strain will be sore to the touch, not just when stretching or contracting. The serious grade three strain has “an immediate burning or stabbing pain”, and there might be “a large lump of muscle tissue above a depression”. Grades two and three strains will also bruise due to tissues bleeding.¹ Patients with muscle strains experience pain at rest and when using the muscles. There will be a weakness in the tendons or muscles with a strain, unlike with a sprain where the ligaments and joints are involved. Some strains may lead to an inability to use the muscle. Medical care might become necessary if there is no relief within 24 hours of the injury. An emergency room visit is warranted if the patient has “a popping sound with the injury”, is unable to walk, has a fever, open cuts, or significant swelling and pain.²

Treatments

Resting calf injuries is crucial, even for competitive athletes. Grade one strains should have a rest for 3 weeks, grade two for about 6 weeks, and grade three ruptures can require surgery and a 3 month rehabilitation period. It is important to follow RICE (rest, ice, compression, elevation) after the injury so that the strain doesn’t get progressively worse. A topical anti-inflammatory gel may be prescribed, and anti-inflammatory medicines could be recommended. After the resting period, rehabilitation exercises and stretches are necessary. It is important to follow the appropriate stretches and exercises so that scar tissue is aligned “along the normal lines of stress”. Prevention is also important. Warming up for 20 minutes before exercise, as well stretching and cooling down are keys to avoiding injuries. Some patients and athletes may wish to wear shock absorbing insoles in their shoes.³ Special athletic tape can also benefit some athletes. Another helpful tool is a foam roller, which can assist patients in self-massage. Exercise tubing and bands are also useful for performing rehabilitation and strengthening activities, such as calf raises, stretching, and range-of-motion exercises. After the injury is resolved, athletes and patients may wish to strengthen the Achilles tendon with special exercises.⁴ Patients need to be in proper alignment and use appropriate techniques when performing athletic activities. Chiropractors can work with patients on biomechanical faults. They may work with acupuncturists and sports massage therapists as well.⁵ Chiropractic care may include athletic taping (e.g., Kinesio Tape, RockTape), as well as treatments such as the Graston Technique and Active Release Technique. Chiropractors can recommend stretches and exercises for rehabilitation.⁶ Ultrasound treatments could also be beneficial.⁷