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Calf Muscle Strain(Pulled Calf Muscle; Gastrocnemius Strain; Gastrocnemius Tear; Gastrocnemius Muscle Injury)
Definition

A calf muscle strain is a partial or complete tear of the small fibers of the muscles. The calf muscles are located in the back of your lower leg.

The Calf Muscles

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Causes

A calf muscle strain can be caused by:

  • Stretching the calf muscles beyond the amount of tension they can withstand
  • Suddenly putting stress on the calf muscles when they are not ready for the stress
  • Using the calf muscles too much on a certain day
  • A direct blow to the calf muscles
Risk Factors

Factors that increase your chance of developing a calf muscle strain:

  • Participation in sports that require bursts of speed. This includes track sports like running, hurdles, or long jump. Other sports include basketball, soccer, football, or rugby.
  • Previous strain or injury to the area.
  • Muscle fatigue.
  • Tight calf muscles.
  • Poor conditioning.
Symptoms

Symptoms may include:

  • Pain and tenderness in the calf
  • Stiffness in the calf muscles
  • Weakness of the calf muscles
  • Pain when pushing off the foot or standing on tiptoe
  • Bruising on the calf
  • Popping sensation as the muscle tears
Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Most calf muscle strains can be diagnosed with a physical exam. Your doctor may want images of the area if severe damage is suspected. Images may be taken with MRI or ultrasound.

Muscle strains are graded according to their severity:

  • Grade 1—Some stretching with micro-tearing of muscle fibers.
  • Grade 2—Partial tearing of muscle fibers.
  • Grade 3—Complete tearing of muscle fibers. This may also be called a rupture or avulsion.
Treatment

Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:

Acute Care
Rest

Your muscle will need time to heal. Avoid activities that place extra stress on these muscles:

  • Do not do activities that cause pain. This includes running, jumping, and weight lifting using the leg muscles.
  • If normal walking hurts, shorten your stride.
  • Do not play sports until your doctor has said it is safe to do so.
Cold

Apply an ice or a cold pack to the area for 15-20 minutes, four times a day, for several days after the injury. Do not apply the ice directly to your skin. Wrap the ice or cold pack in a towel.

Pain Relief Medications

To manage pain, your doctor may recommend:

  • Over-the-counter medication, such as aspirin , ibuprofen , or acetaminophen
  • Topical pain medication—creams or patches that are applied to the skin
  • Prescription pain relievers
Compression

Compression can help prevent more swelling. Your doctor may recommend an elastic compression bandage around your calf. Be careful not to wrap the bandage too tight.

Elevation

Elevation can also help keep swelling down. Keep your leg higher than your heart as much as possible for the first 24 hours or so. A couple of days of elevation might be recommended for severe strains.

Recovery Steps
Heat

Use heat only when you are returning to physical activity. Heat may then be used before stretching or getting ready to play sports to help loosen the muscle.

Stretching

When the acute pain is gone, start gentle stretching as recommended. Stay within pain limits. Hold each stretch for about 10 seconds and repeat six times. Stretch several times a day.

Strengthening

Begin strengthening exercises for your muscles as recommended.

You may be referred to for physical therapy

If you are diagnosed with a calf muscle strain, follow your doctor's instructions .

Prevention

To reduce the chance of calf muscle strain:

  • Keep your calf muscles strong and flexible, so they can absorb the energy of sudden physical stress
  • Learn the proper technique for exercise and sporting activities to decrease stress on all your muscles

RESOURCES:

American Academy of Family Physicians Family Doctor
http://www.aafp.org

American Council on Exercise
http://www.acefitness.org

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca

Healthy U
http://www.healthyalberta.com

References:

Armfield DR. Sports-related muscle injury in the lower extremity. Clin Sports Med . 2006;25(4):803-42.

Calf strain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated November 3, 2012. Accessed April 26, 2013

Campbell JT. Posterior calf injury. Foot Ankle Clin . 2009 Dec;14(4):761-771.

Douis H, Gillett M, et al. Imaging in the diagnosis, prognostication, and management of lower limb muscle injury. Semin Musculoskelet Radiol . 2011 Feb;15(1):27-41.

Johns Hopkins sports medicine patient guide to muscle strain. John Hopkins Medicine website. Available at: http://www.hopkinsortho.org/muscle_strain.html. Accessed April 26, 2013.

Sprains, strains, and tears. American College of Sports Medicine website. Available at: http://www.acsm.org/docs/brochures/sprains-strains-and-tears.pdf. Accessed April 26, 2013.

1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev . 2010;(6):CD007402.



Last reviewed February 2014 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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