Calf strain or calf pull refers to over-stretching of the calf muscle leading to tearing of the muscle fibers. The calf muscle is made up of two separate muscles; namely the gastrocnemius, which is the outer larger muscle and which has a prominent bulge. It is responsible for bending the knee and the ankle joint. The other is the soleus, which lies deeper to the gastrocnemius muscle and is involved in movement at the ankle joint alone.
Half-way down the calf, both these muscles join to form the Achilles tendon, the strongest tendon in the body. As these muscles contract, the tendon pulls the heel off the ground during the push-off phase of the gait cycle.
Calf muscle strain is common in sportspersons, especially between 30 to 50 years of age. The muscle most commonly affected is the medial section of the gastrocnemius muscle. There may be partial or complete tearing of the muscle. Depending on the severity, the strain is classified by three different grades:
- First-degree strain: minimal damage, only a few muscle fibers are torn, heals within about two weeks.
- Second-degree strain: Extensive numbers of fibers (up to 90%) are torn, healing requires one or two months.
- Third-degree strain: the muscle is torn completely, this mainly occurs at the junction of the calf muscle and the Achilles tendon or in the tendon itself. It requires three months or longer to heal. Fortunately, this is a rare injury.
A sudden acceleration or an acute change in direction while running may lead to over-the-limit stretching and tearing of the calf muscle. Tight calf muscles are more prone to injury.
Pain and disability vary according to the extent of injury:
- In grade one, there is only mild discomfort and limited or no disability.
- Grade two is marked with sudden sharp pain at the back of the leg that is worsened by activating the muscle. The area is tender to the touch. Later on a bruise may appear as a result of internal bleeding from ruptured small blood vessels in the muscles.
- Grade three strains leave one unable to walk and are characterized by severe pain and muscle spasm. There is significant swelling and bruising.
RICE regime (Rest, Ice application, Compression, Elevation) works well, especially in the initial phase. It helps to decrease bleeding and swelling and aids in rapid recovery. However, it should be kept in mind that excessively prolonged rest may delay healing. Avoid any painful activities.
Use of anti-inflammatory pain killers also help to reduce swelling and pain. Once the acute pain is over, it is better to start with light stretching exercises, but the movement should not be painful. Ultrasound therapy and massaging the calf muscles improves blood circulation and speeds up recovery. Use of a heel lift helps to reduce stress on the calf muscle. Surgery may be required for a third-degree strain.
Muscle strengthening exercises and a proper warm-up every time you begin activity is essential to avoid muscle injuries. Always consult a physician if an injury is suspected.