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Calf Pain from a Pulled or Torn Calf Muscle
The most common cause of calf pain in athletes is a pulled calf muscle

By Elizabeth Quinn, About.com

Updated: September 24, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Pain that occurs in the calf muscle on the lower part of the leg often is the result of a pulled or torn calf muscle. This is called a calf strain or a calf pull. It occurs when part of the muscle of the lower leg (gastrocnemius or soleus) is torn away from the Achilles tendon.

A calf strain is similar to an Achilles tendon tear or rupture, but occurs higher up in the back of the leg. A sign of a calf strain is similar to that of an Achilles tendon rupture - you may think you've just been hit in the leg and hear a "pop." There is sudden pain at the back of the leg, pain, swelling or bruising in the calf muscle, and you have difficulty standing on the toes.

This injury happens during acceleration or changes in direction. The torn calf muscle may spasm, and contract forcefully. The toes will point down. Bruises show up in the foot and ankle due to pooling of blood from internal bleeding.

Calf strains may be minor or very severe and physician grade the injury according:

  • Grade 1 Calf Strain : The muscle is stretched causing some small micro tears in the muscle fibers. Full recovery takes approximately two weeks.
  • Grade 2 Calf Strain : There is partial tearing of muscle fibers. Full recovery takes approximately 5-8 weeks.
  • Grade 3 Calf Strain : This is the most severe calf strain with a complete tearing or rupture of muscle fibers in the lower leg. Full recovery can take 3-4 months and, in some instances, surgery may be needed.

Treating Calf Strains and Pulls

The first treatment is R.I.C.E. (rest, ice, compression, elevation). Wrap the calf to keep the blood from pooling in the foot, and keep it elevated for the first 24 hours to reduce swelling . Anti-inflammatory medication may help reduce pain. Eventually, the muscle reattaches to the tendon; however, and the calf is often shorter than before the injury and prone to repeat injury.

A visit to a physician and or a physical therapist is recommended to ensure in fast rehab.

Typical rehab for a calf strain depends upon the severity of the injury, and includes the following.

  1. Rest the Muscle. Avoid activities that cause pain. Avoid impact activity or excessive stretching (no running, jumping, or weightlifting). Do not return to your sport until you are pain-free.
  2. Range of Motion Stretching Exercises. When acute pain is gone, begin stretching the muscle moderately with passive range of motion stretching. Gently pull your foot and toes up with legs straight if possible to stretch the calf muscle. Hold for 10 seconds and repeat 5 to 10 times.
  3. Progressive Calf Stretching Exercises. As you heal, you can begin using a regular stretching and flexibility program to gain range of motion and prevent future calf injury. Follow the advice of your therapist when beginning these exercises.
  4. Progressive Strengthening Exercises. Start with exercise tubing or a band and hook it under your toes and press down gently using light resistance. Point your foot down against resistance and then slowly return to the start position. Do 10 reps, rest and repeat 5 to 10 times.

The goal of rehab is to return to normal activity as quickly as possible without any long-term effects. If you return too soon, you risk developing a chronic injury. Keep in mind that everyone recovers at a different rate, and your rehab needs to be tailored to your needs and your progress not the calendar.

You can when you meet the following conditions:

  • You have your physician’s “okay.”
  • You are pain-free.
  • You have no swelling.
  • You have full range of motion (compared to the uninjured side).
  • You have full or close to full (90 percent) strength (again, compare with the uninjured side)
  • You can jog straight ahead without pain or limping.
  • You can sprint straight ahead without pain or limping.
  • You can jump on both legs without pain and you can jump on the injured leg without pain.

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