Pulled calf muscle, calf muscle pain, strain or pull is a condition where the gastrocnemius or soleus muscle is overstretched and when these muscles cannot withstand the tension, it results in tearing of the muscle fibers and pain. If the injury is severe, then there may be complete tearing or rupture of the muscle fibres. Pulled or torn calf muscle is one of the common causes[¹] of calf muscle pain. Calf strain or a calf pull is a condition where the patient feels a sudden pain in the calf muscle during activity.
Causes of Pulled Calf Muscle
Increase in speed or a sudden change in direction when running is the common cause of calf strain or pulled calf muscles. The torn calf muscle can spasm and contract forcefully causing the toes to spontaneously point downward. There may be bruises present over the injured area from internal bleeding.
Classification or Grading of Pulled Calf Muscle[²]
- Grade 1 Calf Strain: The muscle gets pulled or stretched resulting in small micro tears of the muscle fibers. It usually takes around two weeks for the patient to completely recover.
- Grade 2 Calf Strain: In this grade, the muscle fibers are torn partially. It usually takes around 5-8 weeks for the patient to completely recover.
- Grade 3 Calf Strain: This is the most severe calf strain where the muscle fibers in the lower leg are completely torn or ruptured. It usually takes around 3-4 months for patient to completely recover. In some cases, surgery may be required.
Treatment for Pulled Calf Muscle[³]
- R.I.C.E. (rest, ice, compression, elevation) should be done.
- The calf should be wrapped to avoid the blood from pooling in the foot, and the foot should be kept elevated for the first 24 hours to decrease swelling.
- Anti-inflammatory medications (naproxen, ibuprofen) help in reducing pain. As the time goes on, the muscle reattaches to the tendon; however, the calf may be shorter than it was pre-injury and is more prone to re-injury.
- Taping is also helpful.
- Patient should enroll in a rehab program comprising of stretching and strengthening exercises to regain mobility, flexibility and range of motion of the leg.
The aim of rehabilitation is returning to normal activities as quickly as possible minus any long-term effects. If the patient returns too soon, then there is a risk of developing a chronic injury. It should be borne in mind that each patient has a different recovery rate and recovers at their own pace. The rehab needs to be tailored according to patient’s needs and progress.
It is advised that the patient seek medical advice before starting any rehabilitation program or exercises.
Range of Motion Stretching Exercises
- These can be started after the acute pain has subsided. Initially, the muscle should be stretched moderately with passive range of motion stretching.
- Slowly pull your foot and toes up and try to keep your legs straight in order to stretch the calf muscle.
- Hold for 10 seconds.
- Repeat 5 to 10 times.
Progressive Calf Stretching Exercises:
- As the leg continues to heal, regular stretching and flexibility exercises can be started to gain range of motion and to prevent further calf injuries.
- Using a foam roller, gentle self-massage can be done. This helps in reducing the formation of scar tissue and helps in improving blood flow to the area.
Progressive Strengthening Exercises:
- You can start this with exercise tubing or a band which is hooked under your toes.
- Push gently downwards using light resistance.
- Keep your foot pointed down against resistance and then slowly return back to the starting position.
- Do at least 10 reps.
- Rest, and then repeat 5 to 10 times.