Calf strains are very common – in fact one of the more common injuries we see at Central City Physiotherapy.
Usually for us they occur in people engaging in sport who have suffered a muscle strain or tear, they are particularly common in sports that include running, jumping hopping and landing activities. There are lots of other sources of calf pain however,
- Achilles tendon ruptures
- Achilles Tendonitis / Tendinitis
- Calf muscle tears
- muscle pain
- Strains or tears
- Overuse
- Pinched nerves, sciatica
- Sever’s disease
- Shin splints
- Stress fractures
Calf muscle strain or tear
When this happens you may get sudden pain the back of the calf or have the sensation of being hit by a tennis ball or hear a “pop”. The pain will continue and you’ll experience swelling or bruising – this may track down the leg (due to gravity) and result in a swollen ankle or bruising in the foot.
You’ll have difficulty standing on your tippy toes and walking may be difficult.
Like a lot of injuries, the tear may be minor or severe. – Your physiotherapist will tell you how to treat and care for the strain. – Whether it’s minor or severe you will have to do all the right things for optimum recovery:
1) RICE
REST – protect the area by resting – if it’s sore to walk or hop, a return to sport is out of the question. You may even require crutches or some simple inserts into your shoes to help you (ask us about Tulis Heel cups)
ICE – To reduce pain and swelling. Apply for 15min every 2-4 hours initially and when the injury area feels warm or hot.
COMPRESSION – a compression tube bandage to support the area and help resolution of the swelling (we can provide these).
ELEVATION keep your foot above your hip (with the leg fully supported) to enable gravity to help drain away the swelling.
2) EXERCISE
Restore range of motion. Initially gentle range of motion exercises will prevent a bad scar – scar formation takes at least 6 weeks and you will need to perform some exercise to ensure an optimally remoulded scar. It’s important that your scar has full motion and length to prevent further tears or other problems. Your physiotherapist should massage the area to help prevent cross-adhesions. (i.e. a scar that can’t move and isn’t flexible to stretch – this will lead to re-injury).
Improve muscle strength. This will occur gradually – initially your calf needs to be strengthened so that it can support the full weight of your body – so you no longer limp. Other muscles (depending on what your physiotherapist finds in assessment) may also need strengthened.
The calf needs to be strengthened both concentrically and eccentrically;
A concentric muscle contraction takes place when the muscle contracts and shortens like going up on to your toes. An eccentric muscle contraction takes place when the muscles contract to control its lengthening like lowering your heels from standing on tip toes. This type of contraction is more difficult for the muscles and is often the phase during which injury occurs. (This is also why eccentric action of your quads walking downhill makes you sorer than going uphill!)
Eccentric muscle work is vital in your rehabilitation programme both for injury management and prevention of further problems.
3) RETURN TO SPORT
Prior to returning to sport your physiotherapist will assess your ability to function at high speed, under heavy load and with appropriate proprioception and agility. Without addressing these components and sport specific training you risk re-injury.
Your Central City Physiotherapist will guide you back into your sport appropriately, discussing your goals and timelines so that you (and your team / coaches) know what progress to expect.