Calf Muscle Tears and Strains
Date issued: December 2022
Review date: December 2024
Ref: A-538/NB/ED/Calf Muscle Tears and Strains
PDF: Calf Muscle Tears and Strains final December 2022.pdf [pdf] 146KB
What is a calf tear / strain?
A calf strain is a tear in the muscle(s) at the back of your lower leg. The calf has two main muscles: the gastrocnemius, the large muscle closest to the surface, and the soleus, which sits deeper behind the gastrocnemius. Both of these muscles join onto your Achilles tendon.
When you strain your calf muscle you may feel a sudden tearing or stabbing pain. With minor strains you may be able to carry on with your activity, but you may feel tightening and stiffening in your calf muscles. If the strain is severe, the pain may be so bad that you can’t stand on your leg. You may get swelling and bruising in your calf and this may spread to your ankle.
What is the treatment?
Elevation and pain relief are essential, especially within the first 24 hrs. This will help to speed up the healing process.
Gentle pulling up of the toes and ankle and then pointing them whilst sitting or lying will help to slowly restore movement and allow you to increase walking. This is a gradual process and may take more than a week in some circumstances. You can increase the stretch by pulling your foot up with a towel or belt and holding for 30 seconds – then repeating. Wearing a pair of shoes with a slightly raised heel may help you to walk a little easier to begin with.
It is also recommended to use PRICE advice for the first 2 weeks.
PRICE stands for the following:
- Protect your injury from further harm.
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Rest the injured area immediately and then gradually re-introduce pain-free movement so you don't lose too much muscle strength.
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Ice packs or a bag of frozen peas wrapped in a towel can be applied to the injured area to reduce swelling and bruising. Don’t apply ice directly to your skin.
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Compressing the injured area if swollen can help with pain relief. Using a football sock or hiking sock is adequate.
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Elevate the limb above the level of your heart to control swelling. Keep the area supported and try to keep it elevated as much as possible until the swelling goes down.
HARM
For the first 72 hours after an injury there are certain things that you shouldn't do. You can remember these using HARM.
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Heat. Don't use heat packs, hot water bottles or heat rubs on the affected area, as well as saunas or hot baths. Heat encourages blood to flow to the area, the opposite effect of using ice and may potentially make your injury worse.
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Alcohol. Don't drink alcohol because it can increase bleeding and swelling in the area, slowing down healing.
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Running. Any form of strenuous exercise may cause more damage.
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Massage. This can increase bleeding and swelling.
Further treatment
A nasty tear to the muscle can take up to 3 months to fully recover in some cases. You may have been referred to physiotherapy for treatment, but this is not always required and you should follow the advice above for the first few days.
When you can manage, the following diagram shows a stretch you can start to do when standing with your feet flat in an upright position is achievable. It is advisable to repeat this stretch 10 times holding for up to 30 seconds. This can be repeated 2-3 times through the day.
Please be aware it is very important that you see your doctor immediately if, after following advice in this leaflet, your symptoms do not improve and you notice that the calf becomes increasingly tender, red and hot to touch.
DVT (Deep Vein Thrombosis) is a rare complication following any injury which may limit your mobility as it heals.
Symptoms to be aware of and to report include:
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throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
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swelling in 1 leg (rarely both legs)
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warm skin around the painful area
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red or darkened skin around the painful area
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swollen veins that are hard or sore when you touch them
Call 999 or attend the Emergency Department if you develop chest pain or breathlessness whilst having symptoms of a DVT.
Self-Referral to Physiotherapy
You have the option of a delayed referral to physiotherapy should your injury not settle with the advice given during your time in ED. If you feel you require physiotherapy then please use the link below to self-refer. This is also available via your General Practitioner.
