How physiotherapy identifies and treats calf tears

Running-calf

How physiotherapy identifies and treats calf tears

Calf muscle tears are a common injury that we see at Lane Cove Physio.  Unfortunately we also see a lot of re-torn calf muscles that have recurred as a result of failing to rehabilitate the original calf tear completely and returning to activities too quickly.

Your calf is actually a group of muscles on the back of your legs from just below the knee down to your Achilles tendon at the back of your heel.

Your calf complex is composed of three muscles:

  1. Gastrocnemius – Most Calf strains are found in the medial head of the gastrocnemius because it crosses two joints (the knee and ankle) and has a high density of fast-twitch muscle fibres.[1]

Symptoms of gastrocnemius strain can include:

    • Tenderness to the touch
    • Swelling
  • Localised bruising within hours or days
  • Stretching of the muscle will cause pain
  • Pain on resisted plantarflexion
  1. Soleus – located beneath the gastrocnemius muscle, but unlike the gastrocnemius, the soleus is considered lower risk for injury. A soleus strain will usually cause pain when the calf muscle is activated or when pressure is applied to the Achilles tendon
  2. Plantaris – is located in the posterosuperficial compartment of the calf and acts with gastrocnemius as both a flexor of the knee and a plantarflexor of the ankle.

Understanding the grades of calf tears

Grade 1:

Grade one calf muscle tears are commonly the result of mild overstretching that causes small micro-tears in the calf muscle fibres. Symptoms can be quite painful for the first two to three days at least, but in most cases, your recovery will take approximately one to two weeks if you do all the right things.

Your Lane Cove physio will help you to fast-track your recovery.

Grade 2:

Grade 2 tears mean the partial tearing of your muscle fibres. With proper rehabilitation, grade two calf muscle tears take several weeks until recovery. Without proper rehabilitation, recovery is usually only temporary.

Grade 3:

A grade three calf tear is the most severe calf strain with a complete tearing or rupture of your calf muscle fibres.

In order to determine whether an Achilles tendon rupture has occurred along with a grade 3 calf muscle tear, an ultrasound or MRI is commonly used. Full recovery of a Grade 3 tear can take several months and will require rehab with a sports or musculoskeletal physio.

How do physiotherapists treat Calf Muscle Tears?

Physiotherapy is a very effective treatment for the management of calf tears and at Lane Cove, we have seen and successfully treated many patients over the years with varying degrees of calf injuries.

Your sports physio is best placed to know the evidence supporting the initial management of calf tears and the type of exercise prescription that is relevant to allow functional recovery and the prevention of recurrence.

If your calf muscle tear symptoms don’t improve within a few days, you might have a more serious calf injury that requires some hands-on rehab.

When you first injure your calf, along with most muscles, the steps to follow are:

Rest – Keep your weight off the affected leg. The amount of rest required for healing can be greatly increased without getting the correct rest

Ice – Apply ice to the area for about 15-30 minutes every few hours in the first couple of days after the injury, to reduce inflammation and swelling

Compression – Wrap the lower leg with an elastic bandage to reduce swelling, but not tight enough to cut off circulation

Elevation – Sit or lie down with your foot elevated to a position above the level of your heart to reduce swelling and pain

If you have any questions regarding your calf injury (or any other condition), please contact our Lane Cove physio to discuss and organise an appointment to get your recovery on track.

[1] Bryan Dixon, J. “Gastrocnemius Vs. Soleus Strain: How to Differentiate and Deal With Calf Muscle Injuries.” Current Reviews in Musculoskeletal Medicine, vol. 2, no. 2, 2009, pp. 74-7.