Calf Muscle Injury
What is it?
A strain at the calf complex is one of the most common sites of injury for the sporting population. The calf muscle complex is mainly composed of lateral and medial gastrocnemius heads and the soleus.
The two gastrocnemius heads cross over both the knee joint and insert onto the medial and lateral femoral condyle, and then attach to the calcaneus via the achilles tendon. The gastrocnemius primarily performs plantarflexion at the ankle joint (the movement of pointing your toes to the ground) and flexion at the knee joint (bringing heel to your glutes). The soleus sits slightly deeper than the gastrocnemius and also acts as a strong plantar flexor, making this muscle very important to the forward propulsion in running.
A muscular strain occurs when the forces placed through the muscle exceed the tissue capacity – resulting in muscle fibres being damaged and torn. Generally, the greater the number of fibres torn, the worse the calf strain and the longer the recovery.
Some calf muscle injuries may involve damage to the tendon. Calf muscle injuries with intramuscular tendon involvement generally require a longer time to heal and slower return to play timeframes. Hence, a detailed and thorough physiotherapy assessment following a calf injury is essential to determining the severity of a muscle tear.
Grading of a calf muscle injury:
- Grade 1: low grade injury, minimal muscle tear.
- Grade 2: moderate grade injury, partial muscle tear.
- Grade 3: severe injury, complete muscle tear.
Symptoms commonly associated with calf muscle injuries
SYMPTOMS MAY INCLUDE:
- A sudden onset of sharp pain
- Pain in the lower leg or behind the knee.
- Tenderness in the lower leg
- Bruising
- Swelling
- Weakness when pointing toes
Contributing Factors associated with calf muscle injuries
NON-MODIFIABLE:
- Age
- History of calf injury injury
- Type of sporting activity
- History of hamstring muscle injury
MODIFIABLE:
- Strength imbalances
- Muscular fatigue
- Core strength and stability
- Type of sporting activity
Considerations in the management of calf muscle injuries
SHORT TERM
DIAGNOSIS AND EDUCATION
At the Injury Clinic, your physiotherapist will look to assess and appropriately diagnose what structure or structures of the calf complex are injured.
Your physiotherapist will provide education to the reasons why an injury may have occurred, and work collaboratively to provide a specific and targeted rehabilitation plan.
NON-STEROIDAL ANTI-INFLAMMATORIES
It is also necessary to consider principles of PEACE & LOVE. Generally, it is recommended the consumption of anti-inflammatory medication should be avoided within the first 48-72 hours following an acute muscle injury.
However, following the 48-72hr timeframe post injury, anti-inflammatories can aid recovery and settle the inflammatory process – which may improve symptoms. Always consult your GP or pharmacist before taking any medication.
SOFT TISSUE TECHNIQUES/DRY NEEDLING
These modalities can assist with soreness and discomfort in surrounding tissues and muscles that cross
Such techniques look to relieve tightness of not only the calf, but also certain muscles that may be utilised as an adaptive strategy and causing exacerbation of symptoms.
For more information regarding acute management of an injury, click here
LONG TERM
Following a calf injury, consistent physiotherapy and strengthening and conditioning is encouraged. By completing specific and tailored exercises over a prolonged period of time, the risk of recurrence is significantly minimised.
RESISTANCE TRAINING
A specific and tailored strengthening and conditioning program should be conducted to improve long term function of the calf muscles.
Resistance training should include a variety of exercise types, including considerations of plyometric exercises, and eccentric/concentric movements.
MOBILITY EXERCISES
It is important to consider mobility exercises for long term management of the calf muscle to maintain optimal hip and knee joint mechanics.
ONGOING TRAINING LOAD MANAGEMENT
Training volume should be monitored and tailored for individuals to mitigate risk of re-injury or ongoing symptom exacerbation due to overload.
SUMMARY
Injury to the calf muscle is a very common sporting related injury. Physiotherapy and strengthening and conditioning is essential to the effective management of this injury.
A detailed and thorough physiotherapy assessment will look to determine the severity of a muscle injury.
Like any muscular strain, a tailored exercise program would look to prevent likelihood of further calf strains by building strength, range of motion, coordination and control.
If you have any questions or concerns, please do not hesitate to contact us on (03) 5229 3911, email us at info@theinjuryclinic.com.au or book an appointment to see one of our Physiotherapists in Geelong.
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